Last Updated: May 9, 2019
The Pennsylvania Supreme Court will hear a case, Maas v. UPMC Presbyterian Shadyside et al, examining the extent to which mental health professionals must warn third parties against who a patient makes threats of serious bodily injury. If the Supreme Court affirms the lower court decisions in this case, this duty to warn would be expanded. Such expansion could compromise the confidentiality needed for effective treatment and potentially threaten the patient-physician relationship.
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. 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. During this time, Andrews remained under the care of UPMC staff.
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. However, Andrews provided no other information to specifically identify his neighbor.
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. Andrews also informed the authorities that he had disclosed his homicidal plans to his health care providers at UPMC.
When is There a Duty to Warn?
Pennsylvania case law, Emerich v. Philadelphia Center for Human Development,Inc., 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. Precedent from courts outside Pennsylvania impose no duty to warn absent specifically known and designated individuals.
Ms. Maas’ estate alleges that UPMC had a duty to warn Ms. Maas of the risk presented by Andrews. UPMC counters that mental health professionals only have a duty to warn identifiable persons, not a vague group of individuals. Andrews lived in a large apartment complex with numerous tenants and never specifically identified which of his neighbors he wished to harm.
Lower Court Rulings and Appeals
After the action 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, Allegheny County 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. Whether UPMC practitioners had breached this duty, 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, are all questions for a jury to answer.
UPMC has appealed the case to the Pa. Supreme Court. The Supreme Court will now decide whether an identifiable or readily identifiable third party, for purposes of a mental health professional’s duty to warn third parties of specific imminent serious bodily injury threats, can consist of a group of unnamed neighbors.
PAMED Joins AMA and PaPS in Amicus Brief
The Pennsylvania Medical Society (PAMED) has joined the American Medical Association (AMA) and the Pennsylvania Psychiatric Society (PaPS) in filing an amicus brief in support of maintaining the integrity of the current rule; which imposes 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 would fundamentally change the legal framework for treating mentally ill patients. Managing a person’s re-entry into society is a delicate and risky process, 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. Read the amicus brief here.
PAMED will continue to monitor the case and update members of all additional developments.
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