Kowalski v. St. Francis Hosp. & Health Ctrs. , 20 N.Y.3d 483 (2013)
A hospital generally does not have a duty to prevent an intoxicated patient who is not suicidal and who voluntarily seeks treatment from leaving the premises, as doing so could constitute false imprisonment.
Summary
The New York Court of Appeals held that a hospital and its emergency room doctor did not owe a duty to an intoxicated patient to prevent him from leaving the hospital after he voluntarily sought treatment. The patient, who had a high blood-alcohol content but was alert and able to walk, removed his IV and stated his intention to leave. The doctor declined to call the police. The court reasoned that absent statutory authority or common-law principles permitting restraint (such as the patient posing an immediate danger to himself or others), preventing the patient from leaving would infringe on his liberty and expose the hospital to liability for false imprisonment. The court emphasized that Mental Hygiene Law § 22.09 governs the retention of intoxicated individuals and does not allow for involuntary retention of individuals who come to the hospital voluntarily.
Facts
Plaintiff was brought to St. Francis Hospital’s emergency room seeking admission to its detoxification facility, “Turning Point.” He had a prior admission for suicidal thoughts a month earlier. On this visit, he showed severe signs of intoxication (blood alcohol content of .369%) but was alert and able to walk. He was accepted into the Turning Point program. Four hours later, while waiting for transport to Turning Point, he removed his IV, stated he was leaving, and ignored a nurse’s request to wait for a ride. The nurse informed the doctor, who notified security but did not call the police. Plaintiff left and was hit by a car shortly after.
Procedural History
Plaintiff sued the hospital and doctor for negligence and medical malpractice. The Supreme Court denied the defendants’ motion for summary judgment. The Appellate Division reversed, granting summary judgment to the defendants, finding they lacked authority to confine the plaintiff. The Court of Appeals granted leave to appeal.
Issue(s)
Whether a hospital and emergency room doctor have a duty to prevent an intoxicated patient, who voluntarily seeks treatment but is not suicidal or an immediate danger to himself or others, from leaving the hospital.
Holding
No, because absent legal authority to restrain the patient, the hospital and doctor had no duty to prevent him from leaving. To do so would have exposed them to liability for false imprisonment.
Court’s Reasoning
The court emphasized the fundamental right of individuals in a free society to come and go as they please, subject to limited exceptions. It noted that common law permitted restraint only in extreme circumstances where a person’s mental state posed an immediate danger to themselves or others, citing Warner v. State of New York, 297 NY 395, 401 (1948). Mental Hygiene Law § 22.09 governs the retention of intoxicated individuals. While it allows for emergency retention of those brought against their will if they pose a likelihood of harm to themselves or others (manifested by suicidal threats or attempts at serious bodily harm), it makes no provision for involuntary retention of individuals who voluntarily seek treatment. The court stated, “A patient cannot be confined simply because he was having suicidal thoughts a month ago.” The court rejected the argument that a duty to restrain flowed from the common-law duty of care, stating, “there can be no duty to do that which the law forbids. To restrain plaintiff on these facts would have exposed defendants to liability for false imprisonment.” The court also dismissed the significance of the doctor’s failure to call the police, stating the police lacked the authority to force the plaintiff to return based on the known facts. The dissent argued the Mental Hygiene Law was not implicated and the defendants failed to follow their own protocols; however, the majority stated there was no causal connection between the alleged protocol departures and the plaintiff’s injury.