Last Updated: Feb 25, 2020
With its recent unanimous decision in the case of Dean v. Bowling Green-Brandywine, the Pennsylvania Supreme Court has denied the application of the Mental Health Procedures Act’s (MHPA) limited immunity protection to a case where the underlying treatment that the patient received was unrelated to the facilitation of recovery from a mental illness.
The MHPA establishes rights and procedures for all involuntary treatment of mentally ill persons, whether inpatient or outpatient, and for all voluntary inpatient treatment of mentally ill persons. Under Section 114 of the MHPA, a physician or any other authorized person who participates in a decision that a patient be examined or treated under the MHPA, in the absence of willful misconduct or gross negligence, is not civilly or criminally liable for such decision or for any of its consequences.
Background of the Case
The case at issue concerns a patient who died of a cardiac arrhythmia while undergoing voluntary inpatient drug detoxication treatment at a drug addiction treatment facility. Upon admission, the patient self-reported a decades old diagnosis of bipolar disorder and ADHD, but was not currently undergoing any treatment for these reported conditions. For purposes of detoxification, the patient was placed on a methadone taper.
The patient did undergo a psychiatric evaluation during his time at the facility. Following this evaluation, he was prescribed medication to help with his anxiety symptoms and chronic back pain.
Following the patient’s death, his estate filed medical malpractice, wrongful death, and survival claims against the treatment facility and its physicians. The defendants asserted a defense of immunity under the MHPA.
After both the trial court and Superior Court granted this immunity at least in part, the plaintiffs appealed to the Pa. Supreme Court.
The Pa. Supreme Court's Decision
On Feb. 19, 2020, the Supreme Court issued its decision denying the application of MHPA immunity to the treatment facility and its physicians. To reach this decision, the Court reasoned that the MHPA only applies to treatment decisions that supplement and aid or promote relief and recovery from mental illness.
The Court also looked for a definition of mental illness. Because the MHPA does not define mental illness, the Court turned to a definition utilized by the Pa. Department of Human Services in accompanying regulations. This definition, see 55 Pa. Code § 5100.2, explicitly states that drug dependence by itself does not constitute mental illness, though the presence of it does not preclude such a finding.
Applying this rationale to the present case, the Court concluded that the factual scenario does not warrant MHPA coverage as the treatment received by the patient in the instant case was for voluntary drug detoxification and not to facilitate a recovery of mental illness. The Court further reasoned that applying MHPA protection under the circumstances of this case would expand immunity to all facilities and providers that treat patients with any history of mental illness, however remote or unrelated to the current treatment.
The case will now return to the trial court for further proceedings.