In a recent case, a Florida appellate court considered whether a medical malpractice case was appropriate in the case of a suicide where the woman was being treated for depression. The woman’s husband brought the lawsuit.
The woman had a history of depression and was taking Prozac before she was switched to Effexor. The doctor was not aware that the woman had stopped taking the Effexor because of its side effects. She had called her doctor and spoken to his assistant in 2008. She told the assistant she didn’t feel right, wasn’t sleeping well, and was experiencing gastrointestinal distress. She thought it was the Effexor. The assistant wrote this information down in a note to the doctor.
When the doctor saw the note soon after, he decided to change the medication to Lexapro and referred her to a gastroenterologist. The office didn’t ask her to schedule an appointment. The woman picked up samples and a prescription on the same day. The next day she hung herself, leaving no suicide note.
The husband was shocked and said she had never indicated she might hurt or kill herself. Her adult daughter, too, was shocked.
The husband alleged that the doctor had not exercised his reasonable care because he failed to recognize that the plaintiff was experiencing a change in symptoms, was depressed and was seeking medical intervention. He thought the doctor should have asked the staff to have her come in to be evaluated before prescribing Lexapro, among other things. He alleged her suicide was legally caused by those breaches.
The defendants filed a motion for summary judgment stating that the doctor did not owe the woman a duty as a matter of law because the suicide was not foreseeable and she was not under his control. The defendants also argued too many inferences from expert testimony would be needed for the plaintiffs to prove their case.
The husband filed depositions of doctors, including a board certified psychiatrist and a board certified internist. They had testified that given the woman’s history, the standard of care was to see her and assess her condition and intervene. The experts believed the doctor should have been concerned her depression was worsening because she had stopped taking her antidepressant and was in crisis mode. They also opined that the doctor would have been able to see her suicidal ideations and would have intervened.
However, the trial court granted summary judgment against the husband. It found as a matter of law, the doctor didn’t owe a duty to prevent an unforeseeable suicide of an outpatient. The husband appealed.
The trial court had analyzed the doctor’s duty under the standard for proximate cause. However, it wasn’t an issue of whether the defendant could foresee the specific injury that happened. The appellate court explained that the issue here was whether a defendant’s conduct foreseeably created a broader ‘zone of risk’ posing a threat of harm to others.
In Florida, doctors must use the level of care, skill and treatment that is recognized as acceptable by reasonably prudent similar health care providers. What is acceptable depends partly on how long someone was a patient’s doctor. The husband had offered expert testimony that the standard of care when a patient complains of worsening depression is that a doctor is required to assess whether his patient was having thoughts of suicide.
A psychotherapist has a legal duty to provide appropriate psychotherapy. In this case, the plaintiff had submitted affidavits that the doctor had not followed the standard of care. A jury question remained as to whether there was proximate cause.
Therefore summary judgment wasn’t appropriate. The court reversed.
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