Farwell v. Un
| Decision Date | 02 July 1990 |
| Docket Number | Nos. 89-2091,89-2095,s. 89-2091 |
| Citation | 902 F.2d 282 |
| Parties | Katherine B. FARWELL, Personal Representative of the Estate of Brian J. Farwell, Deceased; Katherine B. Farwell, Individually and as Widow of Brian J. Farwell, Deceased; Katherine B. Farwell, Mother and Next Friend of Alan Farwell, Luke Farwell and Neil Farwell, Minor Children of Brian J. Farwell, Plaintiffs-Appellants, v. Chong H. UN, M.D.; Linwood W. Briggs, M.D., Defendants-Appellees. Katherine B. FARWELL, Personal Representative of the Estate of Brian J. Farwell, Deceased; Katherine B. Farwell, Individually and as Widow of Brian J. Farwell, Deceased; Katherine B. Farwell, Mother and Next Friend of Alan Farwell, Luke Farwell and Neil Farwell, Minor Children of Brian J. Farwell, Plaintiffs-Appellants, v. Chong H. UN, M.D.; Linwood W. Briggs, M.D., Defendants-Appellees. |
| Court | U.S. Court of Appeals — Fourth Circuit |
George Woodson Shadoan (argued), Shadoan & Michael, Rockville, Md., for plaintiffs-appellants.
Ronald Upton Shaw, Miles & Stockbridge, Baltimore, Md., argued for Briggs; Bonnie Jo Beavan, Goodell,
DeVries, Leech & Gray, Baltimore, Md., argued for Un; Daniel R. Lanier, David M. Feitel, Miles & Stockbridge, Donald L. DeVries, Jr., Goodell, DeVries, Leech & Gray, Baltimore, Md., on brief.
Before WIDENER, PHILLIPS and WILKINSON, Circuit Judges.
Appellant Katherine B. Farwell (Farwell) as personal representative of the estate of her deceased husband, Brian J. Farwell (decedent), and three of her children brought diversity wrongful death and survival actions against two physicians after their husband and father committed suicide. Dr. Linwood W. Briggs, a family practitioner, had treated decedent for five months before the suicide; Dr. Chong H. Un, a psychiatrist, saw decedent only once, the day before he committed suicide. The district court granted summary judgment for both defendants, ruling that under applicable state statutes the doctors could not have had decedent involuntarily committed to a hospital, hence breached no duty by failing to attempt to do so, and that the plaintiffs' forecast of evidence failed to establish that Dr. Briggs' care during the months preceding the suicide was the proximate cause of decedent's suicide. Though we do so on slightly different grounds, we affirm the judgment of the district court. We hold that, under controlling substantive law and on the undisputed facts of record, the defendant-physicians breached no duty of care owed their patient.
Decedent, a Maryland resident, 1 suffered depression after he was fired from his job with Stauffer Chemical Company in November 1985. Dr. Briggs, a physician licensed and practicing in Maryland, but at the time of this action's commencement a citizen of Maine, diagnosed the depression and prescribed anti-depressant medication on decedent's first office visit in January 1986. Dr. Briggs also saw decedent in February (twice), March, and May of 1986. On June 1, decedent told his wife that he had attempted to hang himself. Farwell called Dr. Briggs on June 2, and Dr. Briggs saw decedent and Farwell that afternoon. Decedent and his wife agreed with Dr. Briggs that decedent should be voluntarily hospitalized that day, but after leaving the office they instead returned home. Dr. Briggs learned from the admissions office on June 3 that decedent had not entered the hospital. He called Farwell, who told him that decedent was feeling better. Dr. Briggs changed decedent's medication but did not attempt to schedule an appointment to see decedent or otherwise follow-up in the matter.
Decedent's mother-in-law arranged for him to see Dr. Un in his Delaware office on June 9. Dr. Un, a citizen of Delaware, licensed to practice both in that state and Maryland, spoke first to decedent individually, then to Farwell, and finally to the two together. Dr. Un did not believe that decedent was imminently suicidal and did not recommend involuntary hospitalization; instead, he recommended that decedent go to the Veterans Administration (V.A.) hospital in Perry Point, Maryland, for voluntary admission that day. Dr. Un then sent decedent back to see Dr. Briggs. Dr. Briggs testified that Dr. Un "said he was sending Mr. Farwell over to see me and I was to talk to him and convince him of the necessity for voluntary commitment," and that Dr. Un told him "that the patient was willing to go to the hospital, but he wanted me to add my opinion's weight to it." While in Dr. Briggs' office, decedent did agree to enter the V.A. hospital the next day. The next day, however, he instead drove to his home in Pennsylvania and committed suicide by hanging.
After the parties had waived the mandatory arbitration provided by Maryland law, Farwell filed this diversity action in federal district court in Maryland. She alleged that Dr. Briggs' care from January 1986 through June 9, 1986, and Dr. Un's care on June 9 was negligent and that the negligence of the two doctors was the proximate cause of her husband's death. The gravamen of the Farwells' complaint is that the defendants should have committed decedent involuntarily or at least taken steps to ensure that he would present at the hospital for voluntary admission. Both defendants moved for summary judgment, and the district court granted the motions on the parties' written submissions.
The court first ruled that under Maryland's choice of law rules, it would apply the law of the place where the alleged medical negligence occurred, that is, the law of Maryland (Dr. Briggs) and the law of Delaware (Dr. Un), rather than the law of Pennsylvania where death occurred. The court recognized that Maryland follows the traditional doctrine of lex loci delicti for choice of law questions in tort actions, but because other states have ruled that suicide constitutes an intervening and superseding cause relieving the treating physician from liability, and because "common sense" mandated that a physician's actions be evaluated under the law of the state in which he practices, the court applied the substantive law of Maryland to Dr. Briggs and the law of Delaware to Dr. Un.
The principal factual contention involved decedent's willingness voluntarily to enter the V.A. hospital for treatment. In the summary judgment record before the district court were the depositions of Farwell, Dr. Briggs, and several experts. 2 Farwell deposed regarding the office visit with Dr. Un:
Q. What happened while you were talking to Dr. [Un] by yourself?
* * * * * *
A. I just wanted Brian to be put in the hospital for treatment and evaluation. And I felt that he would not go by himself, he had shown that the week before. And I felt that he should be involuntarily committed to be treated and helped. And I put this--I said this to Doctor Un, and Doctor Un said that he would not involuntarily commit Brian which was a great shock to me.
* * * * * *
Q. Why did you want your husband involuntarily admitted at the time?
A. Because he would not go voluntarily, he refused. And I really felt he needed help more than he was getting.
She also testified, however, that an agreement was reached at Dr. Un's office to have decedent go to the V.A. hospital at Perry Point, Maryland. Farwell further admitted that decedent told Dr. Briggs at his office the same day he saw Dr. Un that he would go to the hospital. She attempted to undermine the relevance of decedent's agreement at Dr. Briggs' office through expert opinion evidence that Dr. Briggs should have known not to believe decedent because just one week earlier he had indicated he would enter the hospital voluntarily and did not present for admission. Critically, however, the experts agreed that decedent was competent and not psychotic at the time he agreed to voluntary admission.
The district court found that there was "no genuine dispute" that decedent agreed to voluntary hospitalization. The court discounted Farwell's deposition testimony that her husband had refused, while in Dr. Un's office, to accept voluntary admission. The court noted decedent's agreement in Dr. Briggs' office, the acknowledged choice of the V.A. hospital in Dr. Un's office, the separate conversation between decedent and Dr. Un, and Dr. Un's referral to Dr. Briggs so that Dr. Briggs could confirm the hospitalization. This ruling was the linchpin of the court's principal ground for granting summary judgment, because it found that under the relevant statutes in Maryland and Delaware, decedent could not be involuntarily committed if he voluntarily agreed to be hospitalized. See Md. [Health-Gen.] Code Ann. Sec. 10-617 (1990) (); Del.Code Ann. title 16, Sec. 5003 (1988) (). After this legal ruling, the court assumed that it need not consider expert testimony from Farwell's witnesses that the standard of care required the defendants to seek involuntary commitment of decedent.
The court also held that the plaintiffs' forecast of evidence failed to permit the inference that Dr. Briggs' care during the January-May 1986 period was the proximate cause of decedent's suicide. In plaintiffs' answers to interrogatories, six experts were listed as having the opinion that Dr. Briggs failed to meet the standard of care and that this failure was the proximate cause of decedent's suicide, but no dates were specified. Three of plaintiffs' experts, in depositions before the court, opined that Dr. Briggs did not meet the standard of care, but again treatment during the...
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