Johnson v. Grant Hospital

• Decision Date: 15 December 1972
• Docket Number: No. 72-288,72-288
• Citation: 291 N.E.2d 440,32 Ohio St.2d 169,61 O.O.2d 413
• Parties: , 60 A.L.R.3d 871, 61 O.O.2d 413 JOHNSON, Admr., Appellee, v. GRANT HOSPITAL, Appellant.
• Court: Ohio Supreme Court

Page 169

32 Ohio St.2d 169

291 N.E.2d 440, 60 A.L.R.3d 871, 61 O.O.2d 413

JOHNSON, Admr., Appellee, v. GRANT HOSPITAL, Appellant.

No. 72-288.

Supreme Court of Ohio.

Dec. 15, 1972.

Syllabus by the Court

A hospital owes a duty to its patients to exercise such reasonable care for their safety as their known mental and physical condition may require; however, a general hospital is not liable for the death of a patient who voluntarily jumps from a hospital window, where the hospital staff provides the protective measures directed by the attending physician to prevent such act of self-destruction.

Plaintiff-appellee, Irvin R. Johnson, administrator of the estate of Mildred Johnson, deceased, brought an action for wrongful death against defendant-appellant, Grant Hospital, alleging in his petition that:

'3. On the 27th day of May, 1968, defendant undertook for good and valuable consideration to keep and provide safely and carefully for the custody and maintenance of plaintiff's decedent at and upon the premises of the defendant as hereinbefore described and to provide the plaintiff's decedent with treatment and care for illness diagnosed as schizophrenic reaction or acute anxiety reaction.

'4. Upon admission to defendant's hospital, defendant knew, or in the exercise of ordinary care should have known, plaintiff was depressed, delusional and despondent with memory lapses. Following the admission of plaintiff's decedent to defendant's hospital, plaintiff's decedent became increasingly depressed, disturbed and delusional, all of which was known to the defendant. At approximately 9:00 p. m. on May 31, 1968, plaintiff's decedent attempted to leap from the window of her room on the 9th floor of defendant's hospital and at approximately 10:00 p. m. on May 31, 1968 attempted to leap from another room on the 9th floor of defendant's hospital, all of which was observed by and known to defendant hospital. Plaintiff was thereafter placed by defendant hospital in a security room in defendant hospital.

'5. On the following morning, June 1, 1968, plaintiff's decedent left her security room and made her way to the 9th floor solarium room where she jumped from the window to the ground, causing her death.'

At trial, the deceased's attending physician testified as follows:

'Q. Doctor, does the term mentally ill lend itself to a specific mental definition that would have any application to this lady's case?

'A. In a concise concept of being mentally ill, she does not fit. She fits the emotionally disturbed category.

'* * *

'Q. * * * Can you say whether or not with medical certainty-reasonable medical certainty that this lady was or was not mentally ill, insane or deranged at the time she took her life?

'A. She was not mentally ill, deranged or insane at the time she took her life is my concept for this reason: I had a conversation with Mrs. Johnson approximately four or five hours prior to her demise, and she was very clear, concise, rational, and went along with my recommendation for her to wait till I saw her in the morning, then we will make some changes, et cetera. I have four notes that Mrs. Johnson wrote which were written deliberately and carefully and in excellant language and thinking clear thoughts which is not the pattern of a schizophrenic or a person that is deranged. The letters she wrote were evidently why she had planned to take her life sometime that morning, whenever it was, but I am saying that the contents of these notes were so precise and in excellent language and thought plus what I have spoken to her four to five hours prior to that, in no way indicate her to be deranged.

'Q. * * * you just mentioned that you talked with her four or five hours before she took her life. How did this conversation take place? * * *

'A. This was telephone. It originated when Mrs. Johnson called me from her room. She was upset over my asking them to have her locked in for the night, and I received a call from the family, she was disturbed at my having done this, and then shortly after, Mrs. Johnson herself called me and I spoke to her at length and told her that tomorrow we will make some changes and she was quiet-her anger became subdued and we spoke rationally like we always do after we get in conversation, and I felt then that she had remained in good contact.

'Q. Did you indicate in that answer, Doctor, that members of the family had also complained about the locked door?

'A. Yes.

'Q. That evening?

'A. Yes, sir.

'Q. The question of whether or not the door would be locked, did you consider this a medical question within your control?

'A. Yes. I am so responsible for the ordering whether the door is locked or not since I am in charge of the patient's care.

'Q. * * * This is a medically important decision in regard to handling this kind of patient?

'A. Yes, I think it is. The judgment of the physician if he feels his patient may be a particular problem to the nurses and personnel in the ward, or the patient may be unpredictable at a specific time, or three, if the patient is emotionally disturbed and may cause problems to the other patients on the floor, or five, if the patient himself needs to be isolated from others. There are a variety of things that go into a decision like this by the attending physician.

'Q. At the time you made that decision, Doctor, were you in a position to know all of the facts and circumstances of your patient's case?

'A. Yes, I think the nurse and supervisor in charge had briefed me on the patient. * * *

'Q. Doctor, you do have the hospital chart before you, do you not. * * *

'A. These are the physician's orders * * *.

'Q. * * * May 31, 1968, it says, 'Lock door at night.' Was that an order you gave?

'A. Yes. That is a telephone order I gave to the nurse in charge the night of the 31st.

'Q. The order right above that says, would you read the order right above.

'A. I earlier said, 'Please transfer to security room, however, leave door open.'

'Q. So the position of the door either open or closed was a very conscious problem in your opinion?

'A. Yes, sir, in my opinion, yes, sir.

'Q. Now, the 'lock door at night,' Doctor, would you explain what that order means as far as the following morning is concerned, whether the door was to be opened or closed.

'A. It meant that the door was to be opened in the morning at 8:00 o'clock. This is in keeping with hospital practices that activity started at 8:00 o'clock in the morning for the patient, so from 12:00 to 8:00 when we say, 'Lock at night,' is what we are speaking about.

'* * *

'Q. So if A.M. care was given at 5 minutes to 8:00, that wouldn't make it wrong under your order?

'A. No.

'Q. Or at 7:30?

'A. No.

'* * *

'Q. In the course of your conversation you had with the patient, wasn't her family-the night before there was a specific reference by them, an objection, to this locked door, is that not true?

'A. Yes, sir.

'Q. And you at that time assured them that the door would be opened the next morning?

'A. That's correct.

'Q. Now, under all the circumstances, Doctor, would you expect the nurses to overrule your judgment on whether that door should be locked or unlocked?

'A. In hospital practice or medical practice the nurses only act on specific orders given by the attending physician.

'Q. Doctor, in further keeping with the open door question, permitting the door to be opened, you would anticipate that possibly the patient would walk out into the hall, would you not?

'A. Yes, sir.

'Q. This was permissible as far as you were concerned?

'A. Yes, sir.

'Q. You do not imply or tell the hospital even though the door is open, keep her in her room?

'A. No. Once we open her door, it is meant that the patient has the freedom to walk in the aisle or walk in the corridors.

'Q. Again, Doctor, in keeping with your total knowledge and treatment of this patient, you never contemplated or ordered that the hospital stand guard over this patient as though she were being confined, did you?

'A. No.

'* * *

'Q. Is it not true, Doctor, that she was in fact admitted to Grant Hospital on your service because of her physical problems, not her mental problem?

'A. Yes, sir.

'Q. In the course of your practice as a psychiatric specialist, Doctor, do you have occasion to admit patients to other than general hospitals?

'A. Yes, sir.

'Q. Where would that be?

'A. That would be Upham Hall at University or Harding Hospital or to the State Hospital or to Mt. Carmel.

'Q. Is this where you would put a patient that you considered to be deranged or insane?

'* * *

'Q. In one of these other hospitals instead of in Grant?

'A. Yes, sir.

'Q. In your professional opinion and in your experience does Grant hold itself out as a hospital for the treatment of insane or deranged or mentally ill patients?

'A. No. The policy of Grant and the same is true of other hospitals in our area are general hospitals and it is felt that the patients who have psychiatric problems would not be admitted. Arrangements are made if necessary before admission to elsewhere. If they become disturbed within the confines of the hospital, they are transferred to a psychiatric setting.

'Q. As a matter of fact, Doctor, isn't it a well known fact within the medical profession that Grant Hospital and these other hospitals for that matter are not equipped to take care of mentally ill and insane patients?

'A. You are asking me my concept of the hospitals, they usually serve the total needs of the patient in general. They do not have facilities for the person that is deranged.

'* * *

'Q. Doctor, in your professional opinion did the Grant Hospital nursing staff follow your orders to the letter?

'A. Yes, it did.

'Q. Again in your professional opinion and based on your total knowledge of this case, did the Grant nursing staff violate any of its duties to your patient, Mrs. Johnson?

'A. No, they did not.'

At the conclusion of plaintiff's case, the trial court grant...