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Jinkins v. Lee

March 18, 2004

EARLEAN JINKINS, INDIV. AND AS ADM'R OF THE ESTATE OF GEORGE JINKINS, DECEASED, APPELLEE,
v.
DR. CHOONG LEE ET AL., APPELLANTS.



The opinion of the court was delivered by: Justice Fitzgerald

PUBLISHED

Docket No. 95876-Agenda 9-January 2004.

In this case we consider whether the doctrine of sovereign immunity bars plaintiff's claim for negligence against mental health professionals. Plaintiff, Earlean Jinkins (Earlean), filed her complaint individually and as administrator of the estate of George Jinkins (George), her husband, against the defendants Dr. Choong Lee and Paullette Medlin, employees of the John J. Madden Mental Health Center (Madden Center). Plaintiff alleges that defendants failed to properly diagnose and treat George's mental illness, such that George should have been subject to involuntary commitment. This failure, plaintiff alleges, led to George's release from Madden Center and subsequent suicide. The appellate court found that the claim survived. 337 Ill. App. 3d 403. For the following reasons, we affirm the appellate court.

BACKGROUND

George resided with his wife, Earlean, and other family members in Chicago. George began acting abnormally three or four months prior to his suicide. Earlean and their children moved out of the residence when, according to Lorenzo Norwood, a lifelong friend and neighbor, George "told her to get out of the house, go live with her mother, because he didn't want her to be there with him or there would be-instead of one body bag, there'd be two bodies. So she left." George began drinking heavily, was dressing in a dirty and disheveled manner, and was giving away his money and possessions. Norwood also saw George running in front of cars "maybe three or four times." Norwood stated that George did not drink before he started "acting funny," other than "when he went to the clubs, he'd have a beer. That's about it." George did not complain about his condition, but "he just started saying, things going to change."

On June 20, 1996, neighbors found George "laying in a puddle of muddy water face first" with his pants down. The neighbors brought George back to his house, where he still had his pants down; his underwear was bloody because he was bleeding from his rectal area. After George again attempted to run in front of a car, Norwood, a neighbor named Maurice Abernathy, and George's mother took George to Christ Hospital, a private hospital, in Oak Lawn at approximately 7 p.m.

Dr. Daniel Sachs, a resident in emergency medicine at Christ Hospital, treated George in the hospital emergency room. He diagnosed George with "acute psychosis with suicidal behavior," hemorrhoids, and constipation. His blood-alcohol content was 0.203 and he also tested positive for marijuana. Dr. Sachs stated his diagnosis of psychosis was based on the information, related by Norwood or Abernathy, that George walked in front of cars intentionally, George's statements to them that he "just wants to go," and George's mother's statement that George had been suicidal during the previous three weeks. George's mother told Dr. Sachs that George thought he was being poisoned and that when she cooked George would stand over her to watch if she poisoned the food. Dr. Sachs disbelieved George's denial that he was suicidal. According to a Christ Hospital social worker, Earlean arrived at the hospital later in the evening and stated that George's behavior was due to alcohol abuse.

Dr. Sachs' "plan was to have him evaluated and possibly admitted by a psychiatrist." Dr. Sachs explained, "My responsibility was to decide what the patient's disposition should be-is he safe to go home, or does he need an evaluation of possible admission-but not to decide where that should take place." The decision as to where he would be admitted, whether it was Christ Hospital or another hospital, "was an administrative issue rather than a doctor issue," according to Dr. Sachs. The administrative decision belonged to a licensed clinical social worker at Christ Hospital, Leonard Kemp.

Kemp filled out a petition asserting that George was subject to involuntary admission pursuant to section 3-601 of the Mental Health and Developmental Disabilities Code (Code) (405 ILCS 5/3-601 (West 1996) (providing "[w]hen a person is asserted to be subject to involuntary admission and in such a condition that immediate hospitalization is necessary for the protection of such person or others from physical harm, any person 18 years of age or older may present a petition to the facility director of a mental health facility")). The Code defines a "[p]erson subject to involuntary admission" as "[a] person with mental illness and who because of his or her illness is reasonably expected to inflict serious physical harm upon himself or herself or another person in the near future." 405 ILCS 5/1-119 (West 1996). Kemp and George's mother signed the petition, and George's mother and Abernathy were listed as witnesses. The petition stated that George was "a person who is mentally ill and who because of his *** illness is reasonably expected to inflict serious physical harm upon himself *** or others in the near future." George was "in need of immediate hospitalization for the prevention of such harm," in that "George has been hearing noises and voices, thinking he is being shot at, that birds are talking to him, that he has been poisoned. He has been running in front of cars trying to kill himself."

Dr. Sachs prepared a certificate accompanying the petition pursuant to section 3-602 of the Code (405 ILCS 5/3-602 (West 1996) (stating that "[t]he petition shall be accompanied by a certificate executed by a physician, qualified examiner, or clinical psychologist which states that the respondent is subject to involuntary admission and requires immediate hospitalization")). The certificate stated that Dr. Sachs had examined George, and that based on the examination, George was "a person who is mentally ill and because of his *** illness is reasonably expected to inflict serious physical harm on *** [him]self or another in the near future." Dr. Sachs wrote in the certificate that the "patient's mother and two brothers [sic] say that he has repeatedly tried to kill himself by walking into street in front of cars. He tells them, `I just want to go.' "

George was held overnight at Christ Hospital. George was disruptive and given 10 milligrams of Haldol at approximately 11:45 p.m. At approximately 3 a.m. the next day, George attempted to escape the hospital, but was found by hospital security in a nearby car dealership lot and returned to Christ Hospital. At approximately 6 a.m. that same day, after his blood-alcohol content had decreased below 0.10, George was transferred in restraints by ambulance to Madden Center, a mental health care facility operated by the Illinois Department of Human Services (see 20 ILCS 1705/4 (West 2002)). Dr. Sachs believed that Christ Hospital may have transferred George to Madden Center because George lacked insurance. Dr. Sachs spoke on the telephone with Dr. Hasina Javed, the intake psychiatrist who worked the shift prior to defendant, Dr. Lee, regarding George.

Dr. Choong Lee, a board-certified psychiatrist, was the "intake psychiatrist" at Madden Center. Dr. Lee examined George pursuant to section 3-610 of the Code (405 ILCS 5/3-610 (West 1996) (providing that within "24 hours, excluding Saturdays, Sundays and holidays, after admission of a respondent pursuant to this Article, the respondent shall be examined by a psychiatrist" who, "shall not be the person who executed the first certificate. If the respondent is not examined or if the psychiatrist does not execute a certificate pursuant to section 3-602, the respondent shall be released forthwith")). In his deposition, Dr. Lee testified that intake psychiatry is not a specialized role, but that "intake psychiatry is only in our state hospital. I don't think any other place, a private hospital has such an intake psychiatry position." Dr. Lee stated that he decided if a patient required hospitalization or needed outpatient or other care, but he was not responsible for the subsequent treatment of the patients at Madden Center. As to the decision to admit a particular patient, Dr. Lee stated, "[t]hat is totally a clinical decision after the intake psychiatrist reviews the record, talks with the patient, and talks with the family, and gets the collateral information."

Paulette Medlin is a licensed clinical professional counselor and holds a master's degree in rehabilitation counseling. She held the position of "psychologist three" at Madden Center. She works in "intake, and her job is to gather information towards an evaluation of persons presenting to intake for admission or non-admission to the hospital." Medlin stated that she was to assist Dr. Lee, but the final decision as to involuntary admission of a patient belonged to Dr. Lee.

Dr. Lee reviewed Christ Hospital's paperwork. He and Medlin spoke with George and his wife for 30 to 45 minutes. Dr. Lee and Medlin then spoke to George and his mother separately for 5 or 10 minutes. According to Dr. Lee, Earlean disputed the contents of the petition for involuntary admission, stated that George was not suicidal, and told Dr. Lee that she wanted to take George home. Dr. Lee stated that despite George's denial of the events recounted in the petition, Dr. Lee assumed that the events had actually happened.

Dr. Lee's diagnosis of George was "alcohol related disorder, NOS [not otherwise specified]" and alcohol abuse. Dr. Lee did not believe that George was suicidal, but instead that there was some low risk of suicide because of the alcohol and drug use. Dr. Lee said the suicide risk was lower because of the family support. He admitted, however, this opinion would have changed if he had known that Earlean had left George three weeks prior to the examination. Dr. Lee also did not think George was suicidal because "he didn't have a past suicide attempt either and didn't have any history prior of psychiatric hospitalization." Dr. Lee thought that drugs and alcohol were the primary causes of the psychiatric symptoms, but he was not able to rule out other causes. Dr. Lee disagreed with Dr. Sachs' diagnosis, and opined that George's use of alcohol influenced Dr. Sachs' opinion. As to whether George should have been admitted, Dr. Lee stated, "at the time he was not certifiable, so that's why I didn't admit him." George had a right to go home because he was not "certifiable."

Dr. Lee admitted that a doctor-patient relationship existed between himself and George during the intake procedure. If the wife or his mother had requested admission, Dr. Lee stated, "probably I'd have to admit the patient." Dr. Lee and Medlin referred George to a community health center for outpatient treatment. Medlin's report stated that George refused the referral and that he wanted to seek help for himself.

George left Madden Center with Earlean and his mother that same morning and went home. Soon after arriving home, he shot himself in the head. His family took ...


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