Substance Abuse: Patient Assessed for Suicide Potential, Referred to Detox, Court Says Duty Fulfilled
Legal Eagle Eye Newsletter for the Nursing Profession
November 1998
Quick Summary: The outpatient alcohol abuse clinic’s screening counselor asked the patient about current suicidal ideation, which he denied.
If he had expressed suicidal thoughts he would have been walked to the outpatient mental health clinic for immediate evaluation, even though he was drunk and neither clinic in the building offered detox services.
The patient was referred to a facility with detox capability and an inpatient program. The outpatient alcohol clinic had no obligation to check if he admitted himself for detox or if he stayed for the inpatient program.
The facility where he was referred did not have a detox bed available. The patient agreed to go on the waiting list.
When he called the detox facility back for the third time, they had lost his paperwork and they put him down at the bottom of the waiting list.
At this he became despondent and shot himself.
His suicide was tragic, but it was not the fault of the clinic where he was screened ten days earlier.
COURT OF APPEAL OF LOUISIANA, 1998.The outpatient alcohol and drug abuse clinic was on the ground floor of the same building which housed an outpatient mental health clinic. Two men, both drunk, walked into the alcohol and drug abuse clinic seeking help for one of the men’s drinking problem. They were seen together by a counselor.
The man seeking help admitted to the screening counselor he had suicidal thoughts three weeks earlier. He denied current suicidal and homicidal ideation.
The court was satisfied the screening counselor would have made sure the patient got an immediate psychological evaluation at the mental health clinic in the same building if he had expressed current suicidal thoughts.
The counselor determined the man needed detoxification and an inpatient substance abuse program. The counselor gave him information on three facilities with detox capability and inpatient programs. The man indicated he would follow up with the one that was nearest his home.
At this point, according to the court, the outpatient clinic had fulfilled its legal duty to this patient. The clinic initiated no further contact with the patient after he voiced an intention to go to the detox facility and admit himself, and the court ruled the clinic had no legal duty to follow up.
The man never actually got into the facility where the outpatient clinic referred him. He shot himself ten days after his screening. In the family’s lawsuit, the Court of Appeal of Louisiana ruled the clinic which screened him was not responsible for his suicide.
There was a dispute over whether the counselor was certified. However, the court ruled the screening the patient received was completely proper. The court believed the counselor’s having or lacking certification was not a factor in what happened to the patient. Phillip v. Medical Center, 714 So. 2d 742 (La. App., 1998).