Estate of Long v. Broadlawns Med. Center

• Decision Date: 18 December 2002
• Docket Number: No. 00-1769.,00-1769.
• Citation: 656 N.W.2d 71
• Parties: ESTATE OF Jillene LONG, by and through its Administrator, Dolores SMITH, Appellant, v. BROADLAWNS MEDICAL CENTER and Margaret Shin, Individually and in her Official Capacity as Employee or Agent of Defendant Broadlawns Medical Center, Appellees.
• Court: Iowa Supreme Court

656 N.W.2d 71

ESTATE OF Jillene LONG, by and through its Administrator, Dolores SMITH, Appellant, v. BROADLAWNS MEDICAL CENTER and Margaret Shin, Individually and in her Official Capacity as Employee or Agent of Defendant Broadlawns Medical Center, Appellees.

No. 00-1769.

Supreme Court of Iowa.

December 18, 2002.

As Amended on Denial of Rehearing February 10, 2003.

Alfredo Parrish, Maggi Moss and Robert P. Montgomery of Parrish Kruidenier Moss Dunn Montgomery Boles & Gribble, L.L.P., Des Moines, for appellant.

David L. Brown of Hansen, McClintock & Riley, Des Moines, for appellees.

CADY, Justice.

Sixteen people were murdered or killed in Iowa in 1996 as a result of domestic violence.¹ Jillene Long was one of the sixteen victims. This appeal concerns a negligence lawsuit filed by her estate against a hospital that treated the perpetrator of the crime for a psychiatric illness during the week preceding the murder.² Core among an assortment of legal issues presented on appeal and cross-appeal following the entry of a judgment for the estate is the proper theory of negligence to be applied in a case of this nature. Ultimately, we conclude the trial court properly instructed on the theory of negligence, but erred in permitting the jury to award damages for pre-death pain and suffering. We therefore set aside a portion of the damages awarded, but otherwise affirm the judgment of the district court.

I. Background Facts and Proceedings.

During the evening of July 19, 1996, Gerald Long fired a gun at his wife, Jillene Long. This would become the penultimate incident in a long and tragic history of domestic violence perpetrated by Gerald on Jillene, and would be followed six days later by his final act of violence which resulted in her death.

After firing the gun that evening, Gerald left the marital residence and went to the Veterans Administration hospital in Des Moines seeking some form of assistance. Soon after arriving at the Veterans hospital, Gerald was transferred to Iowa Lutheran Hospital, also in Des Moines, where he sought voluntary psychiatric medical treatment. After his arrival at Iowa Lutheran, Gerald was observed exhibiting homicidal and suicidal tendencies, was suffering from hallucinations and flashbacks, and stated that he was "losing control."

Although initially accepted for treatment at Iowa Lutheran, provisions of Gerald's health insurance required a subsequent transfer to Broadlawns Medical Center in Des Moines on July 22. At Broadlawns, Gerald was seen by Margaret Shin, M.D., the attending physician. Dr. Shin further diagnosed Gerald as suffering from post-traumatic stress disorder versus dissociative disorder and dependencies on alcohol, marijuana, and methamphetamine. However, after his arrival at Broadlawns, Gerald's erratic behavior appeared to plateau. On July 23, the decision was made by Gerald's treating physicians to transfer him once again, this time to the University of Iowa Hospitals and Clinics in Iowa City for inpatient substance abuse treatment.

As Gerald was shuttled between the Des Moines hospitals, Jillene was kept abreast of his treatment through contacts with his primary treating physician at Iowa Lutheran and Charlyn Dowling-Smith, a social worker in the adult inpatient behavioral health unit at Broadlawns who had been assigned to his case. Jillene also had contact with the Des Moines Police Department, first on the night of the gun incident and then later when she sought advice on whether she should deliver some of Gerald's personal possessions to Broadlawns so that he would have them during his stay in Iowa City. The conversations between Jillene and medical and police staff included discussions of the history of Gerald's abuse of Jillene, the nature of the treatment being sought by Gerald, and the potential danger to Jillene should she remain in the marital residence. Jillene's conversation with Charlyn Dowling-Smith covered an array of issues. Most importantly, Charlyn told Jillene that Broadlawns would call her on the day of Gerald's discharge.

Gerald was discharged from Broadlawns early in the morning on July 25. He promptly boarded a bus and journeyed to Iowa City where he successfully arrived at the chemical dependency center and took part in a general history and assessment for purposes of his treatment. However, after taking part in the assessment, Gerald walked away from the facility. After leaving the center, Gerald went to a local pawnshop, pawned his watch, and bought a bus ticket back to Des Moines. Gerald returned to the marital residence, perhaps to lie in wait for Jillene. When Jillene returned to the home that evening, Gerald shot her several times, killing her.

This appeal arises out of a civil action pursued on behalf of the Estate of Jillene Long by its administrator, Dolores Smith. The Estate filed the underlying action on May 30, 1997, alleging that Broadlawns and Margaret Shin, M.D. (collectively Broadlawns), as well as other persons, facilities, or agents of those facilities, were negligent in failing to uphold a promise, allegedly conveyed to Jillene during Gerald's week of treatment, to notify her when he had been discharged from Broadlawns. The case was brought to trial on April 10, 2000. The jury returned a verdict on April 27 in favor of the Estate. Broadlawns filed a motion for judgment notwithstanding the verdict and a motion for new trial. The motion for judgment notwithstanding the verdict was granted in part and denied in part while the motion for new trial was denied in its entirety. The Estate subsequently appealed, as did Broadlawns, both on a number of grounds.³ We turn now to our consideration of the many arguments advanced by the parties.

II. Broadlawns' Motion for Judgment Notwithstanding the Verdict.

Broadlawns was largely unsuccessful in its post-trial motions and reasserts on appeal many of the issues initially put before the district court. The lone success in Broadlawns' motions came in the district court's conclusion that the jury's award of punitive damages was improper in light of the evidence adduced at trial. The Estate appeals from that conclusion. In addition, the parties join in challenging, under different theories, the district court's approach to the negligence standard applied in this case. Both of these issues, and others, were raised by the defendant's motion for judgment notwithstanding the verdict and were therefore preserved for our review.

We review the district court's decisions on the motion for errors at law. Iowa R.App. P. 6.4. In undertaking our review, we "inquire whether substantial evidence exists to support each element of the plaintiff's claim, justifying submission of the case to the jury." Gibson v. ITT Hartford Ins. Co., 621 N.W.2d 388, 391 (Iowa 2001). This determination is made viewing "the evidence in the light most favorable to the nonmoving party." Id.

1. Duty to a Nonpatient Family Member.

The principal dispute between the parties focuses on the correct standard of liability to be applied in this case. Broadlawns renews a number of arguments presented to the district court, believing a decision in its favor on any of the issues undercuts the jury's ultimate finding of negligence on the part of the hospital and its agent in failing to timely notify Jillene of Gerald's discharge.⁴ For its part, the Estate asserts as an appellate issue that the trial court erred in failing to submit the case under the principles of liability described in Tarasoff v. Regents of University of California, 17 Cal.3d 425, 131 Cal.Rptr. 14, 551 P.2d 334 (1976). It is important to note that the Estate obtained a favorable verdict on the negligence issue in the district court, which militates against review of its argument on appeal. See Iowa Coal Mining Co. v. Monroe County, 555 N.W.2d 418, 445 (Iowa 1996)

; Johnston Equip. Corp. v. Indus. Indem., 489 N.W.2d 13, 16 (Iowa 1992); Wassom v. Sac County Fair Ass'n, 313 N.W.2d 548, 550 (Iowa 1981); Wyatt v. Crimmins, 277 N.W.2d 615, 617 (1979). Our conclusions on this issue, however, both incorporate and refute the position of the Estate, and we find no harm in considering their arguments together with those of Broadlawns.

Much of the controversy over this issue arises because the factual posture of this case seemingly implicates both Tarasoff and the Restatement (Second) of Torts section 323 (1965). In Tarasoff, the California Supreme Court recognized that a special relationship between a psychotherapist and his or her patient "may support affirmative duties for the benefit of third persons." Tarasoff, 131 Cal.Rptr. 14,551 P.2d at 343. In that case, a patient had threatened in the presence of his doctor to kill a third party. Id. at 339. The court determined that a concomitant duty to warn ran from the psychiatrist to the eventual victim. Id. at 348. Thus, where the psychotherapist determines,

or pursuant to the standards of his profession should determine, that his patient presents a serious danger of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger. The discharge of this duty may require the therapist to take one or more of various steps, depending upon the nature of the case. Thus it may call for him to warn the intended victim or others likely to apprise the victim of the danger, to notify the police, or take whatever other steps are reasonably necessary in the circumstances.

In re Estate of Votteler, 327 N.W.2d 759, 760 (Iowa 1982) (quoting Tarasoff, 131 Cal. Rptr. 14, 551 P.2d at 340). Clearly, this case has factual similarities to Tarasoff. However, the principles of section 323 are also relevant. Section 323 provides:

One who undertakes, gratuitously or for consideration, to render services to another which he should recognize as necessary for the protection of the other's person or things, is subject to liability to the other for physical harm resulting from his failure

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