Hunt v. King County

• Decision Date: 04 January 1971
• Docket Number: No. 360--41053--I,360--41053--I
• Citation: 481 P.2d 593,4 Wn.App. 14
• Parties: Jerome B. HUNT, a minor, by and through his Guardian ad litem, German B. Hunt, Respondents, v. KING COUNTY, a legal subdivision of the State of Washington, Appellant.
• Court: Washington Court of Appeals

Page 14

4 Wn.App. 14

481 P.2d 593

Jerome B. HUNT, a minor, by and through his Guardian ad

litem, German B. Hunt, Respondents,

v.

KING COUNTY, a legal subdivision of the State of Washington,

Appellant.

No. 360--41053--I.

Court of Appeals of Washington, Division 1,

Panel Two.

Jan. 4, 1971.

As Modified on Denial of Rehearing Feb. 22, 1971.

Review Denied March 25, 1971.

Williams, Lanza, Kastner & Gibbs, Joseph J. Lanza, Seattle, for appellant.

Kumm, Maxwell, Petersen & Lee, Raymond J. Petersen, Seattle, for respondents.

HOROWITZ, Acting Chief Judge.

Plaintiff, German B. Hunt, individually and as guardian ad litem for his minor son, Jerome B. Hunt, brought a negligence action against the defendant for damages resulting from defendant's failure to safeguard the minor son from self-inflicted injuries while a hospital patient. The case was tried to a jury. The trial court overruled defendant's challenge to the sufficiency of the evidence and defendant elected to stand on its challenge. Later, after verdict for plaintiffs, the court denied defendant's motion for judgment notwithstanding the verdict and for a new trial. Defendant appeals.

The facts viewed from the standpoint most favorable to the plaintiffs (Holland v. Columbia Irrigation Dist., 75 Wash.2d 302, 450 P.2d 488 (1969)) are these:

Defendant operates a public hospital in Seattle, Washington known as the Harborview Hospital. The hospital contains a closed psychiatric ward on the fifth floor of the hospital building. The ward is operated for short term treatment of patients having acute psychiatric and emotional problems in varying degrees of seriousness pending the formulation of a planned approach for further care. In that connection, the hospital makes a preliminary diagnosis of a patient's propensity for escape, suicide or self-inflicted injuries, and takes precautions to prevent escapes by patients and resulting injuries therefrom.

The psychiatric ward is a self-contained unit accessible from the fifth floor lobby through a main door which is kept locked at all times. Access to the ward is had only through an attendant on duty. The ward has various rooms fronting on a hallway going down the middle of the ward. One of the rooms is the utility room here involved which contains a refrigerator, sink and cabinets for medical supplies. The doors to the patients' rooms are not generally locked but such rooms have metal screens on the windows in order to prevent outside access. Patients, unless restrained, are permitted to roam in and out of their rooms within the closed ward and thus have access to certain rooms with unlocked doors. Various rooms, including the utility room, have no screening on the windows so that outside access through the windows is possible. It is therefore necessary to keep the doors to such rooms locked. The door to the utility room is of the 'Dutch' type in two sections with a counter superimposed on the lower half. Each section has a separate lock. There was a hospital rule requiring nurses, orderlies and the medical staff to keep the utility room door locked at all times. At times, hospital personnel neglected to keep the door to the utility room locked, but when the neglect was discovered efforts were made to enforce the rule.

About 2:50 a.m. on July 7, 1967, plaintiff Jerome, then approximately 20 years of age, was admitted to the hospital as a patient. He had been forcibly taken to the hospital by ambulance with police assistance and arrived with handcuffs on his wrists and ankles, and a belt around his knees. At the time of his admission, the hospital was informed of much of his prior medical history, including the use of drugs and the events of the evening of July 6 which caused him to be taken to the hospital.

On the evening of July 6, Jerome's father first took Jerome to the University Hospital where in May and June of 1967 he had been previously treated for his drug problem over a period of 18 days. The hospital, however, had refused to admit the boy on the evening of July 6 because it was not equipped to handle him. The Harborview Hospital was recommended. The boy refused to go and returned to his parents' home. He was very angry. He locked himself in the basement of the home and demolished the basement contents with a pick. These actions caused him to be taken to the hospital in the manner described.

Dr. Wilson, assigned to the patient, received additional history from the father. The hospital chart notes that:

Patient initially agreed to re-enter night of admission here after being hyperactive and irrational at home the same evening, but then ran away, returned home and tried to destroy house with a hatchet. Had to be subdued by police with tear gas and force. Father believes he may have been on Methedrine again, although he was never this belligerent in the past.

When the patient was admitted to the hospital, plaintiff father informed Dr. Wilson that he thought his son was taking amphetamines and that his son 'was going to try every trick he could to get out of that hospital.' Dr. Wilson assured plaintiff and his wife that the son would be 'under lock and key and would remain that way until something was figured out.' Defendant by its answer admitted that the son was accepted at the hospital 'while he was suffering from emotional and mental disorder' and 'during the period in which the plaintiff was in the psychiatric ward, he exhibited signs of a mentally disturbed person, requiring sedation therefor * * *'

After admission to the closed psychiatric ward of the hospital, a hospital chart was kept by nurses, orderlies and hospital doctors concerning the patient's condition. They were required to keep currently familiar with the chart. The first entry showed that at the time Jerome was admitted he was 'incoherent, dillusional, hallucinating * * *' would 'not answer questions' and was 'threshing about making homicidal threats.' It was noted that he had a history of amphetamine and withdrawal trips, and that he had been '(s)een by a psychiatrist in the past.' He was sent to the psychiatric ward 'agitated' and 'in restraints.' On July 7, at 5:30 a.m., one of the hospital doctors of the pshchiatric service made the diagnosis of 'acute schizophrenic break.' Later that morning Dr. Wilson noted the previous hospitalization at University Hospital for amphetamine withdrawal, the multiple abrasions and lacerations, that he was not oriented to time and place, was 'dulled,' and his impression of 'schizrophrenic reaction, acute, undifferentiated.'

There was evidence that during his stay, on one occasion, the patient had again been placed in restraint. The patient's condition apparently improved somewhat until we come to July 10. The last entry made prior to Jerome's escape was made by orderly Ward and stated that the patient was more cooperative, but '(s)till somewhat difficult to work with or get along with.' Mr. Bell, a family friend, who visited the patient on July 10, was present immediately before the patient jumped and sustained his injuries. It was his impression that Jerome was dangerous and that he still lacked 'the sensibilities you would consider normal. He had a look in his eyes that would scare you.'

Mr. Bell testified that he and the patient walked together in the hall of the psychiatric ward and both reached the door leading to the utility room. He did not know that Jerome had earlier decided to escape through the utility room at the first opportunity. Mr. Bell had temporarily turned his back when suddenly the patient opened the door to the utility room, got out through the window of that room and jumped to the ground floor five stories below. When Mr. Bell turned around and saw that the patient had gotten into the utility room he immediately called the orderly, Mr. Distad. Mr. Distad arrived too late to prevent the escape.

Following the fall, hospital personnel reached the patient on the ground. the evening supervisor noted on the patient's chart that the patient 'was hostile, very belligerent, cursing, spitting, very resistive to any assistance' and 'very conscious.' The examining physician in the hospital emergency room noted that the patient appeared to be 'psychotic' and 'suicidal' and should be 'restrained in the orthopedic ward.' The nurses' chart entry on July 11 noted the boy's irrational behavior and the resident physician who again examined the patient on that day recorded 'still psychotic * * * He is actively suicidal and should be treated accordingly.' He was removed to an orthopedic ward and kept under restraint.

Defendant contends that the plaintiff son's conduct was volitional and responsible and therefore the proximate cause of his own injuries and that the son was also guilty of contributory negligence as a matter of law; that accordingly, the court erred in refusing to sustain defendant's challenge of the sufficiency of the evidence and in refusing to grant judgment notwithstanding the verdict. In our opinion, these contentions cannot be upheld.

It is difficult to distinguish between the scope of the duty owed by the hospital to the patient and the doctrine of proximate cause. It has been pointed out that the failure to distinguish between the two concepts may lead to an incorrect analysis and disposition of the issues involved. W. Prosser, Torts, § 49 (3d ed. 1964). The rule concerning the scope of the duty owed by a hospital to its patient is summarized in Annot., 70 A.L.R.2d 347, 348 (1960) as follows:

The ordinary rule that the duty of a hospital toward its patients is to exercise such reasonable care for their safety as their known mental and physical condition may require, and that in a proper case this duty may extend to affording reasonable protection against self-inflicted injury, has frequently been recognized in actions for injury or death to a patient alleged to have resulted from his escape or attempted escape.

(Footnote omitted.) Washington follows the...