Discharged Psych Patient Kills Parent: Nurses Notes - Psychiatrist Should Have Read, Told Family

Legal Eagle Eye Newsletter for the Nursing Profession

September 1999

  Quick Summary: The court ruled the psychiatrist had a legal duty to inform himself and to disclose to the family the patient assessment data available in the nurses’ notes.   The court said the psychiatrist’s failure to do this was negligence which led to the mother’s injuries and the father’s death.

   The boy attacked his mother and murdered his seventy-three year-old father after being home four days.   The District Court of Appeal of Florida saw grounds for a medical negligence lawsuit against the psychiatrist who discharged a teenage psychiatric patient to his family.

     The court said the nurses had made extensive progress notes concerning the boy’s active hallucinations, delusions, neologistic speech, inappropriate sexual preoccupation, violence, threats voiced toward staff, suicidal tendencies, sleep disturbances and the need at times for two strong male attendants to control him.

   The court said the psychiatrist should not have ignored what the nurses had charted about his history of learning and behavioral disorders, his deteriorating and increasingly psychotic behavior, the fact his behavior was not being controlled by his medication, his agitation and his hostility toward his parents, particularly toward his father.

   The court took the nurses’ notes as proof the boy was in the throes of active psychosis and not an appropriate candidate for discharge to the home of parents who could not care for and control him.

   In general, mental health practitioners have the duty to control their patients and must warn family members when they are in harm’s way, the court said. O’Keefe v. Orea, 731 So. 2d 680 (Fla. App., 1998).