Mental Health Procedures Act; Limited Immunity for Care of Addicted Patients

Dean v. Bowling Green Brandywine, 192 A.3d 1177 (Pa. Super. 2018), allocatur granted March 4, 2019, appeal docket 20 MAP 2019

Andrew Johnson, 23, who was suffering from addiction to opiates and benzodiazepines, voluntarily applied for admission to Bowling Green Brandywine Treatment Center.  During his less than ten day stay, Johnson was twice transported to Jennersville Regional Hospital for emergency treatment, but was back at Brandywine at the time of his death when he was discovered unresponsive on the floor of his room.  The evidence indicated he died of cardiac arrhythmia caused by deficient potassium levels and side effects of the medications in his system.  Johnson’s estate sued both the Brandywine and Jennersville health care facilities and professionals involved in his treatment.

The issue presented is whether either the Brandywine or the Jennersville facilities or their medical professionals who were responsible for Johnson’s care are entitled to limited immunity under the Mental Health Procedures Act (MHPA).  Section 7114 of the MHPA, 50 P.S. § 7114, provides that those who are engaged in treating or examining a patient under the act cannot be held liable absent “willful misconduct or gross negligence.” The MHPA applies to the “voluntary inpatient treatment of mentally ill persons,” 50 P.S. § 7103, but does not define the term “mentally ill person” or “mental illness.”  The MHPA defines “treatment” broadly to include “diagnosis, evaluation, therapy, or rehabilitation needed to alleviate pain and distress and to facilitate the recovery of a person from mental illness and shall also include care and other services that supplement treatment and aid or promote such recovery.” 50 P.S. § 7104.

 The trial court granted an involuntary nonsuit at the close of Johnson’s evidence as to all defendants, finding that the MHPA’s gross negligence limited immunity standard applied to all, and that the evidence did not rise to the level of gross negligence for any.  Johnson appealed, and Superior Court affirmed as to some defendants, but reversed and remanded as to others, reasoning that the defendants who were treating Johnson for mental health issues at the time of the alleged negligent acts were entitled to limited immunity under the MHPA, but that the defendants who were not treating him for mental health issues were not.  Superior Court found that Johnson’s evidence revealed that the health care professionals at Brandywine were treating Johnson for mental health issues (“mood disorder, anxiety disorder, et cetera, [and] opioid substance abuse induced mood” Slip Op. at 10), and thus were entitled to limited immunity,  whereas the emergency medical professionals at Jennersville hospital were not treating for mental health issues and so were not entitled to limited immunity.

Johnson’s estate sought allocatur review by the Pennsylvania Supreme Court, contending that Johnson was not mentally ill and did not seek voluntarily inpatient treatment for a mental illness, such that the MHPA limited immunity provisions do not apply.  The Court has granted allocatur as to the following issues:

  1. Whether the Superior Court, in reviewing a nonsuit, properly applied the provisions of the Mental Health Procedures Act (“MHPA”) and the evidence in the light most favorable to the plaintiffs in granting limited immunity to a drug addiction treatment facility and its physicians where the individual who died while under the care of the facility was not mentally ill and did not seek voluntary inpatient treatment for a mental illness.
  2. Whether the Superior Court properly applied fundamental notions of due process and the provisions of the Mental Health Procedures Act (“MHPA”) to an individual who did not give consent to voluntary treatment under the MHPA.

Allocatur grants present an excellent opportunity for your group or association to advance your legal and policy goals by filing an amicus brief. Participating as an amicus has proven to be an effective method of advising and influencing courts and often can involve far fewer resources than traditional lobbying.

If you are interested or would like more information, contact Kevin McKeon or Dennis Whitaker.