White v. U.S.
| Citation | 250 U.S.App.D.C. 435,780 F.2d 97 |
| Decision Date | 03 January 1986 |
| Docket Number | No. 84-5645,84-5645 |
| Parties | Genoa M. WHITE, Appellant, v. UNITED STATES of America. |
| Court | United States Courts of Appeals. United States Court of Appeals (District of Columbia) |
Appeal from the United States District Court for the District of Columbia (Civil Action No. 81-01280).
Malcolm W. Houston, Kensington, Md., for appellant.
Michael J. Ryan, Asst. U.S. Atty., with whom Joseph E. diGenova, U.S. Atty., Royce C. Lamberth and R. Craig Lawrence, Asst. U.S. Attys., Washington, D.C., were on brief, for appellee.
Before WRIGHT and EDWARDS, Circuit Judges, and DAVIS, * Circuit Judge, United States Court of Appeals for the Federal Circuit.
Opinion for the Court filed by Circuit Judge HARRY T. EDWARDS.
This case arises under the Federal Tort Claims Act and involves appellant's claim for damages for injuries suffered when she was attacked and brutally stabbed by a psychiatric patient from St. Elizabeths Hospital.
On December 7, 1979, Dwayne White, a patient confined to St. Elizabeths Hospital ("St. Elizabeths" or "Hospital") by court order after acquittal of murder by reason of insanity, left the Hospital grounds and repeatedly stabbed his wife, Genoa White, with a pair of scissors. At the time of the attack, Dwayne White had "grounds privileges," permitting him to go anywhere on the Hospital premises from nine in the morning until nine at night. Although these privileges did not include permission for White to leave the Hospital grounds, at least three Hospital exits are open for access; by the Hospital's own admission, St. Elizabeths is not an entirely secure facility.
Genoa White, the appellant in this case, brought a Federal Tort Claims Act action against St. Elizabeths alleging two separate theories of liability. First, she alleged that, although Dwayne White had related a fantasy about harming her to a Hospital psychotherapist, the Hospital failed to warn her of this threat, thereby breaching an alleged duty to her. Second, she claimed that the Hospital was negligent in failing to take the reasonable precautions necessary to ensure that Dwayne White did not leave Hospital grounds. After a bench trial, the District Court found that Dwayne White's psychotherapist was acting within professional standards of competence in concluding that Dwayne White's fantasy did not represent a threat to appellant. The District Court further concluded that the Hospital had not been negligent in granting Dwayne White unsupervised access to the Hospital grounds because it was not foreseeable that he would leave the institution and attack his wife.
After careful scrutiny of the record in this case, we uphold the judgment of the District Court finding that the Hospital did not violate its duty to warn Genoa White of Dwayne White's threats against her. However, we hold that the judgment of the District Court was clearly erroneous in finding that the Hospital was not negligent in failing to supervise White so that he remained confined to its grounds. St. Elizabeths was obligated by the D.C.Code and by court order to keep Dwayne White confined to Hospital premises; the failure to confine an admittedly dangerous psychiatric patient constituted negligence in this case. Additionally, Hospital officials had every reason to know that Dwayne White was routinely leaving the Hospital grounds to visit his wife; consequently, the failure to take steps to prevent White's departures is legally inexcusable. We therefore reverse the judgment of the District Court and remand for consideration of the Hospital's affirmative defenses.
Dwayne White was first admitted to St. Elizabeths Hospital on February 8, 1968 at the age of 18. Medical staff at St. Elizabeths consistently have diagnosed him as an "explosive personality" who will become uncontrollably violent if his low tolerance for frustration is exceeded. This diagnosis is confirmed by an examination of his Hospital records, which are replete with examples of assaults and other violent behavior. Indeed, within months of his original admission to the Hospital, Dwayne White attacked five police officers who were attempting to arrest his father and, in the ensuing struggle, killed one officer. Charged with the police officer's murder, White was found not guilty by reason of insanity and ordered by the District Court to remain at St. Elizabeths. As a result of this acquittal, White must remain at the Hospital until the District Court determines that he no longer presents a danger to himself or others. For ten years following this incident, Dwayne White remained a patient at St. Elizabeths and his violent behavior continued, including numerous assaults on fellow patients and ward staff, an assault and robbery attempt against a cab driver while on unauthorized leave in 1971, and a second assault on several police officers in August 1978.
In mid-1978, the Hospital decided to grant Dwayne White limited grounds privileges 1 that were to be increased on a gradual basis. In May 1978, he was granted the privilege to walk unaccompanied to and from his therapy sessions with telephone checks to ensure his arrival. Later that same month, these privileges were increased to include one hour of unaccompanied grounds privileges. After the August 1, 1978 altercation with police, Dwayne White's ground privileges were suspended temporarily, but the Hospital restored these privileges--in full--three weeks later. The Hospital increased the duration of his unaccompanied privileges to two hours per day in September 1978, and to four hours per day in March 1979. Finally, in September 1979, the Hospital granted Dwayne White "9 a.m. to 9 p.m." grounds privileges. Although he was required to report for meals, work and industrial therapy, at the time of the assault on his wife, he had most of his afternoon free.
Dwayne White met appellant sometime in 1978 while she was a patient at St. Elizabeths and married her several months later on March 10, 1979, at a church off the Hospital grounds. At the time of the marriage, Genoa White was no longer a patient at the Hospital. Although the Hospital records suggest that the staff knew that Genoa White was Dwayne White's "girl friend," the staff was not aware of the marriage until June 1979. According to both Dwayne White and his wife, he left the Hospital grounds to visit appellant at her home on a routine basis.
From 1977 to January 1980, Dwayne White had weekly individual psychotherapy sessions with Dr. Lorraine Brown, a clinical psychologist employed by the Hospital. Under a Hospital policy known as the "therapist-administrator split" ("T/A split"), Dr. Brown did not participate in administrative decisions concerning Dwayne White's treatment. The purpose of the T/A split is to keep individual psychotherapy independent of regular treatment in order to ensure a trusting relationship between the therapist and the patient. Sometime in June 1979, Dwayne White related a fantasy to Dr. Brown in which he harmed his wife with a gun. Although Dr. Brown and Dwayne White discussed this fantasy on several occasions, Dr. Brown never disclosed the fantasy to the Hospital administrators or to Genoa White. According to Dr. Brown, she did not consider the fantasy to be a threat to Genoa White because Dwayne White talked about his fantasy as a fantasy and he was not afraid that he would act upon it. Furthermore, Dr. Brown did not view the fantasy as presenting a real threat to Genoa White because Dwayne White had no history of assaulting women and had not assaulted anyone in recent months.
Dwayne White's assault on appellant occurred almost six months later, on December 7, 1979. White had attended a court proceeding that morning in District Court concerning his request for a conditional release to his sister's custody during the upcoming Christmas holiday. A similar request for a conditional release had been denied by the District Court in February 1979. On a few occasions in the past, court appearances had been very stressful to White, but the Hospital staff testified that they detected little stress in connection with this particular court appearance. After the December 7 hearing was postponed because an attorney failed to appear, Dwayne White returned to the Hospital, and that afternoon left the Hospital grounds to visit his wife. Before this visit, Genoa White had been drinking with a friend. She testified that her husband was very upset by the court proceedings and was pessimistic about the likelihood of receiving a conditional release. Later that afternoon, Genoa White left the apartment to visit a friend and returned around seven o'clock. Upon her return, she was surprised to find her husband still at the apartment. Because he said that he needed carfare for the return trip to St. Elizabeths, appellant went to a friend's house to borrow money. After drinking at her friend's house, Genoa White returned to the apartment, and soon after her arrival showed her husband pictures of herself dressed in a bathing suit and kimono and of a male wearing boxer trunks. When she turned her back, Dwayne White picked up a pair of scissors, and repeatedly stabbed her, inflicting 55 wounds. At a subsequent criminal trial for the assault of his wife, Dwayne White claimed insanity as a defense, but was convicted of assault with intent to kill appellant.
The appellant's first claim is that the Hospital had a duty to warn her that Dwayne White harbored hostility toward her and therefore posed a threat to her safety. In particular, it is appellant's view that Dwayne White's fantasy of harming his wife with a gun was a genuine threat that should have been relayed to the Hospital Administration and to appellant after her husband told Dr. Brown about the fantasy.
The duty to warn foreseeable victims of mental patients originated in Tarasoff v. Regents of the University of...
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