Lockhart v. County of Los Angeles

• Decision Date: 27 August 2007
• Docket Number: No. B188674.,B188674.
• Citation: 66 Cal.Rptr.3d 62,155 Cal.App.4th 289
• Court: California Court of Appeals Court of Appeals
• Parties: Timothy LOCKHART, Jr., Plaintiff and Appellant, v. COUNTY OF LOS ANGELES, et al., Defendants and Respondents.

66 Cal.Rptr.3d 62

155 Cal.App.4th 289

Timothy LOCKHART, Jr., Plaintiff and Appellant, v. COUNTY OF LOS ANGELES, et al., Defendants and Respondents.

No. B188674.

Court of Appeal, Second District, Division 3.

August 27, 2007.

As Modified September 19 and October 4, 2007.

Law Offices of Kuhn & Belz, David L. Belz and Mary Luetto Nichols for Plaintiff and Appellant.

Monroy, Averbuck & Gysler and Jon F. Monroy, Westlaw Village; Pollak, Vida & Fisher, Daniel P. Barer and Anna L. Birenbaum, Los Angeles, for Defendants and Respondents.

CROSKEY, J.

Government Code section 854.8 provides immunity to public entities for injuries to inpatients of mental institutions. Government Code section 855 creates an exception to this liability for injuries "proximately caused by the failure of the public entity to provide adequate or sufficient equipment, personnel or facilities required by any statute or any regulation of the State Department of Health Services,¹ Social Services, Developmental Services, or Mental Health prescribing minimum standards for equipment, personnel or facilities...." In this case, we consider which statutes and regulations are sufficient to trigger liability under Government Code section 855. Specifically, we conclude that only statutes and regulations promulgated by the described departments are sufficient; County regulations, federal Medicare regulations, and Joint Commission on Accreditation of Healthcare Organization ("JCHO") standards are insufficient bases for liability under Government Code section 855. Moreover, we conclude that only statutes and regulations which "prescrib[e] minimum standards" for equipment, personnel or facilities can create liability; regulations that simply require "sufficient" equipment, personnel or facilities are too broad to fit within the narrow immunity exception of Government Code section 855.

Plaintiff and appellant Timothy Lockhart, Jr. appeals from a summary judgment entered in favor of defendant and respondent County of Los Angeles ("County") in this action for the wrongful death of Timothy Lockhart, Sr. ("decedent"), arising out of decedent's suicide while a patient at County's Augustus F. Hawkins Comprehensive Community Mental Health Center ("Hawkins"). We conclude plaintiffs complaint is barred by statutory immunity, and therefore affirm.

FACTUAL AND PROCEDURAL BACKGROUND

Hawkins is an inpatient mental health care facility. It is not separately licensed as an acute psychiatric hospital (see Health & Saf.Code, § 1250, subd. (b)), but is the psychiatric unit at the Martin Luther King Jr./Charles R. Drew Medical Center ("King/Drew"). King/Drew is licensed as a "general acute care hospital."

On November 14, 2002, decedent was admitted to Hawkins as an inpatient pursuant to Welfare and Institutions Code section 5150, based on a determination that he was a danger to himself based on a history of suicide attempts.²

Decedent underwent a psychiatric evaluation at Hawkins and was admitted as an inpatient for further treatment and evaluation. He was placed on "Level 1 Suicide Prevention Protocol," which required patient checks every 15 minutes. This required the least level of supervision of the three suicide prevention protocols in use at Hawkins. On November 17, 2002, medical staff applied for a further 14-day involuntary psychiatric hold on decedent.

Decedent was housed in Ward B at Hawkins, sharing a four-bedded room with three other patients. On November 18, 2002, between 5:30 and 5:45 a.m., decedent was observed by staff to be out of bed and pacing around the room. Sometime after 6:00 a.m., decedent, locked himself in the bathroom in his shared patient room and hanged himself with some blankets. When nursing staff knocked on the bathroom door and received no answer, they spotted a piece of bed linen tied in a knot protruding from the top of the bathroom door. They feared another suicide attempt. Nursing staff attempted unsuccessfully to open the bathroom door. However, they did manage to cut through the knot at the top of the door. When the knot unraveled, the fabric slipped back into the bathroom, and a sound was heard from within.

A call was placed to the Los Angeles County Sheriffs Department. The Sheriffs Department has a station at King/Drew and has officers at King/Drew at all times.³ Sergeant David Johnson looked at the bathroom doorknob, and recognized it to be a "privacy lock," possessing a safety release which could easily be opened with any small item with a straight edge, such as a flathead screwdriver, a coin, or the rounded portion of any key. Sergeant Johnson opened the lock with the back of a car key. The bathroom door opened a few inches inward, and decedent was discovered with his head hanging approximately one foot above the floor by strips of blanket tied around the inside doorknob. Sergeant Johnson used his knife to cut through the makeshift rope. As he slowly opened the door, decedent then slid down to the ground on his back.

Decedent was not breathing and did not have a pulse. The nursing staff started CPR and called a `Code Blue." The crash cart was stored in the "clean utility room" in Ward B. The crash cart was brought into the room approximately one minute after the code was called. Decedent "did show a small trace* of a heartbeat on the EKG." He was then taken to the emergency room. He was pronounced dead in the emergency room at 6:39 a.m.

1. Allegations of the Complaint

On February 6, 2004, plaintiff filed the complaint⁴ in this action, alleging a single cause of action for wrongful death. Factually, the complaint implies the bathroom door in decedent's room required a key to unlock;⁵ all of the evidence in the case subsequently revealed that this was not the case. Legally, the complaint overlooks the broad governmental immunity for injury to inpatients of mental institutions provided by Government Code section 845.8, and makes no attempt to plead a specific exception to the immunity. Instead, the complaint seeks relief for simple negligence. Specifically, plaintiff alleged that County "negligently failed to adequately manage and treat [decedent], who had a known history of attempted suicide, and committed the following negligent acts and/or omissions, among other negligent acts and/or omissions: Failed to adequately supervise [decedent], while an impatient at [Hawkins]; negligently performed a suicide watch on [decedent]; negligently allowed [decedent] to have access to potential instruments for suicide, including bed sheets and blankets; negligently allowed [decedent] to leave his assigned bed without assistance or supervision when [decedent] was on suicide watch; negligently allowed [decedent] access to a bathroom with a locking device when [decedent] was on suicide watch; negligently failed to have a key to the bathroom lock available to its employees and personnel; failed to have adequate policies and procedures for suicide watch and prevention; failed to have adequate protocol for suicide watch and prevention; failed to have adequate protocol and emergency procedures for a patient locking himself into a bathroom, including failure to have a key or other unlocking mechanism available to its agents and employees; failed to identify and institute adequate suicide watch and prevention; and failed to adequately train its agents and employees in suicide watch and prevention, among other failures."⁶ In contrast to arguments plaintiff would subsequently make, plaintiff did not allege in his complaint that Hawkins had insufficient nurses or psychiatrists on staff at the time of decedent's death, or that the crash cart had been stored too far away from decedent's room.

Similarly, on July 8, 2004, plaintiff served answers to interrogatories. When asked to identify all facts on which he based his contention that County was negligent in decedent's care, plaintiff did not identify insufficient staffing, or a poor location of the crash cart. Plaintiff instead focused on his allegations that decedent had not been placed on a more restrictive suicide prevention level, and that the nursing staff had not complied with the 15-minute checks required by the suicide prevention level on which he had been placed. As to the issue of the lock on the bathroom door, plaintiff stated as follows: "Several members of the hospital staff attempted to unlock the door of the restroom, but failed to do so. Yet when the police officer, Sergeant Johnson, arrived on the scene he was able to unlock the door with ease, reporting that the lock on the door has a safety release mechanism that does not require a key. Plaintiff believes that the members of the hospital staff should have been aware of this, or should have had a key to the door." (Italics added.) Notably, plaintiff did not assert negligence in the fact that the door had a privacy lock on it.

2. County's Motion for Summary Judgment

On November 12, 2004, County moved for summary judgment on the basis of the absolute immunity provided by Government Code section 854.8. Additionally, County argued that its employees acted at all times within the standard of care.

3. Plaintiffs Initial Opposition

On August 25, 2005, plaintiff filed his first opposition to the summary judgment motion. As to the issue of standard of care, plaintiff introduced expert affidavits indicating County's doctors and nurses had acted below the standard of care. County effectively conceded that plaintiffs evidence raised a triable issue of fact on this issue, and it was not a basis on which the trial court subsequently granted summary judgment.

In opposition to the assertion of immunity, plaintiff conceded that Hawkins "is the type of facility set forth in the immunity statute."⁷ However, plaintiff asserted that the exception to immunity set forth in Government Code section 855, subdivision (a) applied. That subdivision provides as follows: "A public entity that operates or maintains any medical facility that is subject...