Estates of Morgan v. Fairfield Family Counseling Center

Supreme Court of Ohio · 1997 · Torts

TortsNegligenceDutyPsychotherapist liabilityThird-party harmspecial relationduty to controloutpatient

Facts

Dr. Brown treated Matt Morgan as an outpatient after receiving records from a prior Pennsylvania hospitalization, but according to plaintiffs' experts he failed to review those records or contact the prior physician, misdiagnosed Matt in part as a malingerer, and weaned him off antipsychotic medication. Experts testified that Matt had been medication-controlled, that stopping the medication increased the risk of dangerousness, and that continued monitoring, reinstatement of medication, aggressive intervention, or involuntary hospitalization could have prevented the later violence. FFCC later treated Matt, received repeated reports of his deterioration, violent outbursts, and gun purchase, and plaintiffs' experts testified FFCC used unqualified personnel to assess involuntary hospitalization and was ill-equipped to treat psychotic patients. On July 25, 1991, more than nine months after Dr. Brown last saw Matt, Matt killed his parents and injured his sister.

Issue

Does a psychotherapist owe a duty in the outpatient setting to take reasonable steps to control a patient's violent propensities and protect others from resulting harm? If so, is that duty in this case limited to readily identifiable victims, and were Dr. Brown and FFCC entitled to summary judgment?

Rule

The psychotherapist-outpatient relationship embodies sufficient elements of control to create a duty to exercise reasonable care to control the patient's violent propensities. In non-failure-to-warn cases, that duty is not limited to readily identifiable victims; it is enough that the defendant's conduct is likely to result in injury to someone. A psychotherapist is not required to predict violence perfectly, but must make an informed assessment of dangerousness and exercise professional judgment based on a careful examination and adequate information.

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One of 10 multiple-choice questions for this case. Pick an answer to see why.

In Columbus, psychiatrist Nina Patel treats Aaron Voss as an outpatient for psychosis. After several visits, she learns he has stopped sleeping, is becoming paranoid, and has begun carrying a knife, but she takes no further steps because he is not hospitalized and can leave her office whenever he wants. Two weeks later, Aaron stabs a stranger at a bus stop.

If the injured stranger sues Dr. Patel for negligence, which is the strongest argument against Dr. Patel's motion to dismiss for lack of duty?

Explanation. The majority held that the psychotherapist-outpatient relationship may contain enough real control to support a duty to exercise reasonable care to control the patient's violent propensities. The court rejected the view that actual confinement or physical custody is required. It also did not limit non-warning claims to named victims, and it emphasized that psychotherapists are not insurers of patient behavior.