Pa. Supreme Court Holds That Physicians Cannot Be Held Liable under the Mental Health Procedures Act for Harm Caused by Mentally ill Patient

Last Updated: Dec 23, 2020

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On Dec. 22, 2020, in a 6-1 decision, the Pennsylvania Supreme Court ruled that a lawsuit against the doctors who did not take steps to involuntarily commit a man who killed one person and injured others in a March 2012 shooting at Western Psychiatric Institute and Clinic cannot go forward.

The Supreme Court found that the doctors who were subject to the initial lawsuit could not be found liable under the state’s Mental Health Procedures Act (MHPA) because it applies only to involuntary treatment or voluntary inpatient treatment, and the physicians had not taken the steps necessary under the MHPA to have the patient committed.  In so making this ruling, the Court held that “The requirements under the MHPA are clear in that physicians who never invoke a necessary requirement for involuntary emergency examination are not, for purposes of the MHPA participating in a decision that a person be examined.  Therefore, the lawsuit against the physicians based on the MHPA cannot go forward.

The Pennsylvania Medical Society, in an amicus brief filed with the American Medical Association, the Pennsylvania Psychiatric Society, and the Pennsylvania Coalition for Civil Justice Reform, argued against expansion of the MHPA to apply to practitioner decisions during voluntary outpatient treatment.

A copy of the amicus brief can be accessed here.

The majority opinion can be accessed here.

Read the concurring opinions here and here.

The dissenting opinion can be accessed here.

Background of Case

This case stems from a 2012 shooting incident at the Western Psychiatric Institute and Clinic (WPIC), where John Shick shot seven people—injuring six and killing one—in the lobby of the WPIC mental health treatment facility.

Ms. Kathryn Leight was the facility’s receptionist and was one of the injured. Ms. Leight and her husband sued Shick’s estate and his mother (Susan Shick), as well as the University of Pittsburgh Physicians (UPP), UPMC, and the University of Pittsburgh (Pitt).

Shick had a history of mental health issues. While in New York, between 2005 and 2008, and while in Oregon, between 2009 and 2011, Shick was involuntarily committed and received involuntary mental health treatment several times. Upon moving to Pennsylvania in 2011, Shick established a patient-physician relationship with UPP. Shick was seen by several UPP physicians and specialists for various complaints about non-existent diseases and ailments. A few of the physicians diagnosed these complaints as psychosomatic, due to Shick’s mental illness.

Shick was later referred to and underwent a psychiatric treatment evaluation. As a result of this evaluation, Shick was diagnosed as being schizophrenic and noncompliant with his medications. The physician who conducted Shick’s evaluation gave Shick’s mother the number for the WPIC clinic and Resolve—a WPIC program that takes and responds to calls about involuntary civil commitments and sends mobile teams to evaluate and support individuals requiring the same.

During the course of his interactions with UPP, practitioner opinions varied regarding whether Shick was a candidate for involuntary commitment. However, his primary care physician contacted Resolve after an incident where Shick brandished a baseball bat in a threatening manner at a UPMC clinic and was subsequently removed from the premises by security. A dispatch team from Resolve was sent to pick Shick up for an evaluation and possible commitment; however, once they reached him, Shick refused the evaluation.

Afterwards, three separate inquiries were made by UPP physicians and staff with regards to initiating the paperwork for the involuntary commitment process. However, no one followed through with filing any paperwork or otherwise starting the process.

On March 8, 2012, Shick entered the unguarded WPIC lobby with firearms and ammunition that he had purchased the previous year in New Mexico. Shick shot and killed one person and injured several others, including Ms. Leight. Shick was then shot and killed by responding police.

Lower Court Rulings and Appeals

In June 2012, the Leights initiated the instant lawsuit. Amongst other claims, the Leights argued that, pursuant to MHPA standards, UPP and UPMC were grossly negligent in their failure to complete the involuntary commitment process of Shick despite recognizing that Shick was severely mentally ill, a clear and present danger to others, and in need of emergency involuntary examination. Because of this alleged negligence, the Leights asserted that UPP and UPMC were liable for the harm committed by Shick.

After the Allegheny County Court of Common Pleas Civil Division dismissed the MHPA claims from the suit, the plaintiffs appealed to the Pennsylvania Superior Court where a three-judge panel affirmed the trial court dismissal.

Reasoning that the MHPA does not apply to voluntary outpatient treatment, the Superior Court held that voluntary outpatient treatment decisions made established no duty on UPP and Pitt to protect Ms. Leight or others from Shick.

To reach this decision, the Superior Court opined, that because UPP physicians only saw Shick on a voluntary outpatient basis and never started the process for an emergency examination, it could not conclude that the mere thought or consideration of initiating an involuntary examination during voluntary outpatient treatment falls within the explicit scope of the MHPA.

PAMED's Legal Resource Center 

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