In re A.B., 011019 MDSCA, 1680-2017

Docket Nº:1680-2017
Opinion Judge:REED, J.
Party Name:IN RE: A.B.
Judge Panel:Reed, Friedman, Alpert, Paul S., (Senior Judge, Specially Assigned), JJ.
Case Date:January 10, 2019
Court:Court of Special Appeals of Maryland


No. 1680-2017

Court of Special Appeals of Maryland

January 10, 2019

Circuit Court for Carroll County Case No. 06-C-16-072378

Reed, Friedman, Alpert, Paul S., (Senior Judge, Specially Assigned), JJ.



After an administrative law judge ("ALJ") ordered the involuntary admission of A.B. ("Appellant") to a mental health hospital, Appellant petitioned for judicial review of that decision. See Md. Code, § 10-632(e), § 10-633 of the Health-General Article ("HG"); COMAR Because Appellant was discharged from the hospital, the Circuit Court for Carroll County dismissed her petition on the ground that it was moot. Appellant filed a timely appeal seeking reversal of the circuit court's decision to dismiss her petition for mootness.

For the foregoing reasons, we reverse the decision of the Circuit Court for Carroll County and remand for further proceedings consistent with this opinion.

Factual and Procedural Background

On September 15, 2016, following a physical altercation with the father of her son, Appellant was admitted to Springfield Hospital Center ("the Hospital") to determine her competency to stand trial on criminal charges. At a hearing on October 20, 2016, Appellant was given probation before judgment, conditioned on taking prescribed medications.

The previous day, in anticipation of that disposition of Appellant's criminal charges, the Maryland Department of Health ("the Department"), Appellee, asked the circuit court to extend Appellant's mental health hospitalization by issuing an order for involuntary admission, pursuant to Md. Code § 10-614 et seq. of the Health-General Article ("HG"). (E.923) At an October 27, 2016 hearing, Appellant's counsel asked for a postponement "because [Appellant] doesn't want a commitment on her record." Counsel proposed that Appellant continue her hospitalization without any commitment order, arguing that being hospitalized "as a non-committed patient for a week is certainly a less restrictive setting. It means that the stigma of insanity [or] of being a danger is not being attached." The court declined to postpone the hearing.

Dr. Katherine Cinnamon, Appellant's treating psychiatrist during her hospitalization, testified that Appellant had been diagnosed with an unspecified psychotic disorder, characterized by paranoia, guardedness, hallucinations, and impaired insight and judgment. She also testified that Appellant refused medications and denied her need for them. On October 12, 2016, Appellant was physically restrained when she became aggressive. As Appellant began taking medications more consistently in October, however, she improved and became compliant with staff.

Dr. Cinnamon testified that unless Appellant remained in the supervised mental health setting where she was making progress, she would likely "decompensate" by failing to take her medications. According to Dr. Cinnamon, Appellant was a danger to herself because if she were to be released, she would stop taking the antipsychotic and other medications treating her condition. When asked whether a one-week postponement might provide enough time to resolve her concerns, Dr. Cinnamon answered that she did not think Appellant's condition would improve significantly enough to be considered for release.

Appellant testified that she did not want to be "committed" because she had certifications to work as a nursing assistant and a pharmacy tech, she sought to volunteer at area churches, and she wanted joint custody of her son.

The ALJ found that Appellant was "in need of inpatient care treatment" because "[h]er comprehension, compliance, and cooperate with treatment at this point remains poor." The ALJ also stated that "[Appellant] needs constant supervision at this point to assure her compliance with medications and treatment[, ]" without which she "is a danger to herself based on her aggressive behavior just two weeks ago." [Id]. As such, the ALJ granted the Department's request for an involuntary admission. [Id].

On November 3, 2016, Appellant petitioned for judicial review of that commitment order in the Circuit Court for Carroll County. On January 4, 2017, she was released from the Hospital.

In a memorandum of law filed on June 8, 2017, Appellant challenged the ALJ's denial of her requests to postpone, arguing that postponement was a viable and less restrictive alternative to involuntary admission because it would have avoided the collateral consequences of the commitment. In addition, Appellant challenged the ALJ's findings that Appellant was a danger to herself and others.

The Department moved to dismiss Appellant's petition on the ground that her challenge was moot following her release from the Hospital. In opposition, Appellant argued that her petition for judicial review was not moot because she "has been stigmatized by the stigma of mental illness and dangerousness" and "there would be no meaningful Judicial Review of commitment hearings" given that "it is often the case that Patients are discharged prior to Judicial Review of the commitment hearing."

At a motion hearing on August 25, 2017, the parties argued both mootness and the merits of the ALJ's decision. The Department maintained that Appellant's discharge mooted her petition for judicial review because there was no longer any existing controversy nor could the court grant an effective remedy. The Department contended that the case did not fall within any of the recognized exceptions to the mootness doctrine and that Appellant was not stigmatized by her involuntary commitment because she already had a previous criminal commitment as well as an involuntary commitment in Virginia.

The circuit court granted the Department's motion to dismiss on mootness grounds without reaching the merits of Appellant's petition. In its Memorandum Opinion and Order, the court concluded that Appellant's petition for judicial review was mooted by her prior discharge, reasoning: Petitioner contends this matter satisfies the "recur frequently" exception positing that to declare this matter moot would man that all post-discharge commitments would be denied any meaningful remedy to address the "stigma" associated with their commitment. This Court disagrees. First, the record of the patient's inpatient commitment is, of course, subject to stringent confidentiality requirements safeguarded through HIPPAA. Second, to the extent HIPPAA's protections are wanting based upon, inter alia, the existence of a record in the Maryland Judiciary Casesearch, they may seek an Order shielding access to such file. Therefore, the Court concludes that no applicable exception to the general mootness doctrine is applicable to the facts of this case.

The circuit court relied on two unreported cases that involved "similar facts" and reached "[a] similar conclusion" regarding mootness. Quoting from an unreported decision of this Court, In re J.C.N., No. 1021, Sept. Term 2016 (filed Aug. 24, 2017), and citing "a similar" dismissal on mootness grounds by the Circuit Court for Howard County, In re [A.O.], No. 13-C-16-107773, the court concluded that there was no "effective remedy" following Appellant's discharge. The court acknowledged that this Court's decision in J.C.N. was not reported and that the decision in Howard County was "a nisi prius," but found "the facts of those cases to be analogous to those in the present matter" and that, "while not binding precedent," those decisions were "highly persuasive."


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