Stallman v. Robinson

• Decision Date: 14 September 1953
• Docket Number: No. 43322,No. 2,43322,2
• Citation: 364 Mo. 275,260 S.W.2d 743
• Parties: STALLMAN v. ROBINSON et al
• Court: Missouri Supreme Court

Page 743

260 S.W.2d 743

364 Mo. 275

STALLMAN v. ROBINSON et al.

No. 43322.

Supreme Court of Missouri, Division No. 2.

Sept. 14, 1953.

J. M. Loomis, Omar E. Robinson, Kansas City, attorneys for appellants.

Charles F. Lamkin, Jr., Bernard L. Trott, Kansas City, attorneys for respondent.

BARRETT, Commissioner.

The appellants, Dr. G. Wilse Robinson, Sr., Dr. G. Wilse Robinson, Jr., Dr. Louise Loewy and Dr. Robert S. Darrow, operate a private hospital or sanitarium and are specialists in the care and treatment of the mentally ill. The plaintiff's wife, Ruby Marie Stallman, entered the defendants' institution as a patient on the 6th day of March 1949 and four days later committed suicide by hanging or strangling herself with strips of cloth torn from her nightgowns and fastened to a water pipe in the bathroom. In this action against the appellants to recover damages for her negligent death the husband, Edward Stallman, has recovered a judgment for $9,000. The appellants, owners and operators of the institution, appeal from the judgment and contend: (1) that the husband pleaded but failed to prove specific negligence, in fact 'plaintiff's proof wholly failed to prove specific negligence of the defendants,' (2) that he did not prove facts demonstrating liability or upon which a verdict and judgment could be based and (3) that the trial court erred in refusing to direct a verdict in their favor because his evidence failed to show that the defendants did not give his wife proper treatment, while their evidence conclusively showed that she was given watchful care and the most careful treatment. Essentially all these contentions are directed to one point and one argument, that the plaintiff has failed in his proof, or, that there was no evidence from which the jury could find that the defendants or their employees were negligent and, therefore, liable in damages for Mrs. Stallman's death.

While the fundamental rules relating to malpractice may be generally applicable to this action, it is not, strictly speaking, a malpractice case. There is no claim or evidence of improper diagnosis and there is no claim or evidence that the appellants were negligent in their treatment of Mrs. Stallman's mental illness. The appellants, having accepted Mrs. Stallman as their patient, owed her the specific duty of exercising reasonable care to safeguard and protect her from injuring herself. Their duty in this regard was proportionate to her needs, that is, such reasonable care and attention as her known mental condition required. Annotation 11 A.L.R.2d 751, 756, 778; Davis v. Springfield Hospital, 204 Mo.App. 626, 218 S.W. 696. Several factors have some bearing upon whether the appellants have discharged their specific duty but 'The most important single factor in determining whether or not a hospital was negligent in failing to prevent the suicide of a patient is whether or not the hospital authorities under the circumstances could reasonably have anticipated that the patient might harm himself.' Annotation 11 A.L.R.2d, loc. cit. 782. And, whether these determinative factors are present depends upon the detailed facts and circumstances of the particular case.

The following is the background of Mrs. Stallman's illness: She was twenty-eight years of age at the time of her death, was married to Edward in 1938, and they had one daughter, Caroline Sue, aged ten years at the time of this trial. They lived in Glasgow and Edward operated a filling station. Their home life was normal and happy and there was no noticeable indication of illness until February 13, 1949, when Edward observed that Ruby Marie was unusually cross, sat shaking her head and crying, complaining that her neighbors and Edward did not like her. During the week she became worse, nervous and depressed, and on Wednesday went to a doctor in Fayette, alone. He gave her some sleeping tablets and she seemed to improve but during the next day or two she became further depressed. On Monday Edward came home in the afternoon just as she slashed her throat with a razor blade and was about to slash again. Her father and mother came from Kansas City and she was taken to a hospital in Fayette where her family was advised that she was mentally ill and should be taken to Dr. Robinson in Kansas City. After six days in the hospital she returned home and appeared to improve but soon became depressed again and was afraid to stay alone. Edward took her to Kansas City and they spent two days with her parents but she was dissatisfied and they returned to Glasgow with her young sister who stayed with her while Edward was at work. By Thursday, March 5th, she was much worse and Edward, the young sister, and the daughter took her to Kansas City to see Dr. Robinson. On the trip, at night, she was riding in the front seat with Edward and he was suddenly attracted by her unusual movements and stopped the automobile to find that she had taken a stocking off, tied it around her neck and was choking herself from beneath her coat. The next day her parents and Edward took her to the appellants' hospital.

The circumstances of her admission, the course of her stay in the hospital and the facts concerning her death four days later were these: Edward and his father-in-law were first interviewed by Dr. G. Wilse Robinson, Sr., on Thursday, March 5, 1949, and Edward gave the doctor a full account of his wife's illness including the details concerning her two attempts at suicide. He expressed to Dr. Robinson his fear that his wife would again attempt to commit suicide and suggested possible methods she might employ but the doctor assured him that every precaution would be taken. The following morning, March 6th, Ruby Marie was admitted to the institution and Edward paid $150 for her first week's hospitalization. Dr. Darrow took her case history and, according to Edward, advised that her ideas of suicide could be dispelled in a short time but that it would take some weeks to improve her nervousness and delusions. She was assigned to a room on the third floor with another patient. All patients with suicidal ideas were admitted to that floor which was particularly equipped to care for such patients and the greater number of nurses and attendants were employed on that floor, twenty-five in staggered shifts for the twenty-five or thirty patients. Dr. Louise Loewy said that from the records and from the other doctors she was informed of Mrs. Stallman's suicidal ideas and so there can be no doubt but that the hospital was forewarned and should have anticipated that their patient might harm herself.

In Mrs. Stallman's newly decorated room there were two low couches around a corner table fixed to the wall. The windows in the room were barred and the clothes closets, where the patients' effects were kept, locked on closing and only nurses could unlock them. The door to the room was always kept open and the door to the bathroom was cut off at the bottom approximately two feet so that attendants walking in the hall could see into the bathroom. This room was a half bath consisting of a stool and a lavatory with a water pipe running down the corner of the room. In this room there was also a chest of drawers. As to all the rooms on the third floor and their patients, according to the appellants, 'The nurses, nurses' aides, maids and all employees on the floor continually, specifically cautioned, and in going about their duties continuously watched the patients in these rooms,' and on the day of Mrs. Stallman's suicide there were eleven people on duty on the third floor.

The doctors had not precisely diagnosed Mrs. Stallman's mental illness. Dr. Loewy said that she 'had ideas of reference' concerning her husband. Dr. Loewy tentatively concluded that Mrs. Stallman was either a manic-depressive or a schizophrenic with paranoid ideas. The course of her treatment, other than interviews and observation, on the 6th, 7th, 8th and 9th of March is not known. On the morning of the 10th, according to the reports, she seemed to be more cheerful, more interested in the activities on the floor and not so depressed as formerly, an attitude patients sometimes feign to escape observation. On the morning of the 10th, between eight and ten o'clock, she was given a muscle relaxing drug, curare, and an electro-shock treatment and placed in a safety belt on her couch, asleep, with an attendant sitting at her side. According to the nurse who assisted in the treatment Mrs. Stallman had a normal reaction and recovery from the treatment. Neither the doctor nor the nurses engaged in giving the treatment saw her again until after her suicide in the afternoon. At two o'clock some of the nurses were changing their staggered shifts and one of the nurses coming on duty at that hour stated that she immediately went to Mrs. Stallman's room 'and she was in her safety belt, it was locked, and * * * (she was) apparently asleep, so I went on to the next room.' While the defendants' evidence tends to show that nurses and attendants were constantly walking up and down the hall, looking into patients' rooms, no other witness than this one nurse at two o'clock saw Mrs. Stallman alive again. About two-thirty Dr. Loewy and a nurse were in a room across and down the hall a door or so and heard another patient say that someone should come in the room because Mrs. Stallman had fainted. Dr. Loewy and one or two nurses rushed to the room and found Mrs. Stallman with her feet sticking out from under the bathroom door into the bedroom, plainly visible from the hall. Her head was underneath the washbowl and there was a yellow and pink 'string' around her neck which was tied to the water pipe. Dr. Loewy thought that she was still alive and artificial respiration was applied for a half hour and her death was reported at three o'clock.

In the briefly detailed circumstances whether the appellants breached their specific duty to reasonably safeguard and protect Mrs....