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Justices Consider Health Care Providers’ Liability for Denied Care Under the Mental Health Procedures Act – Partner Maureen McBride Quoted

May 15, 2024 at 06:23 PM, the Legal Intelligencer, by Riley Brennan

The Pennsylvania Supreme Court is mulling a decision if health care providers can be held liable under the Mental Health Procedures Act for denying treatment to a man, who later killed his girlfriend, when there was no written application for voluntary inpatient treatment.

The Pennsylvania Supreme Court agreed to hear oral arguments Tuesday in Matos v. Geisinger. The petitioners, Alley Medical Center, David Y. Go, Kyle C. Maza, Geisinger Medical Center, Michael H. Fitzpatrick and Richard T. Davies Jr., challenged the state Superior Court’s decision denying their motion for summary judgment, arguing they were immune from liability under Section 114(a) of the MHPA, 50 P.S. 7114(a).

Westley Wise allegedly fatally stabbed his girlfriend, Jessica Frederick, and attempted to kill himself three days after he submitted himself to Geisinger and Alley for voluntary inpatient treatment, but he was denied services. Stephen Matos, the administrator of Frederick’s estate, filed suit against the two medical centers, alleging they were liable under MHPA for gross negligence or willful misconduct as they denied Wise’s warning that he felt suicidal or homicidal.

The state high court considered whether the lower courts’ decisions were in line with its 2020 ruling in Leight v. University of Pittsburgh Physicians, a decision that addressed the involuntary examination process under the MHPA.

Relying on Leight, Maureen Murphy McBride of Lamb McErlane argued on behalf of Maza, Go and Alley Medical Center, and Charles Eppolito of White and Williams represented Davies, Fitzpatrick and Geisinger Medical Center. The defendants’ counsel contended their clients weren’t liable under MHPA as there was never a written application made to admit Wise for voluntary inpatient treatment.

The justices questioned when liability would attach to the defendants, specifically Geisinger, with Eppolito claiming Wise would have completed the application and then be admitted.

Justice Daniel McCaffery asked about who controlled the application process. This prompted the judges to dissect the fairness of allowing a hospital or medical center to control the allegedly required applications.

Justice Sallie Updyke Mundy opined that allowing the hospitals to essentially serve as gatekeepers to the applications could put the commonwealth at risk, if, for example, a hospital manager instructed employees not to hand out the applications to those in need of mental health treatment.

Mundy inquired if the defendants’ position put the citizens of the commonwealth at risk of having hospitals say, “‘Hey, if anybody comes in here for mental health treatment, don’t give them the form. If they don’t fill out that darn form we’re scot-free no matter what happens.’”

In response, McBride said that hospitals and other medical facilities are in the business of helping people, and the notion that a hospital would turn people away so that they don’t have to provide services would be illogical.

Mundy said she took issue with the defendants’ position based on whether the hospital-controlled form was filled out. If the medical centers didn’t give potential patents a form to fill out, then they never had to be responsible, she said.

Justice P. Kevin Brobson questioned what the point was of having those seeking mental health treatment fill out an application if the medical center has already denied treatment, or if they will be denied treatment minutes after filling out an application.

“How can you fill out a form if the provider has determined that you don’t need treatment?” Bronson asked.

According to McBride, the language of the statute requires the written application, otherwise, there is a statutory gray area.

Michael D. Shaffer of Shaffer & Gaier in Philadelphia represented the estate before the state high court Tuesday, arguing the statute doesn’t require a written application for voluntary inpatient treatment.

Justice Christine Donohue noted that the application, the MHPA’s voluntary treatment forms, the MH 781, wasn’t an application at all. Rather, the form is a consent for treatment, after someone has been accepted for treatment, she explained. She said it was her understanding that the consent to treatment form includes agreements to different types of medication and exam procedures, but it is only given to those who are deemed accepted for treatment.

“To me an application is something that would have to proceed this particular step,” Donohue said, expressing that she believes there needs to be some other sort of application in place. “It also says that the treatment has already been explained to them. The treatment that they will be getting. So to me that means they’ve been accepted for treatment by this point in time. I’m not disagreeing with you, I understand your argument about the parallels and the necessity for definitive points in time, but this 781, to me, is not an application.”

McCaffery questioned when it becomes incumbent upon the hospital to perform an evaluation and present the required application document.

“This is where I’m confused, even under the involuntary 302, if you’re a danger to yourself or to others, there is the classic line that indicates that someone should receive an evaluation,” McCaffrey said. “I’m trying to understand your logic, as that you have an individual who twice went to mental health providers saying, ‘I’m a danger to myself and to others,’ and then a second time comes back and says, ‘I’m a danger to myself and to others,’ as does a third party, his dad. At what point is it incumbent upon the hospital to provide him this form that you say is necessary to do the appropriate evaluation for appropriate treatment?”

McCaffrey also noted that when someone comes in for mental health treatment, asking them to fill out an application imposes a burden on the person suffering. Chief Justice Debra Todd reiterated this concern, saying it seemed unreasonable to have someone at the height of a mental health crisis fill out an application when they are voluntarily seeking treatment.

“My concern goes back to what Justice McCaffrey asked earlier, and it’s almost an impossibility situation, if someone is at the height of a mental health crisis and truly in need of commitment and wants to have voluntary commitment, it just seems so preposterous to me that they would be expected, in connection with that, to fill out an application,” Todd said.

McCaffrey further noted that when dealing with someone in a mental health crisis, or someone who isn’t considered mentally competent, criminal confessions are thrown out due to questions around whether the statement was willful and voluntary, and questioned if it wasn’t the same case here.

Read the article on Law.com.