Dimitrijevic v. Chicago Wesley Memorial Hospital

• Decision Date: 22 January 1968
• Docket Number: Gen. No. 50720
• Parties: Natalia DIMITRIJEVIC, Administratrix of the Estate of Dimitrije Dimitrijevic, Deceased, Plaintiff-Appellant, v. CHICAGO WESLEY MEMORIAL HOSPITAL, an Illinois corporation, and Benjamin Boshes, M.D. and Benjamin Blackman, M.D., Defendants-Appellees.
• Court: United States Appellate Court of Illinois

Page 309

236 N.E.2d 309

92 Ill.App.2d 251

Natalia DIMITRIJEVIC, Administratrix of the Estate of Dimitrije Dimitrijevic, Deceased, Plaintiff-Appellant, v. CHICAGO WESLEY MEMORIAL HOSPITAL, an Illinois corporation and Benjamin Boshes, M.D. and Benjamin Blackman M.D., Defendants-Appellees.

Gen. No. 50720.

Appellate Court of Illinois, First District, Fourth Division.

Jan. 22, 1968.

Francis J. Mahon, Edward J. Bradley, Chicago, for appellant.

Ross, Kralovec, Sweeney & Marquard, Chicago, for Chicago Wesley Memorial Hospital, appellee.

Kirkland, Ellis, Hodson, Chaffetz & Masters, and Dent, Hampton & Doten, Chicago, Charles M. Rush, John M. O'Connor, Jr., John P. Hampton, Chicago, of counsel, for Benjamin Boshes, M.D. and Benjamin Blackman, M.D., appellees.

DRUCKER, Justice.

This was a wrongful death action brought by the Administratrix of the Estate of Dimitrije Dimitrijevic in which plaintiff sought to prove that malpractice on the part of the defendant doctors and negligence on the part of defendant hospital were responsible for the suicide of her intestate. From the direction of verdicts in favor of all the defendants at the close of her evidence, plaintiff appeals. On appeal she contends:

1. That the evidence established a prima facie case of malpractice against defendant doctors;

2. That the evidence established a prima facie case of negligence against defendant hospital;

3. That the court below erred by weighing the evidence in directing the verdict.

The evidence showed that plaintiff's decedent had been suffering increasing depression and that on February 28, 1958, on the advice of his family doctor he went to the Wesley Memorial Hospital for psychiatric treatment. He was put in a double room on the eleventh floor next to an unguarded window. His movements were not closely restrained nor was he constantly supervised. On the 5th of March decedent leaped from the window to his death.

Dr. Joel Brumlik, called as a witness for plaintiff, testified that he had been a resident in psychiatry and at the time of decedent's stay in the hospital was a resident in neurology under the supervision of the defendant doctors. He stated that he saw the decedent upon his admission, that he was not authorized to make diagnoses but that he worked up an 'impression'; that he prescribed a sleeping tablet, a sedative and aspirin; that decedent had suicidal thoughts but that he prescribed no restraints on the decedent's mobility and at no time thought that the precautions used in the case of a suicidal risk were necessary.

Dr. Blackman, called by plaintiff under Section 60 of the Civil Practice Act, ¹ testified that he talked to decedent's family doctor and arranged for decedent's admission on February 28; that he diagnosed the illness as an acute anxiety state rather than a psychotic depressive reaction as Dr. Brumlik first thought. Dr. Blackman stated that great restrictions were used if the patient was considered a suicidal risk but that:

I took into consideration the note in the record 'has had suicidal thoughts' in arriving at my opinion that he was not a suicidal risk. Other considerations were: he was clear of mind; related very well; articulate in describing his emotional problems; no delusions; no hallucinations; not agitated; cooperative. He had difficulties in his marriage and worries about his family in Yugoslavia to whom he sent money from time to time.

He was working regularly as a draftsman. He had worked up until the time he came into the hospital.

He also stated that he was influenced by the patient's desire to get well. Later he said:

A suicidal risk means a medical determination that a patient could possibly take his life and a certain procedure should be instituted immediately. When someone expresses suicidal thoughts we cannot institute this rigorous procedure. Many people have suicidal thoughts. Suicidal thoughts are not equivalent to a patient being a suicidal risk.

Dr. Boshes testified under Section 60 of the Civil Practice Act that he was chairman of Wesley Hospital's Department of Neurology and Psychiatry; that decedent was his patient but as chairman of the department he could not personally handle each case; that he had assigned the case to Dr. Blackman and felt that the patient was being well handled. He said that in an hour spent with the decedent the day before his death he had measured the forces of depression against the forces of defense in determining that decedent was not a suicidal risk and that this method was generally followed by the psychiatric profession in making such determination.

The evidence showed that the day before decedent's death Dr. Blackman ordered the decedent transferred to Section 8--W and that this order was never carried out. Section 8--W had locked doors and windows guarded by heavy mesh retention screens. It was staffed by people specifically trained in psychotherapy techniques and afforded special treatment facilities. Kenath Hartman, the hospital administrator, testified under Section 60 of the Civil Practice Act that 8--W had a capacity of thirty-two patients plus three beds for emergency use; that on March 4 all thirty-two beds plus one emergency bed were filled; that he called Dr. Blackman and asked if this was an emergency case for transfer to 8--W and Dr. Blackman said no. He stated that he inquired into the need for restraints based on the suicidal thoughts on the progress reports and that Dr. Blackman said there was no need for special precautions against suicide. He stated that in studying to be a hospital administrator he had received courses in the case of psychiatric patients and that:

* * * the emphasis was placed on the fact that the care of psychiatric patients was in a state of change in treatment; that no longer were we to consider in construction design, a completely closed, isolated unit for these patients, but that we must provide open area for patients that are psychiatric patients; that we should not be too strict upon the doctors in the treatment of psychiatric patients; that they, themselves, are making tremendous strides in the care of patients, which do not require them always to be in confined units, and that they found that we should provide occupational therapy and recreational therapy for these individuals, * * *.

Dr. Boshes further testified that he knew of the order and of the possibility of getting decedent into 8--W as an emergency patient but saw no such need. Dr Blackman stated that he gave the order, not for security reasons, but because he wanted decedent to receive the special supportive therapy that 8--W afforded and that although he did not know decedent could be admitted as an emergency patient, had he thought a security risk was involved, he would have ordered the appropriate supervision and restraint. He stated that he did not expect his order to be carried out immediately but only when a bed became available.

Plaintiff first contends that she established a prima facie case of malpractice against Doctors Boshes and Blackman. In her complaint she alleged that the doctors had:

(a) Carelessly and negligently failed to properly examine the deceased in order that proper diagnosis could be made and care and treatment prescribed;

(b) Carelessly and negligently failed to give hospital attendants necessary and proper instructions as to care and attention to be given to the deceased;

(c) Carelessly and negligently failed to properly oversee and observe the care and treatment given by the hospital under his direction and to note that such instructions as he had given were not being carried out;

(d) Carelessly and negligently failed to follow methods generally approved and recognized in the profession in the treatment and care of the deceased.

Stripped of verbiage her argument is that the doctors should have been aware that decedent was a suicidal risk and that their failure to take the appropriate precautions was malpractice.

Scardina v. Colletti, 63 Ill.App.2d 481, 211 N.E.2d 762, was a malpractice suit for damages resulting from hemorrhaging caused by a severed blood vessel left open after a hernia operation. In denying relief the court stated the general rule governing malpractice cases, at page 488, 211 N.E.2d at page 765:

In a malpractice action a physician will be held responsible for injuries resulting from his want of reasonable care, skill and diligence in his practice. The Plaintiff must prove by affirmative evidence that the defendant was unskillful or Negligent and that his want of skill or care caused injury to the plaintiff. It is not enough to prove that he made a mistake or that his treatment harmed the plaintiff; proof of a bad result or mishap is no evidence of lack of skill or negligence.

Generally, it is necessary for a plaintiff to show by expert testimony not only that the injury occurred, but that such an event does not ordinarily occur in the normal course of events without negligence. Graham v. St. Luke's Hospital, supra, 46 Ill.App.2d 147, pp. 156, 157, 196 N.E.2d 355; Gault v. Sideman, 42 Ill.App.2d 96, 101, 102, 191 N.E.2d 436. The so called 'common knowledge' and 'gross negligence' exceptions to the requirement of expert testimony are applicable if the negligence of the physician is so grossly apparent or the treatment is such a common occurrence that a layman would have no difficulty in appraising it. Neither exception applies to the present case. (Emphasis added.)

In Moline v. Christie, 180 Ill.App. 334, plaintiff sued for an infection arising during the treatment of a crushed finger. The court said at pages 343, 344 (quoting from Goodman v. Bigler, 133 Ill.App. 301):

'Whether or not the treatment was ordiarily skilful and appellant's conduct and management of the case was that of an ordinarily careful and skilful physician, is largely an expert question to be determined from the testimony of witnesses learned and experienced in that kind of service.' To the same effect is ...