Farago v. Sacred Heart General Hospital

LARSEN, Justice,

dissenting.

I dissent. The Mental Health Procedures Act (the Act), Act of July 9, 1976, P.L. 817, No. 143, 50 Pa.Stat.Ann. § 7101-7503 (Purdon’s Supp.1988), does not in my view immunize Sacred Heart General Hospital, the appellee, from civil liability in this case.

Section 114 of the Act, 50 P.S. § 7114, provides that in the absence of gross negligence or willful misconduct, the following are immune from civil or criminal liability for decisions relating to treatment, admission, discharge, etc. of *420persons covered by or subject to the Act: “a county administrator, a director of a facility, a physician, a peace officer or any other authorized person who participates in a decision” regarding said treatment, admission, discharge, etc. Because the Act does not specifically define “person,” the majority looks to the Statutory Construction Act of 1972 for guidance, specifically definitional section 1991, 1 Pa.C. S.A. § 1991, which provides: '

The following words and phrases, when used in any statute ..., unless the context clearly indicates otherwise, shall have the meanings ascribed to them in this section:
>j< jjc $ # 3[c
“Person.” Includes a corporation, partnership, and association, as well as a natural person.

The Mental Health Procedures Act (the Act) clearly indicates otherwise — “person” is used in section 114 and throughout the Act to refer to natural persons. Section 114 specifically names four natural persons (county administrator, director of a facility, physician, and peace officer) who receive some immunity under the Act when they participate in decisions regarding admission, treatment, discharge, etc. and names a fifth non-specific “other authorized person who participates in a decision____” to receive said immunity. Clearly, decisions under the Act and under this section are made by natural persons, not by corporations, associations, etc. “Persons” is used later in this same section to refer to those natural persons needing/receiving treatment — surely the legislature did not mean to include corporations, etc. as “persons” who would receive or be refused treatment under the Act, nor did they intend to have two different operative definitions of “person” within the same section.

To the contrary, throughout the Act “person” is used to describe natural persons, both those receiving/needing treatment and those administering it, while “facility” is used to define the corporate, business entities providing the services. Section 114’s “any other authorized person who *421participates in a decision that a person be examined or treated under this act, or that a person be discharged, or placed under partial hospitalization ...,” etc., would presumably include those natural persons identified in section 106, “Persons responsible for formulation and review of treatment plan,” 1 and those natural persons who are authorized in section 201 to subject a child under 14 years of age to examination and treatment.2 In contrast, “facility” is clearly and specifically defined in section 103 of the Act, 50 P.S. § 7103, as follows:

Scope of act
This act establishes rights and procedures for all involuntary treatment of mentally ill persons, whether inpatient or outpatient, and for all voluntary inpatient treatment of mentally ill persons. “Inpatient treatment” shall include all treatment that requires full or part-time residence in a facility. For the purpose of this act, a “facility means any mental health establishment, hospital, clinic, institution, center, day care center, base service unit, community mental health center, or part thereof, that provides for the diagnosis, treatment, care or rehabilitation of mentally ill persons, whether as outpatients or inpatients. (Emphasis added.)

The legislature made a clear distinction, then, between those natural persons who participate in decisions under the Act and administer its provisions, and the mental health care facilities providing services under the Act. Just as clearly, had the legislature intended to immunize the mental health care facility from immunity with section 114, 50 P.S. § 7114, it would surely have immunized “any other authorized person or facility____” The legislature did not do this, however, and the context not only of this section but of *422the entire Act indicates that this omission was intentional and that “person,” for purposes of immunity under section 114, means natural persons as it does everywhere else in the Act.

Furthermore, I disagree with the majority’s analysis of the scope of the immunity provided by section 114. I do not believe that appellants’ complaint is limited to the individualized treatment prescribed for Jessie L. Farago “in this unscientific and inexact field.” At 417-419. That is, assuming for argument’s sake only that appellee hospital is immune from liability under the Act, its “decision to admit Mrs. Farago under routine orders, including hourly checks ... specially formulated for her particular needs at the time of her admission,” at 304, might well be an immunized decision. However, appellants do not complain solely of that decision or its consequences; rather their complaint alleged negligence on the part of the hospital for failing to adequately supervise Jessie Farago and protect her from other potentially and actually dangerous persons in the facility such as her alleged rapist.

Appellants do not seek recompense for damages caused by her “routine” admission with hourly checks, but rather from a sexual assault upon her by an unsupervised patient. It is obvious that “sexual assault by an unsupervised patient” was not part of the individualized treatment plan prescribed for Jessie Farago and that appellant’s complaint does not seek remedy for damages arising from her treatment plan. If Jessie Farago had wandered onto a driveway on hospital grounds and was struck by a car commandeered by an unsupervised patient, her complaint for damages would not be based upon the method of treatment or the treatment plan devised for her or for the other patient, but upon the hospital’s ordinary negligence in failing to take adequate security measures to prevent such occurrence. No legitimate treatment plan under the Act would provide for or contemplate negligent supervision of patients.

I would hold that Sacred Heart General Hospital is not immune from liability under the Act and that, therefore, the *423jury should have been instructed on a standard of ordinary care, not gross negligence or wilful misconduct. I would reverse Superior Court on that basis and would not reach the issue of the scope of the immunity provided by the Act, although I express my disagreement with the majority’s analysis thereof and its holding that Sacred Heart’s conduct in this case was within the scope of the immunity provided.

PAPADAKOS, J., joins this dissenting opinion.

. Section 106 of the Act, 50 P.S. § 7106, provides for "treatment teams” to formulate and review individualized treatment plans for persons in treatment under the act, which teams are to be under the direction of either a physician or a licensed clinical psychologist.

. Section 201 of the Act, 50 P.S. § 7201, provides that "A parent, guardian or person standing in loco parentis to a child less than 14 years of age may subject such child to examination and treatment under this act____”