Lavoie v. Manoharan
| Decision Date | 27 November 2019 |
| Docket Number | CV146027376 |
| Parties | Heather Lavoie, Admin’x et al. v. Nachiyappan Manoharan, M.D. et al. |
| Court | Connecticut Superior Court |
UNPUBLISHED OPINION
Judge (with first initial, no space for Sullivan, Dorsey, and Walsh): Shortall, Joseph M., J.T.R.
On the afternoon of October 28, 2012 Michael Lavoie attempted suicide by ingesting large quantities of alcohol and medication. His attempt was unsuccessful, but it left him in a comatose state that led to his hospitalization at the defendant Bristol Hospital (hospital), first in the emergency department and then in the intensive care unit. Mr. Lavoie’s attempt followed his wife Heather’s having told him that she would be seeing a lawyer, with a view toward dissolution of their marriage.
Mr Lavoie continued to be an in-patient at the hospital on October 29, sometimes in restraints and under sedation made necessary by his insistence on leaving the hospital and his resistance to hospital staff’s efforts to calm him and to persuade him that it was necessary for him to stay until he had been evaluated by a psychiatrist. That psychiatric evaluation, with the defendant Nachiyappan Manoharan, M.D. took place on the morning of October 30, 2012. After the evaluation was completed and Mr. Lavoie had promised to call the doctor’s office that afternoon to schedule an appointment, Dr. Manoharan approved Mr. Lavoie’s discharge by the hospital. He was discharged at or about noon on October 30, 2012.
Late that afternoon Mr. Lavoie took his own life.[1]
These facts are undisputed. The defendants have moved for summary judgment[2] pursuant to Practice Book § 17-44 which authorizes the court to enter judgment for the moving party "if the pleadings, affidavits and any other proof submitted show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law."
The defendants seek summary judgment on two grounds. First, they claim that Dr. Manoharan "did not owe the decedent a duty of care to involuntarily commit him to the hospital." Second, the plaintiffs are "unable to raise a genuine issue of material fact that the alleged failure to involuntarily hospitalize the decedent would have prevented his suicide after his eventual discharge from the hospital."
(Internal quotation marks omitted.) Sherman v. Ronco, 294 Conn. 548, 553-54, 985 A.2d 1042 (2010).
(Citations omitted; internal quotation marks omitted.) Michaud v. Gurney, 168 Conn. 431, 434, 362 A.2d 857 (1975). "The existence of a duty is a question of law and only if such a duty is found to exist does the trier of fact then determine whether the defendant violated that duty in the particular situation at hand." (Internal quotation marks omitted.) Neuhaus v. Decholnoky, 280 Conn. 190, 217, 905 A.2d 1135 (2006).
Ramirez v. Health Net of the Northeast, Inc., 285 Conn. 1, 10-11, 938 A.2d 576 (2008).
"Duty is a legal conclusion about relationships between individuals, made after the fact, and imperative to a negligence cause of action." Ryan Transport, Inc. v M&G Assoc., 266 Conn. 520, 525 (2003). "The issue of whether a defendant owes a duty of care is an appropriate matter for summary judgment because the question is one of law." Pion v. Southern New England Telephone Co., 44 Conn.App. 657, 660 (1997). "If a court determines, as a matter of law, that a defendant owes no duty to a plaintiff, the plaintiff cannot recover in negligence from the defendant." (Citation and internal quotation marks omitted.) Mozeleski v. Thomas, 76 Conn.App. 287, 290-91 (2003).
There are two independent components to the decision whether a legal duty exists. The court must determine "whether an ordinary person in the defendant’s position, knowing what the defendant knew or should have known, would anticipate that harm of the general nature of that suffered was likely to result." Mendillo v. Board of Education, 246 Conn. 456, 483 (1998). This is known as the foreseeability prong of the test for existence of a legal duty. Separately, the court must also determine "on the basis of a public policy analysis, ... whether the defendant’s responsibility for ... negligent conduct should extend to the particular consequences or the particular plaintiff in the case ..." Gazo v. Stamford, 255 Conn. 245, 250 (2001). The defendants explicitly eschew reliance on a foreseeability analysis. "Rather, the motion is based on the public policy prong of the duty inquiry." Reply Brief of Defendants, 6 n.3 (July 24, 2019) (defendants’ reply).
Thus far, the defendants’ duty argument is unexceptionable. But, in applying these principles to the plaintiffs’ claims, as articulated in the operative complaint,[3] the defendants set up a straw man of an argument and proceed to attack it. That is to say, the defendants claim that "the sole basis for plaintiff’s negligence action is that Dr. Manoharan should have involuntarily committed Michael pursuant to [General Statutes] § 17a-502(a)"; [4] Memorandum of Law in Support of Motion for Summary Judgment, 15 (May 8, 2019) (defendants’ memorandum); when an examination of the complaint demonstrates that is not the case.
Defendants make a strong public policy case against finding a duty on the part of Dr. Manoharan to commit Mr. Lavoie involuntarily. There is a well-established right on the part of legally competent patients to refuse medical treatment even when it is likely that death will occur in its absence, a right that has been recognized by the appellate courts of this state. See McConnell v. Beverly Enterprises-Connecticut, 209 Conn. 692, 701 (1989); Stamford Hospital v. Vega, 236 Conn. 646, 665-66 (1996); Wood v. Rutherford, 187 Conn.App. 61, 82 (2019). Add to that the near-impossibility of predicting future dangerousness, either to oneself or to another, a factor recognized by the expert physicians designated by the plaintiffs; see, e.g., defendants’ memorandum, exhibit H, transcript of Dr. Mack’s deposition of 2.4.2019, 298-99; and the case becomes stronger still. This court, however, is not required to decide, and does not decide, whether or not Dr. Manoharan had a duty to commit Mr. Lavoie involuntarily because the operative complaint alleges professional negligence in many other particulars.
The court begins with the premise that Dr. Manoharan’s duty to Mr. Lavoie was no different than that of any other health care provider, i.e., the duty prescribed by General Statutes § 52-184c(a):
In any civil action to recover damages resulting from personal injury or wrongful death ... in which it is alleged that such injury or death resulted from the negligence of a health care provider ... the claimant shall have the burden of proving by the preponderance of the evidence that the alleged actions of the health care provider represented a breach of the prevailing professional standard of care for that health care provider. The prevailing professional standard of care for a given health care provider shall be that level of care, skill and treatment which, in light of all relevant surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similar health care providers.
The first of the specifications of negligence, the one on which the defendants focus all their attention, is that Dr. Manoharan "failed to admit or commit Michael Lavoie to an inpatient facility for appropriate psychiatric and medical evaluation, counseling, and treatment to ensure that he was not discharged when he was a high suicide risk." Summary judgment is not authorized on part of a claim, however, and there are nine additional specifications of negligence stating claims that cannot be resolved on a motion for summary judgment.[5] Dr. Manoharan, it is alleged:
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