DeMontiney v. Desert Manor Convalescent Center, Inc.

MEYERSON, Judge,

dissenting:

Because I believe that the majority opinion is in error with respect to two crucial issues presented in this appeal, I dissent.

First, the majority affirms the directed verdict granted in favor of Yuma County. In so doing, I believe that the majority misinterprets A.R.S. § 36-545.06. Subsection (A) provides:

Each county, or any combination of counties, shall provide directly or by contract the services of a screening agency and an evaluation agency for the purposes of this chapter.

The majority states that “[w]e find the legislative intent clear that, while a county must provide for emergency evaluation services it may do so either by providing the services itself, or by contracting with another qualified party to provide such services for it.” Implicitly, the majority necessarily concedes that the duty to provide for emergency evaluation services rests with the county. Indeed, the statute expressly provides that each county “shall provide” the necessary services. The county may fulfill its obligations either by providing the services directly or by contracting for such services. Regardless of how the services are delivered, I believe the ultimate legal obligation to provide the services rests with the county.

If this is the correct reading of the statute, then Restatement § 424 is directly applicable. It provides:

One who by statute or by administrative regulation is under a duty to provide specified safeguards or precautions for the safety of others is subject to liability to the others for whose protection the duty is imposed for harm caused by the failure of a contractor employed by him to provide such safeguards or precautions.

The Restatement would apply whenever a statute imposes a duty upon one to provide “safeguards or precautions” for the safety of others. The specific safeguards and precautions owed to a person such as the *30decedent are contained in A.R.S. § 36-530 (1974).*

A person admitted to an evaluation agency shall receive an evaluation as soon as possible after the court’s order for evaluation and receive care and treatment as required by his condition for the full period that he is being evaluated.

Because the county has a duty to provide the services of an evaluation agency, it thus had the duty to provide for the decedent’s “care and treatment ... required by his condition.” Although the delivery of evaluation services may be done by a contracting agency, the legal duty to insure that appropriate care and treatment are given remains with the county.

This is not a case in which the basis of the county’s liability was solely derivative from the acts of its contracting agencies. Appellant contended below that Yuma County was actively and independently negligent. The deceased was taken to and confined in a room at Desert Manor by a deputy sheriff. During his entire stay no one entered his room other than a deputy sheriff; in fact, no one could enter the room without the permission and presence of a deputy. Although the deceased was ordered to be released from the detention room by late morning on June 7, 1978, he remained in custody and locked in the room until he was pronounced dead that evening.

The majority’s analysis of the contracts between the county, HSRI, Desert Manor and Yuma County Guidance Clinic is not persuasive. The county contracted with Desert Manor for, among other things, “isolation facilities and space for maximum security.” The decedent was placed in such isolation facilities. The majority candidly points out that this contract expressly states that it is “agreed and understood between the parties that professional and legal responsibility for patients confined in said maximum security section shall be the responsibility” of Yuma County and that Desert Manor “shall provide only nursing service, dietary service and housekeeping within said facility.” Thus, even if the statute were construed to mean that the county could delegate its duties, the contract between the county and Desert Man- or expressly reserves for the county the “professional and legal responsibility” for patients confined in the isolation facilities. With the county removed from the case, the plaintiff was placed at a serious disadvantage in presenting its case against Desert Manor to the jury because the jury could have understandably concluded that Desert Manor’s responsibility was contractually limited to services unrelated to the statutory duty to provide for the deceased’s “care and treatment.”

The majority finds “persuasive” a provision in the contract between the county and HSRI. In that contract, HSRI agreed to “deliver medical care” to “mental hold” patients. The provision relied upon by the majority states that “[sjupervision and job performance of the employees will remain with HSRI. Employment of personnel to fill new or vacated positions will also be the responsibility of HSRI.” The majority concludes that this provision means that the medical care of the decedent at the time of his death was the responsibility of HSRI and not the responsibility of Yuma County. But the majority is using the word “responsibility” in a very loose sense. Although under the contract HSRI had the responsibility to provide medical services, there is nothing in the contract to suggest that the legal obligation or duty to provide medical services in any way was shifted from the county to HSRI. Thus, in my opinion, the contract language relied upon by the majority fails to support its position.

The second error made by the majority is directly related to its decision affirming the directed verdict in favor of Yuma County. The majority upholds the trial court’s refusal to give appellant’s requested Instruction No. 7. That instruction provides:

*31You are instructed that if those charged with the care and treatment of a mentally-disturbed patient knew of facts from which they could reasonably conclude that the patient would be likely to harm himself in the absence of preclusive measures, then they must use reasonable care under the circumstances to prevent such harm.

The majority says that this instruction is not required under Maricopa County v. Cowart, 106 Ariz. 69, 471 P.2d 265 (1970). Although the instruction is not required under Cowart, it is at least suggested by Cowart. The majority does not state that the foregoing is an incorrect statement of law. Indeed, the instruction is taken verbatim from Meier v. Ross General Hospital, 71 Cal.Rptr. 903, 906-07, 69 Cal.2d 420, 424, 445 P.2d 519, 522-23 (1968). See generally, Comment, Civil Liability for Suicide: An Analysis of the Causation Issue, 1978 Ariz.St.L.J. 573.

Without pointing to other instructions, the majority suggests that the gist of appellant’s instruction was covered by others. But the other instructions only concern general negligence and malpractice. No instruction set forth a specific duty of care owed to a suicidal patient. The defendants argued to the jury that if someone has made up his mind to take his own life there is nothing that anyone can do to stop him. Clearly, unless the jury was instructed that those having the responsibility and care for a suicidal patient had a specific duty to prevent him from taking his own life, the jury could have simply concluded that the prevention of suicide is outside of and beyond the scope of the general standard of nursing and medical practice. The core question of whether the defendants owed the deceased the specific obligation to prevent him from taking his own life was an issue central to appellant’s case and the trial court’s refusal to give such instruction deprived appellant of a substantial and important right.

For the foregoing reasons, I dissent.

This subsection has subsequently been slightly amended. Laws 1979, ch. 64, § 28. The substance of this provision, however, remains the same.