Tuesday, January 27, 2015

To Admit or Not To Admit? Healthcare Providers Are Immune Either Way

In Gineene Williams, et al. v. Peninsula Regional Medical Center, et al., 2014 Md. LEXIS 781 (2014), the Court of Appeals of Maryland held that that the involuntary admission immunity statute codified at the Health General Article of the Maryland Annotated Code, Section 10-618 applied to health care providers who evaluated an individual and decided in good faith to involuntarily admit - or not admit - that individual. 

Section 10-618 reads in relevant part that "[a] person who applies for involuntary admission of an individual shall have the immunity from liability described under § 5-623(b) of the Courts and Judicial Proceedings Article," which states that "[a] person who in good faith and with reasonable grounds applies for involuntary admission of an individual is not civilly or criminally liable for making the application." The Court’s ruling dissolved any ambiguity in the statute in relation to its application of liability to situations in which a healthcare provider declines to apply for involuntary admission of an individual.

On April 20, 2009, Gineene Williams brought her son, Charles Williams, Jr. (“Williams”), to Peninsula Regional Medical Center (“PRMC”) for evaluation relating to suicidal ideation and auditory and visual hallucinations. Upon completing the examination, the health care providers elected not to admit Williams, instead discharging him to the care of his mother and advising her to remove any firearms from the home. Later that evening, Williams escaped from his mother's care, wandered the streets, broke into a local residence, and engaged with law enforcement, resulting in his death. His family sued PRMC for wrongful death. 

PRMC filed a Motion to Dismiss for failure to state a claim upon which relief may be granted, asserting statutory immunity under section 10-618. Plaintiffs asserted the statute only applied to situations in which a healthcare provider ultimately sought admission of a patient, and thus did not apply to PRMC in Williams’ case. The trial court, Court of Special Appeals, and the Court of Appeals of Maryland all disagreed. 

In reaching its opinion upholding both the lower courts, the Court considered the language of the text, the legislature's intent, and general public policy. The Court reasoned that:

"[i]f the General Assembly’s intention was to protect individuals from undue deprivation of liberty, it would make little sense to give health care providers an incentive to err on the side of involuntary admittance in order to receive statutory immunity and avoid liability. Instead, the statutory scheme protects the discretion of health care providers tasked with deciding whether to involuntarily admit an individual."

            Williams, 2014 Md. LEXIS at *19.

By applying the statute in the reverse, the Court of Appeals of Maryland resolved the ambiguous statutory language and removed the fear of a lawsuit out of the decision making process for the analysis of involuntary admissions.

For medical providers and healthcare facilities  -- and the insurers of both --  this is an important decision as it strengthens the ability of doctors and nurses to make decisions based on what is medically appropriate rather than based upon fear of liability.