Maas v. UPMC Presbyterian Shadyside

• Decision Date: 21 July 2020
• Docket Number: No. 7 WAP 2019,7 WAP 2019
• Citation: 234 A.3d 427
• Court: Pennsylvania Supreme Court
• Parties: Laura L. MAAS, Administratrix of the Estate of Lisa Christine Maas, Deceased, Appellee v. UPMC PRESBYTERIAN SHADYSIDE d/b/a Western Psychiatric Institute and Clinic; Western Psychiatric Institute & Clinic; Michelle Barwell, M.D.; and Western Psychiatric Institute & Clinic Adult Community Treatment Team, Appellants

234 A.3d 427

Laura L. MAAS, Administratrix of the Estate of Lisa Christine Maas, Deceased, Appellee

v.UPMC PRESBYTERIAN SHADYSIDE d/b/a Western Psychiatric Institute and Clinic; Western Psychiatric Institute & Clinic; Michelle Barwell, M.D.; and Western Psychiatric Institute & Clinic Adult Community Treatment Team, Appellants

No. 7 WAP 2019

Supreme Court of Pennsylvania.

Argued: October 16, 2019

Decided: July 21, 2020

OPINION

JUSTICE DOUGHERTY

We consider the duty of mental health treatment providers to warn individuals who may be the subject of their patient's threats. In the present appeal, the mental health patient lived in a forty-unit apartment building and repeatedly told his doctors and therapists he would kill an unnamed "neighbor." Tragically, he ultimately carried out his threat, killing an individual who lived in his building, a few doors away from his own apartment. In subsequent wrongful death litigation filed by the victim's mother, the providers argued they had no duty to warn anyone about their patient's threats because he never expressly identified a specific victim. The trial court rejected this argument and denied the providers’ motion for summary judgment, allowing the case to proceed to trial. On appeal, the Superior Court agreed, and we now affirm.

I. Background

Prior to 2008, Terrance Andrews resided in a supported living facility under the supervision of and while receiving ongoing mental health treatment from appellants UPMC Presbyterian Shadyside d/b/a Western Psychiatric Institute and Clinic, Western Psychiatric Institute and Clinic ("WPIC"), the Western Psychiatric Institute and Clinic Adult Community Treatment Team ("CTT"), and Michelle Barwell, M.D. In January 2008, Andrews signed a one-year lease for an apartment on the fourth floor of Hampshire Hall in Pittsburgh.¹ This move was facilitated by appellants WPIC and CTT, who paid rent on Andrews's behalf out of his psychiatric disability benefits through a representative payee service. Andrews did not function well in the independent environment. His treatment notes indicate his living situation was a stressor, apparently due, in part, to his unpleasant interactions with Hampshire Hall neighbors and/or their guests. See Maas v. UPMC Presbyterian Shadyside , 192 A.3d 1139, 1142 (Pa. Super. 2018). Andrews repeatedly complained to appellants about his housing circumstances and asked to be returned to a supported living environment with caregivers on-site.²

Specifically, for a period of five months after moving into Hampshire Hall, Andrews frequently expressed to appellants suicidal and homicidal ideation, complaining about his "neighbors" and others, including threats to kill a "neighbor" who had been knocking at his door in the middle of the night. Id. He reportedly had several verbal run-ins with various neighbors, one of which resulted in his next-door neighbor's boyfriend hitting him with a baseball bat. On May 9, 2008, he again reported homicidal ideation against a "neighbor" to staff at WPIC's Department of Emergency Care, and a plan to stab the "neighbor" with scissors, but he was allowed to leave. Within 24 hours, Andrews returned to the Department of Emergency Care and expressed homicidal ideation against an unnamed "next-door" neighbor, and a brief voluntary hospitalization ensued. Id. Following discharge, on May 15, 2008, he again described a plan "to kill the next-door neighbor and everyone." Id. Andrews did not identify any neighbor by name and appellants took no measures to warn any residents of Hampshire Hall regarding these threats.³

On May 25, 2008, Andrews again sought an in-patient admission at WPIC, asserting he had not been taking his medication for three weeks, was hearing voices, and was having suicidal and homicidal thoughts. A case manager at that facility dissuaded him from seeking admission, and sent him home to his apartment with medication for agitation and a promise to secure him placement in a personal care home within 36 hours. Four days later, on May 29, 2008, Andrews murdered Lisa Maas, a nineteen-year-old Pennsylvania Culinary Institute student, by stabbing her to death with scissors in her apartment located five doors away from Andrews's own apartment on the fourth floor of Hampshire Hall. Andrews was arrested at the scene, telling officers, "Take me to jail. I did it[;]" and offered, "I told [a psychiatrist] to put me in Western Psych. I told them the medication wasn't working. I told people I was going to kill someone." Complaint, 8/23/12, at 12, ¶44-45; Police Report of Officer George Satler, 5/30/08 at 1. A jury subsequently convicted Andrews of murder and the trial court sentenced him to life imprisonment.

A.

Appellee Laura Maas, the victim's mother and administratrix of her estate, filed a wrongful death and survival action against appellants and others.⁴ Among other things, the complaint alleged: "At the time of his discharge from Mercy Behavioral on May 13, 2008, Mr. Andrews presented clear and present danger to all Hampshire Hall tenants, particularly those who resided on the same floor as Mr. Andrews." Complaint, 3/4/11, at 6 ¶24. The complaint additionally alleged appellants were negligent in "failing to recognize the likelihood that Mr. Andrews was a danger to people living in his apartment complex, in particular, to those people living on his floor;" id. at 8 ¶31(j), and in failing to warn those residents. Id. at ¶31(l) (asserting negligence "in failing to warn ... Hampshire Hall tenants of the danger created by Mr. Andrews").

Following discovery, appellants filed a motion for summary judgment on the basis of Emerich v. Phila. Ctr. for Human Dev., Inc. , 554 Pa. 209, 720 A.2d 1032 (1998). Emerich stands for the proposition that "under certain limited circumstances[,]" a mental health professional "owes a duty to warn a third party of harm against that third party." 720 A.2d at 1036. The Emerich Court held "the circumstances in which a duty to warn a third party arises are extremely limited." Id. at 1040. The patient must communicate a "specific and immediate threat" against "a specifically identified or readily identifiable victim." Id. Appellants asserted, and the parties do not dispute, Andrews never specifically named the decedent as the object of his homicidal ideation. Thus, appellants sought summary judgment because the allegedly amorphous, non-immediate threat against an unidentifiable "neighbor" or "neighbors" did not create a duty to warn.

The trial court denied summary judgment, concluding there was "evidence in this case from which a jury could reasonably conclude the tenants residing on Andrews’[s] floor in Hampshire Hall were a readily identifiable group of people to whom [appellants] owed a duty to warn." Trial Court Op., 5/23/17 at 10-11. The trial court certified its order as involving a controlling question of law upon which there is a substantial difference of opinion pursuant to 42 Pa.C.S. § 702, and the Superior Court granted an interlocutory appeal.

B.

The Superior Court determined appellee's complaint "made the requisite prima facie showing of a duty under Emerich ." Maas , 192 A.3d at 1149. The panel recognized Emerich involved a threat to a specifically identified individual, and acknowledged "Mr. Andrews expressly communicated threats to kill his ‘neighbor’ but did not identify, by name or description, the specific neighbor." Id . at 1148. Nevertheless, the panel recognized Andrews "threatened to kill an unidentified individual who was a member of an identifiable group of approximately twenty people." Id. Thus, the Superior Court framed the controlling question as whether appellants "had a duty to warn the potential targets, i.e ., the fourth floor tenants of Hampshire Hall who were Mr. Andrews's neighbors." Id .

Next, the panel noted Emerich relied on the seminal case of Tarasoff v. Regents of Univ. of California , 17 Cal.3d 425, 131 Cal.Rptr. 14, 551 P.2d 334 (1976). In Tarasoff , the patient did not expressly identify his threatened victim, but his therapist could "readily" identify who she was from the context of the threat; in litigation following her murder, the California Supreme Court held the therapist's failure to warn her breached a duty to use reasonable care to protect a third party from harm. 131 Cal.Rptr. 14, 551 P.2d at 341. The Superior Court acknowledged the Tarasoff duty was subsequently limited in Thompson v. County of Alameda , 27 Cal.3d 741, 167 Cal.Rptr. 70, 614 P.2d 728 (1980), where the California Supreme Court determined there was no duty to warn a "large amorphous public group" in a particular neighborhood. Maas , 192 A.3d at 1145, citing Thompson , 167 Cal.Rptr. 70, 614 P.2d at 738.⁵ Nevertheless, the panel concluded, "[u]nlike the threat to all of the ‘young children in the neighborhood’ in Thompson , which we agree was a large and amorphous public group, the threat herein was directed at a member of a small, distinct, and identifiable group." Maas , 192 A.3d at 1148.

Noting the victim in Tarasoff was not named, but was readily identifiable, the panel reasoned "the duty to warn exists where the target is identifiable, not just identified by name, and that mental health professionals must use reasonable efforts to identify the victim. To give any other interpretation to our Supreme Court's holding in Emerich would negate the meaning of the ‘readily identifiable’ language entirely." Id. at 1147. The Superior Court further reasoned "[t]he duty to warn recognized in Emerich may extend to individuals who are readily identifiable because they are members of a group." Id . at 1147-48. The panel found support for this position "in the Code of Ethics of Pennsylvania's State Board of Psychology, section 41.61, which was relied upon by the Emerich Court in defining the duty. That provision states that psychologists should take ‘reasonable measures to prevent harm when a client has expressed a serious threat or intent to kill or seriously injure an...