Last Updated: Jul 23, 2020
With a 3-2 decision in the case of Maas v. UPMC Presbyterian Shadyside et al., the Pa. Supreme Court has ruled on the extent to which mental health professionals must warn third parties against whom a patient makes threats of serious bodily injury.
Pennsylvania case law imposes a duty on mental health professionals to warn of a danger posed by a patient when the patient makes imminent threats of serious bodily injury against a specifically or readily identifiable third party. For purposes of providing a duty to warn, the Pa. Supreme Court’s decision in Maas v. UPMC holds that neighbors of a patient are such identifiable third parties when a patient makes threats to kill his neighbor but never specifically identifies which of his neighbors.
Background of Case
The estate of Lisa Maas filed a wrongful death lawsuit against UPMC after Ms. Maas was attacked and killed by Terrance Andrews in 2008. Ms. Maas’ estate alleged that UPMC had a duty to warn Ms. Maas of the risk presented by Andrews. UPMC countered that mental health professionals only have a duty to warn identifiable persons, not a vague group of individuals.
Mr. Andrews was a psychiatric patient at UPMC with a history of mental illness as well as suicidal and homicidal ideation. A few months prior to Ms. Maas’ death, Andrews moved from an assisted living facility to independent living in a private apartment building. Ms. Maas lived on the same floor as Andrews in this apartment building.
In the weeks leading up to the killing, Andrews voiced homicidal desires to UPMC personnel on several occasions and explicitly said he wanted to kill his neighbor. Andrews did not specifically name his neighbor and UPMC took no measures to warn any residents of Andrews’ apartment building of these threats.
One evening, Andrews fatally stabbed Ms. Maas upon her return home. Andrews then waited for law enforcement to arrive at the scene and immediately admitted to killing Ms. Maas. A jury subsequently convicted Andrews of murder and the trial court sentenced him to life imprisonment.
Lower Court Rulings and Appeals
After the lawsuit was filed in the Allegheny County Court of Common Pleas, UPMC moved for summary judgment, alleging that mental health professionals only owe a duty to warn specifically or readily identified persons and not a nebulous group of individuals. However, the trial court denied UPMC’s motion and concluded that UPMC had a duty to warn based on the facts presented.
UPMC then appealed to the Superior Court of Pennsylvania. The Superior Court affirmed the trial court’s decision that the plaintiff had demonstrated that a duty to warn existed and the case should proceed to a jury trial. A panel of the Superior Court concluded that the tenants of Andrews’ apartment building who lived on the same floor were an identifiable group of third parties. Whether UPMC practitioners had breached their duty to warn, whether their conduct fell below the standard of care, and if so, whether it was a cause in fact of Ms. Maas’ death, the Superior Court concluded, were all questions for a jury to answer. UPMC subsequently appealed the case to the Pa. Supreme Court.
Supreme Court Decision
The Pa. Supreme Court affirmed the order of the Superior Court and concluded that the trial court did not error in denying the defendants’ motion for summary judgment. The lawsuit will now proceed to a jury.
Justice Dougherty authored the majority opinion, with which Justices Todd and Mundy joined. Justice Baer filed a dissenting opinion in which Chief Justice Saylor joined. Justices Donohue and Wecht did not participate in the consideration or decision of this case.
The majority opinion can be accessed here.
The dissenting opinion can be accessed here.
Pennsylvania case law, Emerich v. Philadelphia Center for Human Development, Inc., imposes a duty to warn “readily identifiable” victims. Reviewing the factual record of the case, the Supreme Court concluded that the given circumstances support a finding that Ms. Maas, who was a neighbor on the same apartment floor as Andrews, was just such a “readily identifiable” victim.
In the dissenting opinion, the dissent opined that a threat against a “neighbor,” at least in the context of an urban environment, does not delineate a readily identifiable third party to whom a mental health professional owes a duty to warn. The dissent also recognized the significant public interest in supporting the effective treatment of the mentally ill and protecting the rights of patients to privacy in their confidential communications with their mental health care providers.
The Pennsylvania Medical Society (PAMED) joined the American Medical Association (AMA) and the Pennsylvania Psychiatric Society (PaPS) in filing an amicus brief in support of imposing a duty to warn a third party only when the threat is immediate, known and potentially lethal, and the target has been identified or is readily identifiable.
PAMED, AMA, and PaPS believe allowing liability in this case will fundamentally change the legal framework for treating mentally ill patients. Managing a person’s re-entry into society is a delicate and risky process, and mental health professionals should not impede that process by broadcasting a patient’s condition to his or her community or issuing medically improper restrictions to protect themselves from liability.