P.L.P., In Interest of, 960343

• Decision Date: 04 December 1996
• Docket Number: No. 960343,960343
• Parties: In the Interest of P.L.P. WAYNE P., Petitioner and Appellee, v. P.L.P., Respondent and Appellant. Civil
• Court: North Dakota Supreme Court

Page 657

556 N.W.2d 657

In the Interest of P.L.P. WAYNE P., Petitioner and Appellee, v. P.L.P., Respondent and Appellant.

Civil No. 960343.

Supreme Court of North Dakota.

Dec. 4, 1996.

Jeanne L. McLean Behrens, State's Attorney, Bottineau, for petitioner and appellee. Submitted on brief.

Cynthia G. Schaar-Mecklenberg (argued), Jamestown, for respondent and appellant.

MESCHKE, Justice.

P.L.P. appealed a 90-day forced-hospitalization order for treatment of her chemical dependency on prescription drugs for pain. We affirm.

P.L.P., separated from her husband pending a divorce, voluntarily entered a hospital to evaluate her medication usage for chronic migraine headaches. While there, her estranged husband filed a verified petition on September 19, 1996, that listed the 18 doctors she had seen and the many medicines she had used since January 17, 1996. Her husband identified these medications "either from pill bottles that I have collected, pharmacy receipts, checks written, or insurance claim vouchers." The petition alleged: "In addition to these medicines, she has been taking medications prescribed for their cat. She has lied to a pediatrician about symptoms for their 7 year old daughter in order to get a Rx for something w/ codeine. She has been going up to Canada now to get medication as she's having difficulty getting an area Dr. to prescribe."

Her husband believed P.L.P. was refusing to follow a doctor's recommendation that she "definitely needs 30 days treatment," "is threatening to discharge herself," and "is overmedicate[d] and mixing medications to the point it is extremely dangerous to herself." His petition asked the Bottineau County District Court to take P.L.P. "into immediate custody" because "an evaluation of the respondent's condition should be made and involuntary commitment and treatment is required."

From this petition, the Bottineau County District Court found probable cause to believe P.L.P. was "chemically dependent and is imminently likely to injure [her]self ... if allowed to remain at liberty" so that an emergency existed, ordered P.L.P. temporarily detained for up to seven days at the Jamestown State Hospital, and also ordered the necessary treatment hearing be held in Stutsman County District Court where the hospital is located.

The petition, the emergency detention order, and a report of examination of P.L.P. by Addiction Counselor Dave Tompkins in consultation with Dr. Esther Spahr that recommended P.L.P.'s hospitalization and treatment, were filed in Stutsman County District Court on September 24, 1996. The next day, that court appointed counsel for P.L.P., found "good cause was shown for a continuance" because "the Stutsman County District Judge is unable to schedule the treatment hearing on the calendar on or before September 27, 1996," and scheduled the treatment hearing for October 2.

At the hearing, Dr. Spahr testified that P.L.P. had admitted to her that she used more than the prescribed amounts of pain medication. Dr. Spahr also testified that P.L.P. was chemically dependent on pain medications. Dr. Spahr believed that P.L.P.'s continued usage of pain medications would cause her physiological problems within a few years, and that, while inconclusive tests on P.L.P.'s liver made it difficult to say how immediate the danger was, it was possible P.L.P. might already have physical problems. Dr. Spahr anticipated that P.L.P.'s treatment would be the "standard program of 28 days" in the structured environment of the hospital. P.L.P. insisted she did not need treatment, and testified that doctors in her clinic believed one doctor had been giving her improper medication so, upon request of her doctor, she had entered a hospital only to determine whether she was suffering from withdrawal headaches. However, an addiction-counselor intern testified P.L.P. had admitted to her that her drug usage had become a problem in recent years. An addiction counselor also testified P.L.P. had admitted to her that she used more than prescribed dosages, that she was addicted, and that she "had a problem with her drug usage."

The trial court found P.L.P. was "very resistant to treatment," had "poor insight into medication treatment problems," and "appears dependent upon her prescribed medication and uses a substantial amount of time obtaining such medication through elaborate and extreme schemes." The trial court concluded, "if [she] continues in her present circumstances and usage of medication, she will substantially damage her physical health in time." The court concluded P.L.P. was chemically dependent, was thereby "substantially impair[ed][in] her capacity to use self-control, judgment and discretion in her social affairs" including a "substantial deterioration in physical health," and that alternative treatment was not appropriate "at this time." The court ordered P.L.P. hospitalized for treatment for not over ninety days.

Three weeks later on October 22, 1996, because P.L.P. "no longer require[d] hospitalization," the superintendent of the Hospital released P.L.P. to out-patient treatment at the North Central Human Service Center upon condition that she undergo "aftercare counseling" there, become involved "with NA including sponsorship," and abstain "from misuse of prescription pain medication." On October 24, upon receipt of the Hospital's notice of release and P.L.P.'s waiver of hearing, the Bottineau County District Court ordered P.L.P. to undergo outpatient treatment on those conditions for the remainder of the ninety days.

On November 1, 1996, P.L.P. filed an expedited appeal, urging that the Stutsman County trial court's scheduling difficulty was not good cause for delaying the required hearing for forced treatment, and that the evidence was not clear and convincing that she required involuntary treatment for chemical dependency. The Hospital recognizes that, when a person said to be suffering from chemical dependency has been detained by an emergency commitment, NDCC 25-03.1-26(2) requires a treatment hearing to "be held no later than seven days after detention" unless, among several reasons, the court extends the time for the hearing upon good cause shown.

The trial court's schedule was "a legitimate factor for ... good cause to continue an involuntary treatment hearing," the Hospital urges, citing In Interest of Nyflot, 340 N.W.2d 178 (N.D.1983) and In Interest of Ebertz, 333 N.W.2d 786 (N.D.1983), because "[t]he purpose of the statute is for the benefit of the [patient] and the determination as to the [patient's] need for treatment." Even if there was "insufficient cause" here, the Hospital argues, the delay was not serious enough to abandon the treatment ordered after a completed hearing. The Hospital urges that there was clear and convincing evidence for the findings and conclusions that P.L.P. was chemically dependent and needed treatment.

In Ebertz, the patient sought dismissal of a petition for involuntary hospitalization, after his suicide attempt, because a petition for a hearing had not been filed, as NDCC 25-03.1-26(1) requires, within twenty-four hours after the emergency commitment. The trial court refused a dismissal because the patient had voluntarily submitted to treatment two days after the emergency detention. Ebertz, 333 N.W.2d at 787. After a hearing, the trial court found Ebertz needed outpatient treatment for up to ninety days. Ebertz appealed, and this court affirmed, differentiating between criminal procedures and involuntary treatment procedures that are "more for the benefit of the [patient] than for anyone else." Ebertz, 333 N.W.2d at 789. This court reasoned:

We are ultimately concerned that the respondent was afforded due process...