Doe v. Graham

• Decision Date: 13 August 2009
• Docket Number: Docket: Cum-08-168.
• Citation: 977 A.2d 391,2009 ME 88
• Parties: Jane DOE v. Jennifer GRAHAM et al.
• Court: Maine Supreme Court

977 A.2d 391

2009 ME 88

Jane DOE v. Jennifer GRAHAM et al.

Docket: Cum-08-168.

Supreme Judicial Court of Maine.

Argued: November 19, 2008.

Decided: August 13, 2009.

Mark C. Joyce, Esq. (orally), Disability Rights Center of Maine, Augusta, ME, for Jane Doe.

Christopher C. Taintor, Esq. (orally), Norman, Hanson & DeTroy, Portland, ME, for Jennifer Graham, Maine Medical Center and Security Guards.

Panel: SAUFLEY, C.J., and CLIFFORD, ALEXANDER, LEVY, SILVER, MEAD, and GORMAN, JJ.

SAUFLEY, C.J.

[¶ 1] Jane Doe was the subject of an evaluation and assessment for possible emergency involuntary commitment for mental health treatment. After staff at Maine Medical Center certified Doe for emergency commitment, she was delivered to Spring Harbor Hospital for treatment. She was released from Spring Harbor within several hours of her arrival. Doe eventually sued Jennifer Graham, M.D., Maine Medical Center, and two unnamed security guards, based on their allegedly wrongful acts and omissions in holding, assessing, and certifying her for involuntary commitment. On motion of MMC and its staff, the Superior Court (Cumberland County, Delahanty, J.) dismissed Doe's complaint. She appeals from the judgment of dismissal, and we affirm the judgment.

I. BACKGROUND

[¶ 2] Because the matter was resolved on a motion to dismiss pursuant to M.R. Civ. P. 12(b)(6), "[w]e examine the complaint in the light most favorable to the plaintiff to determine whether it sets forth elements of a cause of action or alleges facts that would entitle the plaintiff to relief pursuant to some legal theory." Saunders v. Tisher, 2006 ME 94, ¶ 8, 902 A.2d 830, 832 (quotation marks omitted). We will affirm the dismissal "when it appears beyond a doubt that the plaintiff is not entitled to relief under any set of facts that he might prove in support of his claim." Id. (quotation marks omitted).

[¶ 3] Thus, we view the following facts alleged in Doe's complaint as if they were admitted. On August 15, 2004, Doe confronted her husband about having an extramarital affair. In response, Doe's husband claimed that Doe was suicidal and called the police. The police arrived and took Doe against her will to the emergency department at MMC in Portland. There, Graham evaluated Doe for an emergency involuntary commitment to a psychiatric hospital. At the time of this evaluation, Graham was a medical resident practicing under an educational certificate and not a fully-licensed physician.

[¶ 4] Doe repeatedly informed Graham that she was not suicidal and that she wanted to leave. Graham responded that she could "make things difficult" for Doe, or she could make the process easy if Doe agreed to cooperate. Doe continued to ask to be released, and at one point two hospital security guards untied the restraints on a nearby table and told Doe that they would strap her to the table and put a diaper on her if she did not give them her wallet. One of the security guards also held Doe's keys in the air and told her that she was "stupid" if she thought they would be returned. Graham told Doe that she had "no control over what the guards do," which Doe interpreted to be a threat of physical force.

[¶ 5] Graham refused Doe's request for immediate release. Graham included in her assessment of Doe's psychiatric status information obtained during telephone conversations with a number of individuals, including the woman with whom Doe believed her husband was having an affair. Doe alleges that Graham released confidential information to this woman without Doe's authorization and disregarded Doe's assertions regarding an advance directive prohibiting Doe's husband from making any healthcare decisions for her. Graham certified Doe for emergency involuntary commitment pursuant to 34-B M.R.S. § 3863 (2005).¹ Doe was then transported to Spring Harbor Hospital and was discharged within two hours when providers there completed an evaluation and determined that she did not require hospitalization.

[¶ 6] On July 19, 2007, Doe filed an eighteen-count notice of claim against Graham, MMC, and the two security guards pursuant to the Maine Health Security Act, see 24 M.R.S. §§ 2853(1)(B), 2903(1)(A) (2008), and amended the claim on August 9, 2007.² The eighteen counts included three federal counts, one count seeking declaratory relief, and fourteen state law damages counts. Graham, MMC, and the security guards moved to dismiss the fourteen state law counts, comprising thirteen common law tort claims and one civil rights claim,³ arguing in part that they are entitled to discretionary function immunity pursuant to the Maine Tort Claims Act and because they are "deemed to be a governmental entity or an employee of a governmental entity under the Maine Tort Claims Act" pursuant to 34-B M.R.S. § 3861(1)(A) (2008).

[¶ 7] The Superior Court granted the motion to dismiss. With regard to the thirteen common law tort claims, the court concluded that, pursuant to the Maine Tort Claims Act, Graham, MMC, and the guards are immune from any liability associated with the involuntary commitment process. The court also dismissed Doe's civil rights claim, determining that because the involuntary commitment statute provided adequate procedural protections, her due process rights had not been violated. Doe timely filed this appeal from the Superior Court's dismissal and subsequently amended her notice of claim by removing the four counts not subject to the motion to dismiss, thus finally resolving each count before the court.

II. DISCUSSION

A. Common Law Tort Claims

[¶ 8] The Maine Tort Claims Act, 14 M.R.S. §§ 8101-8118 (2008), provides broadly that "[e]xcept as otherwise expressly provided by statute, all governmental entities shall be immune from suit on any and all tort claims seeking recovery of damages," id. § 8103(1). The Tort Claims Act also extends personal immunity to employees of governmental entities in certain circumstances, including for "[p]erforming or failing to perform any discretionary function or duty, whether or not the discretion is abused; and whether or not any statute, charter, ordinance, order, resolution, rule or resolve under which the discretionary function or duty is performed is valid." Id. § 8111(1)(C).

[¶ 9] The Superior Court premised its determination that Graham, MMC, and the security guards are immune from suit pursuant to the Tort Claims Act on two grounds: (1) the statutory grant of governmental status conferred to nonstate mental health institutions and their employees when they admit, treat, or discharge involuntarily committed patients, see 34-B M.R.S. § 3861(1)(A); and (2) our precedent establishing that discretionary function immunity extends to physicians and support staff participating in involuntary commitment evaluations at both state and private hospitals, see Clark v. Me. Med. Ctr., 559 A.2d 358 (Me.1989); Taylor v. Herst, 537 A.2d 1163 (Me.1988); Darling v. Augusta Mental Health Inst., 535 A.2d 421 (Me.1987). We address each basis for immunity in turn.

1. Immunity for Treatment of Involuntarily Committed Patients Pursuant to Section 3861(1)(A)

[¶ 10] In 1990, the Legislature amended the statute governing the reception of involuntarily committed persons, and articulated that Tort Claims Act immunity extends to nonstate facilities that accept such individuals for treatment. See P.L. 1989, ch. 906 (effective July 14, 1990). The pertinent portion of the statute, as amended, provides:

1. Nonstate mental health institution. The chief administrative officer of a nonstate mental health institution may receive for observation, diagnosis, care and treatment in the institution any person whose admission is applied for under any of the procedures in this subchapter. ...

A. The institution, any person contracting with the institution and any of its employees when admitting, treating or discharging a patient under the provisions of sections 3863 and 3864 under a contract with the [Department of Health and Human Services], for purposes of civil liability, must be deemed to be a governmental entity or an employee of a governmental entity under the Maine Tort Claims Act. ...

34-B M.R.S. § 3861(1)(A) (emphasis added).

[¶ 11] The statute's express grant of governmental status to facilities "under a contract" with the Department of Health and Human Services is intended to encourage nonstate hospitals to accept committed patients by encompassing those facilities within the provisions of Tort Claims Act immunity. Lever v. Acadia Hosp. Corp., 2004 ME 35, ¶¶ 17-18, 845 A.2d 1178, 1182.

[¶ 12] The focus of section 3861(1)(A) is the admission, treatment, and potential discharge of patients who have already been involuntarily committed. It does not address those instances, governed by section 3863, in which public or private facilities and their staff undertake the evaluations and assessments that are necessary to determine if involuntary commitment is appropriate in the first instance. Thus, it addresses a different part of the continuum of evaluation and care than that at issue here. Graham and the MMC staff accepted Doe for evaluation and assessment regarding a potential involuntary commitment and were not "admitting, treating or discharging" an involuntarily committed patient. 34-B M.R.S. § 3861(1)(A). Therefore, section 3861(1)(A) was not applicable to their conduct, and the Superior Court's reliance on that provision, on these facts, was misplaced.

[¶ 13] The enactment of section 3861(1)(A) did not, however, alter or eliminate the discretionary act immunity already provided to those physicians and support staff participating in the initial evaluative services prior to involuntary commitment and treatment. Lever, 2004 ME 35, ¶¶ 19-20, 845 A.2d at 1182. Thus, we next consider if this immunity extends to Graham, MMC, and the security guards in this instance.

2. Immunity for Evaluation and Certification Prior to Involuntary Commitment

[¶ 14] Both state-employed...