Pierce v. Pemiscot Mem'l Health Sys.

• Decision Date: 13 June 2014
• Docket Number: Case No. 1:11–CV–132 (CEJ).
• Court: U.S. District Court — Eastern District of Missouri
• Parties: Ruth PIERCE, Plaintiff, v. PEMISCOT MEMORIAL HEALTH SYSTEMS, et al., Defendants.

25 F.Supp.3d 1198

Ruth PIERCE, Plaintiff,
v.
PEMISCOT MEMORIAL HEALTH SYSTEMS, et al., Defendants.

Case No. 1:11–CV–132 (CEJ).

United States District Court, E.D. Missouri, Southeastern Division.

Signed June 13, 2014

Plaintiff's motion denied; defendants' motion granted in part and denied in part.

[25 F.Supp.3d 1201]

Jim R. Bruce, II, Jim R. Bruce, Attorney at Law, Kennett, MO, for Plaintiff.

Scott R. Pool, Rachel L. Hill, Gibbs and Pool, P.C., Jefferson City, MO, Paul D. McNeill, Womack and Landis, Jonesboro, AR, Ted R. Osburn, Osburn and Hine, L.L.C., Cape Girardeau, MO, for Defendants.

MEMORANDUM AND ORDER
CAROL E. JACKSON, District Judge.

This matter is before the Court on the separate motions of defendants James Pang, M.D., and Bonnie Moore, R.N., for summary judgment, the motion of plaintiff Ruth Pierce for partial summary judgment, defendant Moore's motion to dismiss for failure to file a health care affidavit, and the defendants' joint motions to strike plaintiff's statement of fact and to strike plaintiff's reply.¹

Plaintiff brings this action pursuant to 42 U.S.C. § 1983, asserting claims that defendants Pang and Moore improperly detained her in an inpatient psychiatric unit ² following the expiration of a 96–hour detention order. She alleges that her continued detention violated her due process rights under the United States and Missouri Constitutions and violated the provisions of Chapter 632, Mo.Rev.Stat., governing involuntary commitment procedures. She also asserts state law claims for false imprisonment, assault and battery in the form of forced medication, and intentional infliction of emotional distress. She seeks compensatory and punitive damages and a declaration that defendants violated her due process rights.

I. Background

At the time of the events giving rise to this lawsuit, plaintiff was an 84–year–old widow living alone in Steele, Missouri. On May 15, 2009, an application for detention was filed with the Pemiscot County Circuit Court based on allegations that she had displayed mental instability and threatened bodily harm to others. Order, Pl. Ex. O [Doc. # 133–14]. The court issued an order of detention, evaluation and treatment at Resolutions, an inpatient psychiatric unit based at Pemiscot Memorial Hospital. The order stated that the period of detention was “not to exceed 96 hours unless a petition for a further period of detention and treatment is filed with the court of competent jurisdiction.” Id. (emphasis added). Plaintiff was admitted to Resolutions on May 16, 2009. Med. Rec. at Pierce 0308, Pl. Ex. A [Doc. # 136–4]. She was not discharged until July 22, 2009. It is undisputed that no petition was filed for a further period of detention beyond the initial 96 hours.

Stacy Jeffers completed the initial paperwork at plaintiff's admission on May

[25 F.Supp.3d 1202]

16th. Jeffers Dep. at p. 21, Def. Moore Ex. N [Doc. # 100–14]. She testified that she placed an unsigned voluntary admission form on the top of plaintiff's medical chart, with the date May 21, 2009 filled in next to the blank signature line. She stated that the dated form was meant to serve as a “flag” that plaintiff's 96–hour detention expired on May 21st, and that her signature on the voluntary admission form had to be obtained on that date. In actuality, however, plaintiff did not sign the form until July 15, 2009. See Pl. Ex. A, Pierce 0508 [Doc. # 136–5]. On that date, Jeffers and Randy DeProw took the form to plaintiff for her signature. Jeffers testified that they crossed out the May 21st date and wrote in “July 15, 2009.” Plaintiff signed the form and Jeffers and DeProw signed as witnesses.

The Nurses' Notes for July 15, 2009, include an entry at 10:55 that states: “Pt awake in room states ‘That doctor told me I was getting to go home today.’ Voluntary admission paperwork obtained per S. Jeffers.” Pl. Ex. A, Pierce 0236 [Doc. # 136–3]. The notation “err” is made immediately above this entry. The nurse who made the notation, Zanetta Dillard Johnson, testified that she recognized her handwriting but could not recall why she struck out the entry. Johnson Dep. at p. 10, Def. Moore Ex. Q [Doc. # 100–17]. The entry made at 2:00 p.m. states that plaintiff requested a bag to pack her clothes. Nurse Johnson reviewed the chart and did not find an order for discharge and noted “need Dr. Pang called.” Id. at pp. 39–40. At 2:15, she noted, “Spoke with Dr. Pang per G. Hosford RN, no orders received.” Pl. Ex. A, Pierce 0236. She testified that Nurse Hosford spoke with Dr. Pang who declined to issue an order discharging plaintiff. It was Nurse Johnson's understanding that a patient could not be discharged without Pang's authorization.

Teresa Van Sickle, LPN, worked the overnight shift at Resolutions. Van Sickle Dep. at p. 6, Def. Moore Ex. O [Doc. # 100–15]. Van Sickle testified that she knew “fairly early” in plaintiff's admission that she had been involuntarily committed and did not want to be at Resolutions. Id. at p. 10. On July 15, 2009, at 8:30 p.m., Van Sickle wrote:

[Patient] sitting in dining room talking with another pt. Pt. upset and agitated, stating that she had been lied to about going home. Pt. states day nurse brought a paper to her to sign and told her it was for her release to go home. Pt. found out later it was a voluntary admission form ...”

Pl. Ex. A, Pierce 0236. Van Sickle testified that plaintiff told her that she had signed a release form. When Van Sickle looked in the chart, she found the voluntary admission form. She explained to plaintiff that what she had signed was not a release form, but an agreement to stay voluntarily. Plaintiff was surprised and said that she was told it was a form they had forgotten to have signed on the night she was admitted. Van Sickle Dep. at pp. 13–14. Plaintiff was “very very upset” and wanted to go home. Van Sickle explained to her that she could request to be discharged against medical advice and she would have to be released. Van Sickle also explained, however, that if plaintiff were discharged against medical advice, she would be walked out of the facility and left to find her own way home. It was late at night by then, so plaintiff decided to stay until the next day. Id. at pp. 14–15.

On the morning of July 16, 2009, plaintiff told a nurse, “I get to go home tomorrow when that doctor comes in,” and at 5:00 on the morning of July 17, 2009, she asked “to speak with Dr. Pang about going home.” Pl. Ex. A, Pierce 0239.

[25 F.Supp.3d 1203]

Plaintiff submits the affidavit of Johnna McCrary, who worked at Resolutions during the time plaintiff was present. McCrary Aff., Pl. Ex. B [Doc. # 133–2]. McCrary states that she knew that plaintiff was involuntarily committed and that a copy of the order was in plaintiff's file. She also knew that plaintiff did not want to be at Resolutions because she asked on a daily basis when she would be allowed to go home. McCrary states that at a treatment review meeting in July, there was discussion that “they had nothing in the file to justify holding her any longer.” Id. at ¶ 15. Someone suggested asking her to sign a voluntary admission form, but that was rejected because she was unlikely to agree. “Dr. Pang then made the statement they could trick her into signing a voluntary admission form. Nothing else was said and I thought the remark by Dr. Pang must have been a joke. Dr. Pang certified her to be detained for another week of treatment.” Id. On July 21, 2009, McCrary helped plaintiff call her attorney. Plaintiff was discharged from Resolutions the following day.

Defendant Pang testified at deposition that determinations regarding patients' eligibility for discharge were made at weekly treatment team meetings. He further testified that plaintiff was not ready for discharge at the expiration of the 96 hours authorized by court order. Pang Dep. at p. 21, Def. Moore Ex. F [Doc. # 100–6]. He did not know why a petition for further detention was not filed. Id. at p. 37.

Defendant Moore testified at deposition that she was responsible for day-to-day operations of Resolutions, which she described as ensuring adequate staffing for the unit. Moore Dep. at p. 16, Def. Moore Ex. E [Doc. # 100–5]. In response to questions regarding who on the staff was responsible for making sure patients are discharged at the expiration of court-ordered detention, Moore stated that, as “part of the multidisciplinary approach,” patients “are discharged at the time that they are prepared and have a safe discharge.” Id. at p. 20. When asked whether she understood that a patient must be discharged at the expiration of a 96–hour commitment unless a further petition was filed, she answered: “You take care of the patient until they are ready to be discharged.” Id. at p. 21. She did not believe any staff member had been designated to inform patients of their statutory rights. Id. at p. 32.

Defendants argue that it was necessary to detain plaintiff until a safe discharge plan could be made for her. They submit the affidavit of Debbie DiCarlo, a social worker with the Missouri Department of Health and Senior Services (DHSS). DiCarlo states “[i]t is standard procedure that a facility will not formally discharge a patient once a 96–hour hold has expired and a safe discharge plan is not in place.” DiCarlo Aff., Def. Pang Ex. F [Doc. # 94–6]. The record reflects that the discharge coordinator at Resolutions attempted to secure a nursing home placement for plaintiff. File notes, Def. Pang Ex. H [Doc. # 94–8]. The record also reflects that plaintiff was unwilling to consent to placement in a nursing home. DHSS Rec., Def. Moore Ex. T [Doc. # 100–20]. Accordingly, DiCarlo asked Resolutions to provide documents to support a petition for guardianship. The petition was filed on July 16, 2009, and on August 11, 2009, LeAnn Powell was appointed as temporary guardian for medical purposes. On November 6, 2009, Ms. Powell arranged for plaintiff's admission to a nursing home.

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