In its published opinon dated August 31, 2021, the Court of Appeal of the State of California Fourth Appellate District Division Three (“California Appellate Court”) affirmed a jury’s verdict in the amount of $3.9 million ($1.7 million for past damages and $2.2 million for future damages) in a California wrongful death lawsuit regarding Jeffrey Green (Green), who committed suicide by jumping from the roof of the drug rehabilitation treatment facility Anaheim Lighthouse (Lighthouse). The jury found Lighthouse negligent and allocated the fault 65 percent to Lighthouse and 35 percent to Green.
Green was 33-years-old at the time of his admission to Lighthouse. He had been addicted to oxycontin since age 16 and had been taking a high dose of methadone since age 27. At the time of his admission to Lighthouse, no one suggested Green was suicidal, and Green stated he had no suicidal thoughts. In his depression assessment questionnaire, Green responded he had no thoughts of killing himself. Green completed a “no harm contract” where he agreed he was not going to harm himself or attempt suicide. Lighthouse classified Green as “no safety risk” because his only risk factor was a prior family suicide.
At trial, the experts disagreed whether Lighthouse should have admitted Green as a patient. Plaintiffs’ expert, Dr. Michel Sucher, opined Green should have been in a medically managed detoxification (detox) program. Lighthouse’s expert, Dr. Mace Beckson, testified Green did not need to be hospitalized for medical detox. He opined an opiate detox for a person who is otherwise young and healthy does not need to be in a hospital setting.
Prior to Green’s transfer from detox to treatment, a marriage and family therapist intern met with him and noted that Green was anxious and exhibiting withdrawal symptoms, but Green denied any suicidal ideation. Lighthouse’s treating physician, Dr. Michael Bishara, decided to transfer Green from the detox program to the rehabilitation treatment program. Green did not ask to delay the transfer. At trial, the experts disagreed whether Lighthouse should have transferred Green.
After Green was transferred to treatment, he handed the intern a note that read, in part, “If I leave the clinic can you tell the police clinic Im suicidal to hold me.” After receiving the note, the intern immediately informed the program director, program administrator, and program coordinator. She also called the supervising clinical psychologist who instructed the intern to assess Green and call the psychiatric emergency team if needed.
The intern spent one hour with Green and performed a suicide risk assessment. The intern again noted that Green was anxious and experiencing severe withdrawal symptoms. At this meeting Green reported having thought about suicide previously, but denied ever attempting suicide and denied any suicidal ideation. The intern asked Green about his note, specifically about the part referencing “[i]f I leave the clinic can you tell the police . . . Im suicidal to hold me.” Green responded that “‘this is not now.’” After she met with Green for about an hour, the intern concluded he was not suicidal and did not call the psychiatric emergency team.
Green subsequently jumped from the roof. While there was no video footage of Green climbing onto the roof, one of the facility’s cameras showed Green falling. He died from his injuries shortly thereafter.
At trial, the experts disagreed about the cause of Green’s suicide. The plaintiff’s expert, Sucher, stated if Green had gotten the proper level of care, “he would [not] have killed himself or been in a situation where he could have killed himself.” Sucher opined Green’s suicide was preventable and was the result of his intolerable withdrawal symptoms. Sucher questioned the conclusions by the marriage and family therapist interns that Green was not suicidal.
Lighthouse’s expert, Dr. Mace Beckson, testified it is difficult to predict suicide with any accuracy. He noted that Green had not previously been suicidal. Beckson testified Green showed no indication of severe mental illness, and that Green’s note was not a suicide note. He explained that a person normally writes a suicide note to be found after death, but here Green handed the note to a staff member. Green’s act was not consistent with an intent to commit suicide. In contrast, the statement in the note about suicide was conditional: “‘If I leave the clinic, can you tell the police I’m suicidal, to hold me.’” Beckson stated that Green was likely struggling with whether to stay at Lighthouse and wanted to set up a “fail-safe plan.”
Lighthouse appealed the verdict against it and asserted that it was entitled to a new trial because the trial court failed to instruct the jury on the superseding cause defense and premises liability. In general, if the risk of injury is reasonably foreseeable, the defendant is liable. An independent intervening act is a superseding cause relieving the actor of liability for his negligence only if the intervening act is highly unusual or extraordinary and hence not reasonably foreseeable. In an action for wrongful death of an individual who has committed suicide, the intentional act of suicide is a superseding cause of harm and relieves the original actor of liability unless such act was reasonably foreseeable or the failure to foresee such act was a factor in the original negligence.
The California Appellate Court stated, “The only possible basis for the jury’s negligence finding here was that Green’s suicide was foreseeable to Lighthouse. This finding rendered the superseding cause defense inapplicable.”
The California Appellate Court stated: “If the jury had agreed with Lighthouse that Green’s suicide was not foreseeable to Lighthouse, it would have necessarily found that either Lighthouse was not negligent or that its negligence was not a cause of the suicide. Since [the plaintiff’s] theory of negligence was necessarily predicated on Lighthouse’s failure to take adequate precautions to prevent Green’s foreseeable suicide, that suicide as a matter of law could not be a superseding cause. As correctly noted by the trial court in refusing the proposed instruction, “I think this instruction would sort of say that [Green’s] suicide is a superseding cause of [Green’s] suicide.” The suicide cannot be a superseding cause as it was the foreseeable conduct that rendered Lighthouse negligent. Case law endorses the principle that the very conduct forming the basis for a plaintiff’s negligence claim cannot also be a superseding cause [“It is well established that when a defendant’s negligence is based upon his or her having exposed the plaintiff to an unreasonable risk of harm from the actions of others, the occurrence of the type of conduct against which the defendant had a duty to protect the plaintiff cannot properly constitute a superseding cause that completely relieves the defendant of any responsibility for the plaintiff’s injuries”] … Green’s suicide could not have “broken the chain of causation” since it was the very foreseeable risk that rendered Lighthouse’s conduct negligent.”
“The jury here would have been able to reach the issue of superseding cause, only after it first determined Lighthouse’s negligence in failing to protect against Green’s foreseeable suicide. However, as explained above, that negligence finding necessarily meant Green’s suicide could not have been a superseding cause. This was exactly what the trial court sought to explain when it rejected Lighthouse’s requested instruction.”
Source Green v. Healthcare Services, Inc., G057950.
If you lost a loved one due to suicide in California or in another U.S. state for which mental health negligence may have caused or contributed to the death, you should find a California medical malpractice lawyer or a medical malpractice in your state who may investigate your suicide claim for you and represent you or your loved one’s family in a suicide malpractice case, if appropriate.
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