Pennsylvania Supreme Court Affirms Mental Health Provider’s Liability For Psychiatric Patient’s Harm To Others

The Supreme Court of Pennsylvania Western District (“Pennsylvania Supreme Court”), in its Opinion filed on July 21, 2020, stated: “We consider the duty of mental health treatment providers to warn individuals who may be the subject of their patient’s threats. In the present appeal, the mental health patient lived in a forty-unit apartment building and repeatedly told his doctors and therapists he would kill an unnamed “neighbor.” Tragically, he ultimately carried out his threat, killing an individual who lived in his building, a few doors away from his own apartment. In subsequent wrongful death litigation filed by the victim’s mother, the providers argued they had no duty to warn anyone about their patient’s threats because he never expressly identified a specific victim. The trial court rejected this argument and denied the providers’ motion for summary judgment, allowing the case to proceed to trial. On appeal, the Superior Court agreed, and we now affirm.”

The Underlying Facts

Prior to 2008, Terrance Andrews resided in a supported living facility under the supervision of and while receiving ongoing mental health treatment from appellants UPMC Presbyterian Shadyside d/b/a Western Psychiatric Institute and Clinic, Western Psychiatric Institute and Clinic (“WPIC”), the Western Psychiatric Institute and Clinic Adult Community Treatment Team (“CTT”), and Michelle Barwell, M.D. In January 2008, Andrews signed a one-year lease for an apartment on the fourth floor of Hampshire Hall in Pittsburgh.

Andrews repeatedly complained to appellants about his housing circumstances and asked to be returned to a supported living environment with caregivers on-site. For a period of five months after moving into Hampshire Hall, Andrews frequently expressed to appellants suicidal and homicidal ideation, complaining about his “neighbors” and others, including threats to kill a “neighbor” who had been knocking at his door in the middle of the night. He reportedly had several verbal run-ins with various neighbors, one of which resulted in his next-door neighbor’s boyfriend hitting him with a baseball bat.

On May 9, 2008, Andrews again reported homicidal ideation against a “neighbor” to staff at WPIC’s Department of Emergency Care, and a plan to stab the “neighbor” with scissors, but he was allowed to leave. Within 24 hours, Andrews returned to the Department of Emergency Care and expressed homicidal ideation against an unnamed “next-door” neighbor, and a brief voluntary hospitalization ensued. Following discharge, on May 15, 2008, Andrews again described a plan “to kill the next-door neighbor and everyone.” Andrews did not identify any neighbor by name and appellants took no measures to warn any residents of Hampshire Hall regarding these threats.

On May 25, 2008, Andrews again sought an in-patient admission at WPIC, asserting he had not been taking his medication for three weeks, was hearing voices, and was having suicidal and homicidal thoughts. A case manager at that facility dissuaded him from seeking admission, and sent him home to his apartment with medication for agitation and a promise to secure him placement in a personal care home within 36 hours.

On May 29, 2008, Andrews murdered Lisa Maas, a nineteen-year-old Pennsylvania Culinary Institute student, by stabbing her to death with scissors in her apartment located five doors away from Andrews’s own apartment on the fourth floor of Hampshire Hall.

The Pennsylvania Supreme Court stated, “for purposes of determining if appellants had a duty to warn Lisa Maas, we consider whether a “moment’s reflection” by appellants would have sufficed to readily identify Andrews’s unnamed neighbor-victim as a Hampshire Hall resident, and whether imposing a duty to warn under such circumstances is warranted.” The Pennsylvania Supreme Court stated, “The record easily supports the trial court’s conclusion that living in Hampshire Hall was a “stressor” for Andrews … It is also undisputed that, during the period when Andrews repeatedly sought transfer out of Hampshire Hall and back to a supported living facility, he repeatedly told appellants he would kill his “neighbors.” Moreover, viewing the summary judgment record in the light most favorable to appellee as the non-moving party, … it is clear that appellants might have surmised, on “a moment’s reflection,” … that Andrews was targeting residents of his apartment building specifically, and particularly those on his floor with whom he interacted or had greater opportunity to interact. Indeed, Andrews referred on multiple occasions to “nextdoor neighbors,” and a “neighbor” who knocked on his door in the “middle of the night” … Under the undisputed facts of the current record, it cannot reasonably be said that when Andrews threatened to kill a “neighbor,” he was uttering an ambiguous threat against an “amorphous group” of the public at large, residing in the urban South Oakland section of Pittsburgh generally, rather than one of his neighbors residing in Hampshire Hall.”

The Pennsylvania Supreme Court held: “The trial court and the Superior Court thus properly determined the duty to warn applies not only when a specific threat is made against a single readily identifiable individual, but also when the potential targets are readily identifiable because they are members of a specific and identified group — in this case, “neighbors” residing in the patient’s apartment building. In these circumstances, the potential targets are not a large amorphous group of the public in general, but a smaller, finite, and relatively homogenous group united by a common circumstance. Surely, Lisa Maas was a member of such a group relative to Andrews, and described in the complaint as “all Hampshire Hall tenants, particularly those who resided on the same floor as Mr. Andrews.”” (emphasis added)

Source Maas v. UPMC Presbyterian Shadyside d/b/a Western Psychiatric Institute and Clinic, J-88-2019.

If you lost a loved one for which faulty mental health care may have contributed to the death, you should find a medical malpractice lawyer in your U.S. state who may investigate your negligent mental health care claim for you and represent you or your loved one in a mental health malpractice case, if appropriate.

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