Estates of Morgan v. Fairfield Family Counseling Ctr.

• Decision Date: 22 January 1997
• Docket Number: No. 95-131,95-131
• Parties: ESTATES OF MORGAN et al., Appellants, v. FAIRFIELD FAMILY COUNSELING CENTER et al., Appellees; Brown, Appellant.
• Court: Ohio Supreme Court

Page 284

77 Ohio St.3d 284

673 N.E.2d 1311

ESTATES OF MORGAN et al., Appellants, v. FAIRFIELD FAMILY COUNSELING CENTER et al., Appellees; Brown, Appellant.

No. 95-131.

Supreme Court of Ohio.

Submitted April 17, 1996.

Decided Jan. 22, 1997.

SYLLABUS BY THE COURT

1. Generally, a defendant has no duty to control the violent conduct of a third person as to prevent that person from causing physical harm to another unless a "special relation" exists between the defendant and the third person or between the defendant and the other. In order for a special relation to exist between the defendant and the third person, the defendant must have the ability to control the third person's conduct.

2. R.C. 5122.34 does not preclude the finding that a special relation exists between the psychotherapist and the outpatient which imposes a common-law duty on the therapist to take affirmative steps to control the patient's violent conduct.

3. The relationship between the psychotherapist and the patient in the outpatient setting constitutes a special relation justifying the imposition of a duty upon the psychotherapist to protect against and/or control the patient's violent propensities.

4. When a psychotherapist knows or should know that his or her outpatient represents a substantial risk of harm to others, the therapist is under a duty to exercise his or her best professional judgment to prevent such harm from occurring.

On the evening of July 25, 1991, Matt Morgan was playing cards with his parents, Jerry and Marlene Morgan, and sister, Marla Morgan. Matt excused himself from the table, went upstairs, and obtained a gun. He came back downstairs and shot and killed his parents and seriously injured his sister. During the previous year, Matt had been examined by or received counseling from various mental health professionals who were either employed by or served as consultants to appellee, the Fairfield Family Counseling Center ("FFCC"). This case involves the liability of those mental health professionals and FFCC for the injuries and deaths resulting from the tragic events of July 25, 1991.

During his senior year of high school, Matt began to have difficulties at school, work, and home. His grades and attendance at school had fallen, and he was required to attend summer school. He had problems keeping jobs, and became disrespectful and verbally abusive toward his parents, to the point where his parents had grown afraid of him. These problems continued after high school until January 1990, when Matt was removed from his parents' home in Lancaster, Ohio, by police after wanting to fight his father.

Matt then drifted, homeless, until he presented himself at the Emergency Room at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania, on March 26, 1990. There, he was diagnosed as suffering from schizophreniform At the C.A.T.C.H. Respite, Matt came under the care of Miles C. Ladenheim, M.D., who, at that time, was in his third year of psychiatric residency. Dr. Ladenheim first saw Matt on April 2, 1990, at which time he rendered a primary diagnosis of "schizophreniform disorder, rule out schizophrenia, chronic paranoid type." The essential features of schizophreniform disorder are identical to those of schizophrenia, with the exception that the duration is less than six months. Once the signs and symptoms persist for a continuous period of six months, the diagnosis becomes schizophrenia. Schizophrenia is an inability to recognize reality in some way, marked by delusions and perceptual distortions. There is no cure for schizophrenia, but the symptoms can be controlled by medication such as Navane. It was Dr. Ladenheim's opinion that "it was only going to be a matter of time before the six-month period elapsed, and he [Matt] would likely then have schizophrenia."

                disorder and transported to C.A.T.C.H. Emergency Evaluation Center ("EEC"), a mental health facility.  Matt was further evaluated at C.A.T.C.H. EEC between March 26, 1990 and March 29, 1990.  It was noted that Matt had "recent drifting, travel and homelessness," and "[n]eeded to be put out of [his] parents' home by police."   Various symptoms were noted suggestive of either schizophreniform disorder or schizophrenia, including Matt's belief that the government was affecting his body and the air waves, such that he was unable to watch television or listen to tapes or the radio, delusions of persecution and ideas of reference and thought broadcasting.  Matt was prescribed Navane, an antipsychotic or neuroleptic drug, and on March 29, 1990, was admitted to the C.A.T.C.H. Respite
                

Dr. Ladenheim determined that Matt had developed a fixed paranoid delusional system involving his family, the government, unspecified industry and others, including the delusion that he had a "big lawsuit case in both Ohio and Florida, suing his family, aunts, uncles, and some other people," and somatic delusions regarding his legs. Dr. Ladenheim also noted that Matt had an unformed paranoid ideation, ideas of reference from the television and feelings of thought control by others. He noted that Matt also "had feelings of thought manipulation, meaning his thoughts were being manipulated by outside forces or people, and thought withdrawal, meaning that people were able to take thoughts out of his head, and thought reading, meaning that people were able to read his thoughts." Dr. Ladenheim also made a note on April 30, 1990, that prior to leaving Ohio, Matt was becoming increasingly agitated at home and was put out of his parents' home after threatening them.

Matt's art therapist at the Respite noted that Matt had an increased feeling of stress when feelings of anger were discussed. After referring to a particular example of anger in a drawing of a gun made by Matt on or about April 20, 1990 During his twelve-week admission at the Respite, Matt was treated with intensive therapy, Navane, and other medications to aid in sleeping and to offset the potential side effects of the Navane. Eventually, Matt's paranoia regarding his family decreased and he developed improved insight into his mental illness. Dr. Ladenheim explained that Matt's illness could be controlled by medication, and Matt agreed that the medication was helping him and that his symptoms of mental illness may have contributed to his conflicts, especially with his father. Matt began to make contacts with his family and they expressed a willingness to help him. It was Dr. Ladenheim's opinion that Matt should return to his parents' home, but that the treatments and medication must continue in order for Matt to safely return to Ohio. Accordingly, the staff at the Respite contacted defendant-appellee FFCC, and Matt was picked up by his parents on June 22, 1990.

she stated that "[t]his, coupled with aggressive line quality, indicates possible anger toward self and others."

Matt initially presented himself to FFCC on July 16, 1990. After an intake evaluation was conducted by defendant-appellee, Ronald Gussett, Ph.D., Matt was referred for consultation with defendant-appellant, Harold T. Brown, M.D., a consultant contract psychiatrist to FFCC. Dr. Brown first saw Matt at FFCC on July 19, 1990. From his thirty-minute evaluation of Matt, Dr. Brown noted that Matt was "recently discharged from a mental health unit of some sort in Philadelphia, Pennsylvania, on Elavil and Navane. He is out of medication. He comes to the mental health clinic for his medication, continued care and help in completing a Social Security Disability form." Dr. Brown also noted that "[h]is [Matt's] experience in Philadelphia sounds like some sort of acute atypical psychosis. He does not present indicators of thought disorder or schizophrenia at this point."

Dr. Brown did not make any final determination as to Matt's condition at that time, but did make a notation to "rule out malingering" because of a discrepancy between Matt's complaint that his legs are of different lengths and Dr. Brown's observation that Matt's gait and movements were normal, "and that there was a disability form in the works somewhere." Dr. Brown testified that he sees "a lot of people that show up with SSI in mind with a history very similar to Mr. Morgan's. And I think to give it to someone who doesn't qualify for it is a real disservice to them." However, Dr. Brown thought it wise to defer his diagnosis, continue the medication, obtain Matt's records from Philadelphia, and schedule another appointment for a month later.

On August 16, 1990, Matt kept his scheduled appointment with Dr. Brown. Dr. Brown was now in possession of the C.A.T.C.H. records, but it is clear from his testimony that he never read them and never attempted to contact Dr. Ladenheim. Instead, during this fifteen-minute session, Dr. Brown began to The next and last time Dr. Brown saw Matt was for fifteen minutes on October 11, 1990. Dr. Brown noted as follows:

focus more on there being "a strong factor of malingering here or at least overstating symptoms to gain the SSI," and reduced Matt's Navane medication by half.

"We discussed his migration from Ohio to Florida to Philadelphia and back to Lancaster. He now chooses to view it as his extended vacation. No further insight as to just what happened to get him into the mental hospital in Philadelphia or why they may have prescribed neuroleptic [medication] for him.

"We discussed a plan to further taper the Navane. He is now taking only one 10 milligram capsule a day for the last five to six weeks. When this present supply is gone, he is to take a 5 milligram capsule once a day for a month and then discontinue. He will continue with Dr. Gussett in psychotherapy as Dr. Gussett and he both deem it useful.

"He is referred to job counselor, Nancy Lambert, for what help this may be in finding employment.

"Diagnosis for the record will be that of atypical psychosis, not further specified, in remission."

Dr. Brown testified that "[t]he diagnosis of...