Defense Verdict on the Trial and Appellate Levels in a New Hampshire Suicide Case

In a trial involving a psychiatrist insured under The Psychiatrists' Program, plaintiff alleged wrongful death and unfair and deceptive trade practices under the New Hampshire Consumer Protection Act.

The patient treated with the psychiatrist from July 11, 1996 to July 16, 1996 on a voluntary admission following a suicide attempt where he pointed a loaded gun at his head. The diagnosis was major depression, alcohol abuse. A stormy relationship with his common-law wife was also noted. Apparently the patient had knowledge of flirtations between his half-brother and his common-law wife and was no longer residing at their residence. The patient was placed on Paxil.

On July 15, 1996, the patient gave the psychiatrist the required 24-hour notice for voluntary discharge. Prior to release, follow-up care was arranged for the patient at an outpatient facility. At the discharge meeting, the patient told the psychiatrist that he was hurting and talking to other people was depressing, but his stay in the hospital had helped and since suicide meant hurting his family and friends, it was not an option for him. After a determination that there were no grounds for an involuntary admission, the patient was released.

Following his discharge, the patient alleged he experienced some problems with Paxil. No problems were reported to the psychiatrist. Phone records between July 19th -26th showed two phone calls to the hospital, one to the psychiatrist on July 25, 1996 and two to the primary care physician. Allegedly, the psychiatrist received a phone message on July 25 and did not return it until July 29.

On July 28, 1996 the patient committed suicide by gunshot wound to the head.

Witnesses testified that on the date of his suicide, the patient was doing well. He did, however, consume a large amount of alcohol while on an outing with friends that resulted in a .157 blood alcohol level one hour after the shooting. The patient then visited his common-law wife and son. While there, he went experienced a fit of rage that caused his common-law wife to telephone his mother and ask her to come over. When the mother got there she saw the patient on the front lawn slashing his wrists while saying, "This one is for you" and "This one is for her." The patient then returned to the mother's home where he was living. She found him rummaging through her bedroom, apparently looking for a gun, since she told him, "Don't bother looking, you wont find them (guns) here." Still in a rage, the patient went to his father's house, which he broke into, to get a gun. He then drove to a friend's home and shot himself in the friend's driveway.

At no time did either the mother or the common-law wife contact anyone for help with the patient.

The trial lasted about a week and the jury returned a defense verdict finding the psychiatrist negligent but not responsible for any damages to the patient. Obviously the jury saw no causal relationship between the psychiatrist treatment and his patient's subsequent suicide.

Plaintiff then appealed to the Supreme Court of New Hampshire. Defense Counsel, who had filed motions for directed verdict in the initial case, cross-appealed in the appellate case arguing that the trial court erred in denying his motions for a directed verdict. In other words, the defense argued that the facts were so clearly in favor of the psychiatrist that a jury should not have been able to render a verdict at all. The Judge should have ruled that the law required a finding in favor of the psychiatrist because there was no causal relationship between the psychiatrist and the plaintiff's damages.

The Supreme Court of New Hampshire agreed with the defense and affirmed the judgment in favor of the psychiatrist.

Claims Lessons:
An important element in the defense of the case was the well-documented chart of the psychiatrist. While the missed return phone call was an issue, the medical records demonstrated that the standard of care was met. Also, the verdict confirmed the ability of juries to understand the importance of causation as a legal element of negligence.