In re Commitment of M.M.

Decision Date31 March 2006
Citation384 N.J. Super. 313,894 A.2d 1158
PartiesIn the Matter of the COMMITMENT OF M.M.
CourtNew Jersey Superior Court

Lorraine Gormley, Assistant Deputy Public Defender, argued the cause for appellant (Yvonne Smith Segars, Public Defender, attorney; Ms. Gormley on the brief).

Laura J. Paffenroth argued the cause for respondent (Office of the Camden County Adjuster, attorneys; Ms. Paffenroth, on the brief).

Before Judges STERN, GRALL and MINIMAN.

The opinion of the court was delivered by

GRALL, J.A.D.

This case requires us to consider the showing necessary to establish "exceptional circumstances" and "good cause" authorizing extension of the statutory deadline for a hearing on civil commitment pursuant to R. 4:74-7(c)(1). See N.J.S.A. 30:4-27.12a. We hold that absent a request by the patient, the circumstances must be atypical, rather than routine, and reasonably unforeseen and unavoidable, rather than within the reasonable control of the state or the court. We further hold that "good cause" exists when the state's interest in extending the time for a hearing due to "exceptional circumstances" substantially outweighs the patient's interest in terminating confinement that is not supported by clear and convincing evidence of the existence of grounds for commitment.

M.M. was admitted to the Camden County Health Service Center from a crisis center on April 2, 2005.1 A hearing on the state's application for her involuntary commitment was scheduled for and held on April 12, 2005.2 At the conclusion of that hearing, the trial judge equivocated about the adequacy of the evidence, directed the state to subpoena M.M.'s husband, adjourned the hearing for fourteen days and continued M.M.'s commitment pending that hearing. On the return date, April 26, 2005, the judge entered an order conditionally extending M.M.'s commitment pending placement pursuant to R. 4:74-7(h)(2) without taking any testimony about her condition. She was discharged to return home on May 10, 2005.

On May 26, 2005, M.M. appealed from the April 12, 2005 order.3 She contends that the judge erred in continuing her temporary commitment beyond the twenty-day statutory period without a sufficient showing of exceptional circumstances and good cause justifying the delay or adequate proof that she was a person in need of involuntary commitment. See N.J.S.A. 30:4-27.12a; R. 4:74-7(c)(1); N.J.S.A. 30:4-27.2m. The state argues that the judge found clear and convincing evidence of M.M.'s need for commitment and that the order reflecting an adjournment was simply not well-drafted.

We conclude that the evidence did not establish exceptional circumstances and good cause for adjournment or provide clear and convincing proof that M.M. was a person in need of involuntary commitment. Accordingly, we reverse.

I.

There were three witnesses at M.M.'s commitment hearing. Dr. Madrack, who is a psychiatrist, a social worker and M.M. testified. A summary of the evidence presented and the judge's findings and conclusions follows.

M.M. is a licensed dental technician. She also has an Associates Degree in Human Services. She had been married for approximately one year prior to her involuntary admission to a crisis center.

Dr. Madrack was "filling in" for Dr. Friedman, who treated M.M. after her admission to the facility from the crisis center on April 2, 2005. Dr. Madrack reviewed M.M.'s records, including a report prepared by Dr. Friedman on April 8.

According to Dr. Friedman's report, M.M. was admitted to the crisis center for stabilization after kicking in a basement window and throwing glass plates at her husband because she believed that he was having an affair with a super model. He noted that M.M. was chronically non-compliant with medications and follow-up. He described M.M. as "paranoid and hypervigilant," "preoccupied," "mood labile," and "lack[ing in] insight into her illness." His diagnosis was "Axis I: 1) Bipolar I disorder; manic õ psychoses 2) ETOH Abuse"; "Axis II: Deferred"; "Axis III: Amennorhea (sic)." He concluded that M.M. was dangerous to others, property and herself. He recommended hospitalization for a period of ninety days.

Dr. Madrack claimed to have seen M.M. twice during her hospitalization, for approximately twenty minutes on each occasion. She described a meeting on the Friday prior to the April 12 hearing, which would have been April 8, and a meeting on April 11 at which she just reminded M.M. about the hearing.

In Dr. Madrack's opinion, M.M. suffered from bipolar disorder and posed a danger to others and property. Her recitation of the basis for that opinion tracked Dr. Friedman's report:

The patient was originally brought in by the police after she kicked in a basement window at her home. This all stems from the fact that she believes that her husband is having an affair with a super model. She also ha[d] been damaging other proper[ty] at the home at that time by throwing dishes and glass plates at her husband and breaking objects in the house. And, there has been a period that she has for a long time been noncompliant with her medications, and she also displays other delusions at this time.

Like Dr. Friedman, Dr. Madrack concluded that M.M. had "little insight into what she had done" prior to her admission "with regard to destruction of property and throwing objects at" her husband. Dr. Madrack admitted, however, that her information about M.M.'s pre-admission conduct was derived solely from her review of M.M.'s records. She explained that because M.M. had been taken to the crisis center by the police, she assumed that the officers provided some of the information. She did not know whether the police had observed the events, and she reported that M.M. had neither admitted nor denied the conduct during their meetings. None of the reports upon which Dr. Madrack relied were admitted into evidence. When Dr. Madrack saw M.M. on April 8, M.M. was angry and upset with her husband, believed he was having an affair, had thoughts about wanting to get even with him, said he would deserve whatever he got and that she wanted to go home with him.

M.M. testified about her pre-admission conduct. She denied kicking in the basement window and said she may have broken it accidentally while trying to cover her husband's car with a tarp. She also denied throwing or purposely breaking any dishes and explained that her husband sometimes drinks too much and that they sometimes have "spat[s] ... like most people do when they're newlyweds." She admitted that she let a teacup saucer drop on the table during one of those spats and suggested that her husband might have thought that she was aiming at him.

Dr. Madrack described M.M.'s progress and current condition as follows:

While she has been here she has made minimal progress. The only progress that I could see was the fact that she has not destroyed any property in here at the hospital, but, besides that, she has been []very labile, very focused on her husband, making statements that she wants to tell her husband to take her home. She has continued to display the same paranoid delusions that ... presented her here.

Dr. Madrack explained that M.M.'s delusions were her belief that she was pregnant and her belief that her husband was having an affair. She reported that M.M. continued to believe that she was pregnant even after she was told that a pregnancy test was negative. Dr. Madrack did not discuss, however, Dr. Friedman's diagnosis of Amenorrhea. She did not ask M.M. about whether she and her husband were attempting to conceive a child, and she did not explain why she concluded that M.M.'s belief about her husband's affair was delusional.

A psychiatric nurse practitioner who evaluated M.M.'s status on April 11 reported that M.M. was alert and neither disoriented nor delusional. Although Dr. Madrack admitted she had not assessed M.M.'s condition on April 11, she dismissed the nurse's report. According to Dr. Madrack, because the nurse had not evaluated M.M. in the past, she may not have been aware of or talked to M.M. about the delusions.

At the hearing M.M. denied any present delusions. She said she knew she was not pregnant and did not suspect her husband of infidelity. She said she would continue her medications.

In Dr. Madrack's opinion, M.M.'s delusional beliefs were likely caused by her non-compliance with her medication schedule. She had not contacted M.M.'s doctor to determine whether he had discontinued her medication and did not know whether M.M. had ever been hospitalized in the past. She reported that M.M. had been taking her medication at the hospital. Dr. Madrack was not asked and did not offer an opinion as to whether the improvements in M.M.'s condition reported by the nurse practitioner were attributable to M.M.'s renewed compliance with her medication schedule. She did not comment on M.M.'s promise to continue her medication following release.

The social worker assigned to M.M.'s case did not know where M.M.'s husband stood with respect to her return to the marital residence. He noted that the husband had not sought a restraining order and was ambivalent about M.M.'s return, saying he was "afraid of her coming home" but also saying "he guessed she could come home."

M.M. asked the judge to discharge her. Although she wanted to return home, she said she would move in with her mother if not permitted to go to her own home.

M.M.'s attorney asked the court to place her on conditional extension pending placement (CEPP). In the attorney's view, CEPP status would permit a determination as to whether M.M. would return home or make other arrangements.

The judge found:

It doesn't seem like there [has] been any violent behavior since [M.M.] has been in the hospital. I understand ... that [M.M.] has indicated to Dr. Madrack and others...

To continue reading

Request your trial
10 cases
  • In re Civil Commitment of S.W.
    • United States
    • New Jersey Superior Court — Appellate Division
    • August 17, 2021
  • In re Civil Commitment of I.M.
    • United States
    • New Jersey Superior Court — Appellate Division
    • January 20, 2021
    ...reverses only when there is clear error or mistake, a reviewing court must consider the adequacy of the evidence." In re M.M., 384 N.J. Super. 313, 334 (App. Div. 2006) (citing In re D.C., 146 N.J. 31, 58-59 (1996)). Although appellants' liberty rights were affected adversely by their conti......
  • Brunswick Bank & Trust v. Heln Mgmt. LLC
    • United States
    • New Jersey Superior Court — Appellate Division
    • February 21, 2018
    ...This standard provides some leeway, but a judge's exercise of discretion is never unbridled. See In re Commitment of M.M., 384 N.J. Super. 313, 332, 894 A.2d 1158 (App. Div. 2006). In this context, a valid exercise of discretion presupposes a reasoned application of the rules of evidence, a......
  • In re Civil Commitment of C.W., DOCKET NO. A-4227-14T5
    • United States
    • New Jersey Superior Court — Appellate Division
    • May 14, 2018
    ...77 N.J. 282, 311 (1978)). Notwithstanding our deference, we "must consider the adequacy of the evidence." In re Commitment of M.M., 384 N.J. Super. 313, 334 (App. Div. 2006) (citing D.C., 146 N.J. at 58-59). "[W]e have not hesitated to reverse involuntary commitments when the record failed ......
  • Request a trial to view additional results

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT