“Proximate Cause” and the Patient Suicide Problem

Truddle v. Baptist Memorial Hosp.-Desoto, Inc., — So.3d — (Miss. 2014)

A hospital patient suffering from a number of illnesses became agitated and aggressive. He took the IV out of his arm and attempted to leave the hospital. When nurses stopped him and forced him back to his room, he hallucinated that someone was trying to rape him.

Despite these psychiatric symptoms, the patient was discharged and treated as an outpatient. During his outpatient treatment, he complained to his doctor that the medications he was taking “make him crazy.” Six days after his release from the hospital and two days after his last outpatient appointment, the patient barricaded himself in his bedroom and committed suicide.

In the ensuing action for wrongful death, the patient’s mother alleged that his doctors negligently failed to prevent his suicide. The Mississippi Supreme Court ruled that this action is doomed to direct dismissal due to its manifest failure to show proximate cause. The Court explained that “Nothing in Mississippi caselaw, save the irresistible-impulse doctrine, … abrogates the general rule that suicide constitutes an independent, intervening and superseding event that severs the causal nexus between any wrongful action on the part of the defendant.” This principle, the Court further explained, extends to medical-malpractice claims. Because the suit filed by the patient’s mother did not go beyond “an argument that [the defendants] were negligent in not recommending a psychiatric evaluation,” it did not show a cause of action. According to the Court, only an “intentional conduct on the part of [the defendants] that proximately created an irresistible impulse in [the patient] to commit suicide” was actionable under Mississippi law.

Mississippi law thus uses the old “contest of faults” approach to the superseding cause doctrine. By my lights, this approach should be substituted by the “scope of the risk” analysis recommended by the Third Restatement of Torts. Carrying out that analysis could have shown that the patient’s suicide scenario fell within the scope of the risk engendered by the defendants’ malpractice. Remarkably, the Mississippi approach to the patient suicide problem contrasts with the opposite trend in Georgia: see Georgia Clinic v. Stout, — S.E.2d —, 2013 WL 3497703 (Ga. App. 2013) – a case that I discussed and criticized here.