Vistica v. Presbyterian Hospital & Medical Center of San Francisco, Inc.

• Decision Date: 10 October 1967
• Docket Number: No. S,S
• Citation: 62 Cal.Rptr. 577,67 Cal.2d 465,432 P.2d 193
• Court: California Supreme Court
• Parties: , 432 P.2d 193 Jerrold F. VISTICA et al., Plaintiffs and Appellants, v. PRESBYTERIAN HOSPITAL AND MEDICAL CENTER OF SAN FRANCISCO, INC., Defendant and Respondent. F. 22529.

Page 577

62 Cal.Rptr. 577

67 Cal.2d 465, 432 P.2d 193

Jerrold F. VISTICA et al., Plaintiffs and Appellants, v. PRESBYTERIAN HOSPITAL AND MEDICAL CENTER OF SAN FRANCISCO, INC., Defendant and Respondent.

No. S.F. 22529.

Supreme Court of California,

In Bank.

Oct. 10, 1967.

Rehearing Denied Nov. 8, 1967.

Clausen & Clausen and Henry C. Clausen, San Francisco, for plaintiffs and appellants.

Clark, Heafey & Martin, Chris G. Gasparich and Gerald P. Martin, Oakland, for defendant and respondent.

McCOMB, Justice.

Plaintiffs appeal from a judgment in favor of defendant, after trial before a jury, in a wrongful death action.

Facts: Plaintiffs are the deceased's husband, individually, and her minor children by their guardians ad litem, their father and grandmother.

The decedent, Lorraine Vistica, was a mentally ill person. The testimony of witnesses describes her as one who possessed a schizophrenic personality and was paranoid and strongly motivated toward suicide.

On August 5, 1961, while at home, Lorraine stabbed herself in the chest. She was admitted to the psychiatric ward of defendant hospital and there came under the care of Dr. Cartwright. The doctor recognized Lorraine's potential for self-destruction and ordered that ward personnel observe precautions against her suicide.

She remained at the hospital until September 8, 1961, when she was permitted to go home to spend the daytime hours with her family. She did not make satisfactory progress at home, and while on this schedule engaged in at least one alarming incident that suggested her continued motivation to suicide.

On October 19, 1961, she was readmitted to the hospital for full-time care, and Dr. Cartwright again ordered that hospital personnel take precautions against her suicide. Her tendencies toward elopement were also described in her doctor's notes and conveyed to and noted by the nurses on the psychiatric ward.

At the trial, both sides offered testimony as to the meaning of the terms 'suicide precautions' and 'elopement precautions.' Although different witnesses described their understanding of these terms in varying ways, a fair summary of their testimony is that the first term means that increased vigilance must be used in the care of a patient such as Lorraine, while the latter term means that the patient is to be carefully observed and the door of the ward watched to see that the patient does not flee the hospital.

The psychiatric ward where the deceased was a patient was operated on the 'open ward' pattern presently considered best for psychiatric patients. In such a ward, patients are relatively free from restraint. Lorraine's doctor considered it particularly important that she not feel imprisoned. Because of her relative freedom, the need for suicide and elopement precautions was particularly evident to her doctor.

The psychiatric ward had a kitchen, a nurses' station, and a solarium, as well as sleeping rooms for the patients. The furniture in the solarium included a radio console, light wooden chairs, and a metal wastebasket. The windows in the solarium were divided into two sections, a lower one, which was fixed shut, and an upper one, transom-like, which could be opened. The upper portion of each window was fitted with chains and a metal strap, which prevented the window from opening wide. On one window, however, the chains had not been knotted up short. As a result, that window could be opened considerably farther than the others. The solarium was three floors above street level.

On October 29, 1961, Mrs. Miller, Lorraine's mother, visited Lorraine and found her in the solarium. There was dust on Lorraine's dress. Mrs. Miller saw the radio console beneath the window that could be opened widest. The transom was open; a chair was on top of the console; and the metal wastebasket had been placed on top of the chair. Lorraine indicated that she had arranged the furniture as it was found. Mrs. Miller reported these events to the nurse on duty and also to Dr. Cartwright, who said he would order 24-hour surveillance for Lorraine. Other nurses on the ward and a hospital orderly were also informed of the occurrence.

The next day Dr. Cartwright saw Lorraine at the hospital and questioned her about the furniture pile-up in the solarium. She denied any participation in the incident, but at the same time the doctor found her angry, tense, and desirous of returning home. Later, Lorraine's mother arrived, and she, too, found her daughter angry and demanding to be permitted to go home. Dr. Cartwright refused permission for his patient to leave the hospital.

At 4:00 p.m. Dr. Cartwright warned nurses on the ward of Lorraine's emotional state and that she might attempt to escape that evening. He requested that they observe her carefully and that she not be left alone.

A 5:00 p.m. Lorraine had dinner in her room, and afterward lay down on her bed. About 5:30 p.m. an orderly came to her room and invited her to play cards in the solarium. She replied that she would be there in a few minutes. At 5:50 p.m. the orderly was sent to another floor of the hospital, leaving the solarium unattended for approximately eight minutes. At that time one of the nurses was on her 'dinner break,' and the only nurse on the ward was engaged with the other patients at her station at the opposite end of the hall.

At 5:58 p.m. the ward nurse received a telephone call from an unidentified person who said that a girl's body was lying on the ground, beneath a window of the psychiatric ward, on the Webster Street side of the hospital. A quick search of the ward disclosed the absence of a patient.

In the solarium, the radio console stood beneath the window that opened the widest. On top of the console was a wooden chair, and above that, the metal wastebasket. The girl in the street was Lorraine. She was dead.

Question: Was it prejudicially erroneous for the trial court to instruct the jury that in order for plaintiffs to be entitled to the benefit of the res ipsa loquitur doctrine, the jury had to find that the decedent's death was not due to any voluntary action or contribution on her part?

Yes. Although the instruction given ¹ meets the requirements set forth by this court in Ybarra v. Spangard, 25 Cal.2d 486, 489 (1), 154 P.2d 687 to wit: (1) the accident must be of a kind which ordinarily does not occur in the absence of someone's negligence; (2) it must be caused by an agency or instrumentality within the exclusive control of the defendant; and (3) it must not have been due to any voluntary action or contribution on the part of the plaintiff,--an instruction must be measured by the circumstances of the case in which it was given. (Adams v. American President Lines, 23 Cal.2d 681, 688(11), 146 P.2d 1; Schroeder v. Baumgarteker, 202 Cal. 626, 629, 262 P....