Opinion
No. 88-13928.
Decided October 17, 1989.
Robert A. Klingler, for plaintiff.
Anthony J. Celebrezze, Jr., Attorney General, and M. Celeste Cook, for defendant.
On November 9, 1988, plaintiff filed this action against the defendant, Rollman Psychiatric Institute ("Rollman"). Plaintiff states that he was assaulted while he was a patient at Rollman by another patient. He alleges that Rollman failed to exercise reasonable care in observing, supervising, and controlling the other patient and that such failure was the proximate cause of his injuries. Defendant filed a counterclaim based upon the cost of plaintiff's care at said facility pursuant to R.C. 5121.01.
On August 31, 1989, the matter was heard before this court. It was agreed that plaintiff's action and the counterclaim would be bifurcated and thus this decision concerns only the issues raised within plaintiff's complaint. The court has considered the evidence and arguments of counsel and renders the following decision.
Findings of Fact
(1) Plaintiff was a patient at Rollman, a mental health facility controlled and maintained by the Ohio Department of Mental Health, at all times pertinent to this claim.
(2) Plaintiff was received into Rollman pursuant to a court order and was admitted to the substance abuse/mental illness ward (for the court's purposes, "Ward A").
(3) On March 9, 1988, at approximately 5:00 p.m., plaintiff, accompanied by the other patients on his ward, left the ward area and proceeded to the entrance of the dining room where dinner was about to be served.
(4) The dining room doors were locked and the patients had to wait for an aide to open them.
(5) As plaintiff's group arrived at the dining room another group of patients from a different ward (for the court's purposes, "Ward B") had also gathered outside the dining room door.
(6) The two groups of patients began arguing as to which ward should initially be served.
(7) Ward A was accompanied by an aide, but Ward B was unsupervised. Therefore, Ward A was allowed into the dining room first, which action was met with loud protests from Ward B.
(8) The aide unlocked the doors to the dining room and plaintiff's ward entered in an orderly fashion to be served.
(9) Several patients from Ward B entered the dining room and crowded into the line in front of plaintiff, who was close to the end of his ward's line. Plaintiff believed it was mandatory to stay within his group so he returned to his original position in line.
(10) Mr. Hoskins, a patient assigned to Ward B and one of the patients that crowded into the serving line, began to argue with plaintiff concerning his place in line. The argument ended when Hoskins punched plaintiff in the face, causing plaintiff to fall to the floor. The blow decimated plaintiff's left cheekbone and resulted in permanent impairment and disfigurement. Plaintiff and Hoskins had not exchanged bitter words outside the dining room prior to the altercation.
(11) An aide quickly intervened and plaintiff was escorted back to his ward. He was examined by a physician shortly thereafter.
(12) Hoskins had been admitted to Rollman on March 6, 1988, and had not exhibited assaultive behavior prior to the incident herein. He was also taking the medication prescribed to him at Rollman. This was Hoskins' ninth admission into Rollman. He was involved in a couple of skirmishes during his earlier admissions.
(13) Subsequent to the aforementioned medical examination, plaintiff was admitted to a local hospital, as he was experiencing substantial pain, and surgery was performed to reconstruct plaintiff's face.
(14) Plaintiff has incurred $3,000 in unpaid medical expenses and further medical services may yet be rendered.
Conclusions of Law
Plaintiff alleges that defendant "failed to exercise reasonable care in observing, supervising, and controlling Hoskins, which negligent supervision was the proximate cause of [plaintiff's] injuries." (Plaintiff's complaint, Paragraph No. 20.) Plaintiff claims that defendant knew, or should have known, of Hoskins' alleged propensity for violence and, in consideration of his paranoid schizophrenic personality, should have known he was an imminent danger to others.
Plaintiff and another former patient, Mr. Schrader, testified concerning the events which led up to the altercation. Annie Williams, the psychiatric nurse supervisor at Rollman on the day in question, and Jemargarica Jamerson, a nurse at the facility, offered testimony regarding patient admission procedures, a patient's initial seventy-two-hour observation period, and observation procedures in the dining area. It was revealed that when a patient enters Rollman he is examined by a psychiatrist to evaluate and classify the patient as to how dangerous he is to himself and others. In this regard, Hoskins was initially restricted to his ward and placed on suicide precaution; however, this restriction was subsequently removed by his admitting physician and thus he was able to leave his ward. At this point in time, Hoskins was considered a low risk patient by the admitting physician. He was observed for a seventy-two-hour period after admission to Rollman, as are all patients, and did not exhibit any assaultive behavior. Hoskins was taking his medication as prescribed and did not threaten anyone in the facility. Written documentation pertaining to Hoskins' activities and behavior were recorded once per shift, i.e., three times daily. Nurse Williams stated that she was aware that Hoskins had been involved in an altercation at Rollman in the past, but that she had not seen him physically hurt another patient.
Nurse Williams testified that Rollman's personnel is responsible for observing the patients in the dining area and to intervene in a situation that may cause a disturbance. Hoskins was not subjected to high level precautionary methods, i.e., "one-to-one" supervision where an aide is assigned to stay with the patient at all times. He was to be observed in the dining room by an aide or nurse as part of the general population.
Dr. Terry Schwartz, a psychologist and plaintiff's expert witness, testified that Hoskins' personality indicates a propensity for violence. He stated that Hoskins demonstrated this violence in his prior admissions to Rollman and that any threatening stimuli could elicit a violent response. Dr. Schwartz was of the opinion that Hoskins required close supervision by defendant's agents, in close physical proximity, to observe Hoskins' behavior and to calm him down to avoid a violent outburst. He testified that defendant's agents failed to provide such close supervision and should have intervened before Hoskins hit plaintiff.
Dr. Charles D. Feuss, Chief Psychiatrist at the University of Cincinnati, was Hoskins' admitting physician during his first admission to Rollman in 1986. Dr. Feuss examined Hoskins at that time and diagnosed him as suffering from paranoid schizophrenia exhibiting an antisocial personality disorder. He stated that Hoskins was potentially violent at that time and that he experienced confrontations with other patients. Dr. Feuss stated, however, that it is difficult to have an utopian society in such an isolated area where fifty percent of the general patient population are diagnosed as paranoid schizophrenic. He also testified that supervision of a patient is not determined by the diagnosis, but rather by the patient's observed behavior.
As aforementioned, Hoskins was placed on suicidal precautions and restricted to his ward when he was admitted, but those precautions were discontinued by the admitting physician the following day. Dr. Feuss stated that such a decision is not uncommon and is within the physician's discretion. He opined that since Hoskins was taking his medication and was not a behavioral problem, the admitting physician's action was appropriate. Both experts testified that it is difficult to predict violent behavior and it was unforeseeable that an assault would occur in the dining area. See Littleton v. Good Samaritan Hospital Health Ctr. (1988), 39 Ohio St.3d 86, 529 N.E.2d 449, for discussion on psychiatry and the unpredictability of violence. Dr. Feuss indicated that it would be very difficult to provide "close supervision" for those patients that may act violently when faced with threatening stimuli due to the number of patients of that nature at Rollman.
A claim sounding in negligence must allege the existence of a duty, breach of that duty, and damage or injury as a proximate result of the breach. Strother v. Hutchinson (1981), 67 Ohio St.2d 282, 21 O.O.3d 177, 423 N.E.2d 467; Di Gildo v. Caponi (1969), 18 Ohio St.2d 125, 47 O.O.2d 282, 247 N.E.2d 732.
Ordinarily, there is no duty to control the conduct of a third person by preventing him or her from causing harm to another, except in cases where there exists a special relationship between the actor and the third person which gives rise to a duty to control, or between the actor and another which gives the other the right to protection. See Littleton, supra, 39 Ohio St.3d at 92, 529 N.E.2d at 455; Gelbman v. Second Natl. Bank of Warren (1984), 9 Ohio St.3d 77, 78, 9 OBR 280, 281, 458 N.E.2d 1262, 1263; Cleveland, Cincinnati, Chicago St. Louis Ry. Co. v. Potter (1925), 113 Ohio St. 591, 150 N.E. 44; 2 Restatement of the Law 2d, Torts (1965) 122, Section 315. Thus, liability in negligence will not lie in the absence of a special duty owed by a particular defendant. Hill v. Sonitrol of Southwestern Ohio, Inc. (1988), 36 Ohio St.3d 36, 38, 521 N.E.2d 780, 782.
R.C. 5122.29(B)(2), which pertains to the rights of the mentally ill in a hospital, states that "[a] person who is committed, voluntarily or involuntarily, shall be given reasonable protection from assault or battery by any other person." (Emphasis added.) In applying negligence principles to the instant case, it is evident that the defendant owed plaintiff a duty of reasonable care from harm inflicted by another patient during his stay at the facility. The ultimate question is whether defendant breached such a duty. The foregoing discussion and a review of the facts leads to scrutiny of the issue of foreseeability.
"The doctrine of reasonable anticipation or foreseeability of the consequences of one's negligent acts is clearly a part of the negligence law of Ohio. Thus, foresight, not retrospect, is the standard of diligence. To be liable in negligence, one must be guilty of something done or left undone with knowledge, or what is legally tantamount to knowledge, of the situation. Fault on the part of the defendant is to be found in action or nonaction, accompanied by knowledge, actual or implied, of the probable results of his conduct; and a person's liability for his acts depends upon their tendency under the circumstances as they are known or should be known to him. The question of negligence is to be determined by the consideration whether or not a party has guarded against those things which he might reasonably have had cause to anticipate. Although, where it is found that any unreasonable risk of danger should have been foreseen, the practicability of things the defendant might have done to avoid the risk should be taken into account. There is no actionable liability for negligence unless some injury resulting therefrom could reasonably have been foreseen in the light of attending circumstances. In other words, damages for an injury resulting from a negligent act of the defendant may be recovered if a reasonably prudent and careful person should have anticipated, under the same or similar circumstances, that injury to the plaintiff or to those in a like situation would probably result. * * *" (Footnotes omitted and emphasis added.) 70 Ohio Jurisprudence 3d (1986) 49-50, Negligence, Section 11. See, also, Menifee v. Ohio Welding Products, Inc. (1984), 15 Ohio St.3d 75, 15 OBR 179, 472 N.E.2d 707.
"In determining whether [defendant's agents] * * * should have recognized the risks involved, only those circumstances which they perceived, or should have perceived, at the time of their respective actions should be considered. * * *" Menifee, supra, at 77, 15 OBR at 181, 472 N.E.2d at 710. The court is of the opinion that defendant's agents could not have reasonably anticipated Hoskins' actions. In a patient population where fifty percent of the patients are exhibiting some aspects of paranoid schizophrenia, it is unreasonable and arbitrary to impose a mandate upon defendant that it must foresee and prevent hostile actions of each patient. It is difficult to predict a patient's violent outbursts and the ramifications thereof; otherwise, there would have to be an aide assigned to each patient on a daily basis — without doubt an unrealistic proposal.
It was clearly established that there were aides in the dining room observing the patients proceed through the serving line on the day in question. The incident occurred within a few seconds and was stopped by defendant's agents in a timely manner. The court finds that the incident was unforeseeable: there was no cause to anticipate a problem at the specific time and place. The staff's surveillance and protection of plaintiff and others was adequate under the circumstances, especially since there was no prior notice that Hoskins would act violently in such a situation. Upon review of the evidence, the court finds that plaintiff has failed to prove by a preponderance of the evidence that defendant, through its agents, had notice or should have foreseen such danger. Plaintiff has also failed to show by a preponderance of the evidence that Hoskins was a violent patient during this particular hospitalization, prior to the assault, or that the defendant knew or should have known of Hoskins' alleged propensity to be aggressive during the admission process.
In view of the foregoing, the court renders judgment for the defendant. The court finds that proceedings pertaining to defendant's counterclaim are unnecessary due to the rendered judgment; and, thus, this action shall be dismissed in toto.
Cause dismissed.
FRED J. SHOEMAKER, J., retired, of the Court of Common Pleas of Franklin County, sitting by assignment.