In re LINDA B.
Linda B., Appellant. The People of the State of Illinois, Appellee,
JUSTICE KARMEIER delivered the judgment of the court, with
opinion. Justices Freeman, Thomas, Kilbride, Garman, Burke,
and Theis concurred in the judgment and opinion.
KARMEIER, CHIEF JUSTICE
1 The overarching issue presented in this appeal is whether a
timely petition was filed, seeking immediate, involuntary
admission of respondent for inpatient psychiatric treatment
in a mental health facility pursuant to article VI of the
Mental Health and Developmental Disabilities Code (Mental
Health Code) (405 ILCS 5/3-600 et seq. (West 2012)
(Emergency Admission by Certification). In order to reach
that issue, we must find that an exception to the mootness
doctrine applies, as the 90-day period of hospitalization
ordered by the Cook County circuit court has expired. The
appellate court so found and affirmed the judgment of the
circuit court. 2015 IL App (1st) 132134. On this record, and
with some qualification with respect to the appellate
court's analysis, we affirm the judgment of the appellate
3 Proceedings in this case were initiated on May 9, 2013,
when Connie Shay-Hadley, the mental health facility director
at Mount Sinai Hospital (Mt. Sinai), filed a petition
alleging that respondent, Linda B., was a person subject to
involuntary admission to a treatment facility. The petition
sought emergency inpatient admission by certificate, pursuant
to section 3-600 of the Mental Health Code (405 ILCS 5/3-600
(West 2012)), stating that respondent was admitted to the
"Mental Health Facility/Psychiatric Unit" on April
4 The petition was supported by certificates submitted by Dr.
Medela Gartel, who examined respondent on May 9, 2013, and
Colleen Kurtz, a licensed clinical social worker who examined
respondent later that same day. Both checked form boxes
stating that respondent was mentally ill and required
"immediate hospitalization" for the prevention of
harm to respondent or others. Both stated that respondent was
in need of treatment to prevent deterioration of her
condition and that she could not understand the nature of her
illness or the need for treatment. Gartel added, via
handwritten notation, that respondent had exhibited
"multiple psychiatric symptoms including paranoid
delusions, " she had been violent with medical staff,
and she had been wandering and defecating in the hall. Kurtz
corroborated that observation as well as Gartel's
suggestion that respondent suffered from paranoid delusions.
Kurtz added that respondent was refusing both medical and
5 On June 11, 2013, the trial court held a hearing addressing
the matter of involuntary admission. At that hearing, Dr.
Elizabeth Mirkin, a board-certified psychiatrist, testified
that respondent's hospitalization at Mt. Sinai began on
April 22, 2013, when she was admitted to a "medical
floor, " where she was also "treated
psychiatrically." With respect to the circumstances
prompting respondent's admission, Mirkin volunteered:
"She actually was board-agitated and very angry
behaviors before she was admitted in medical floor because
she was tachycardia and found to be severely
anemic. She was admitted to the medical floor. She
was followed by a psychiatrist throughout her stay on the
also stated that respondent had sitters "throughout her
stay on the medical floor."
6 Mirkin testified that she first saw respondent on the
medical floor on May 25, 2013. She had previously spoken to
other staff members and had reviewed "other people
psychiatry progress notes, nursing notes, doctors
notes." Mirkin stated that respondent was hospitalized
for "both" psychiatric and medical treatment.
Mirkin noted that this was not respondent's first
hospitalization. She had been admitted to Mt. Sinai's
psychiatric unit in January 2013 "with similar
presentation." According to Mirkin, respondent was
admitted again in April. There had been "multiple prior
hospitalizations." Mirkin diagnosed respondent as
suffering from schizophrenic disorder, stating that
respondent had suffered from that malady for years.
7 Mirkin described, in detail, the symptoms respondent had
exhibited: "[S]he was very delusional, very aggressive,
agitated and threatening, labile and did not sleep,
threatened staff, did not take medications for psychiatric
and medical reasons." Mirkin said that respondent was
"much less symptomatic" at the time of the hearing
because, pursuant to court order entered May 14, 2013,
respondent was taking prescribed medications. Though
Mirkin acknowledged that respondent was "less
symptomatic, " she maintained that respondent was still
delusional, easily agitated, aggressive, and subject to rapid
mood swings. Mirkin observed that respondent had a history of
noncompliance in taking medications, particularly whenever
she was discharged from the hospital. Mirkin rendered her
opinion, based upon a reasonable degree of psychiatric
certainty, that respondent was unable, because of her mental
illness, to provide for her basic physical needs without
assistance and thus should be treated on an inpatient basis.
Mirkin recommended that respondent be treated at Park Shore
8 In her cross-examination, counsel for respondent asked:
"Is [respondent] recommended for nursing home placement
because of mental health reasons or because of medical
reasons?" Mirkin responded:
"Because of combination of mental health reasons and
medical reasons. In her case, her mental health conditions
prevents her from taking care of her medical condition. When
she has exacerbation of her mental illness, then she
doesn't take care of herself, including her many medical
Inquiries by counsel regarding Park Shore Nursing Home
revealed that Mirkin had very limited knowledge thereof.
However, when asked whether Park Shore Nursing Home provided
"behavioral mental health care or whether they primarily
provide[d] medical care to elderly senior citizens, "
Mirkin replied: "Because [respondent's] diagnosis is
schizoaffective disorder, she could not be admitted to the
nursing home, which does not provide care for behavioral
9 Upon further examination of Mirkin by respondent's
counsel, the following colloquy ensued:
"Q. Doctor, according to the chart, you've indicated
as of approximately May 28th, the respondent was ready for
discharge from Mt. Sinai, correct?
A. I had a note there. I saw her on the unit and I didn't
say that she is ready for discharge. I said that she does not
need inpatient level of psychiatric care.
I said this is her baseline, but I never indicated that she
could be discharged home. There was a process going on while
she was on medical floor for her to be admitted to the
nursing home; and by my note, I stated that she does not need
to be transferred to inpatient psych unit.
Q. So all this time, from April 22nd to the present day,
[respondent] has been on a medical unit and not a psychiatric
hospital [sic] at the hospital?
A. She was cleared medically only as of last Saturday. *** At
that time we found out we're going with a nursing home
placement. There's no point of her to be transferred to
six-the transfer to Six East mainly because on the medical
floor, she's been on one-to-one supervision; and the
nursing home will not accept anybody to the nursing home
unless their 24 hours of supervision and psychiatric unit is
more appropriate for her.
She hasn't been on supervision here unless she was
admitted there last night. She hasn't been put on
While on medical floor, she needed one-to-one sitter. ***
Constantly, she needed to have supervision all of the time.
Q. That's one of the conditions for Park Shore to accept
[respondent], that she goes 24 hours without having a sitter?
A. Yes. Any nursing home inpatient, yes."
10 Following cross-examination and after the State rested,
respondent's counsel moved to dismiss the petition for
involuntary admission "based upon the petition having
been filed well beyond the 24 hours after [respondent's]
admission." Counsel argued that the petition was
untimely filed where respondent was admitted to the medical
floor of Mt. Sinai on April 22, 2013, but was also being
treated psychiatrically from that date.
11 Over counsel's objection, the court allowed the State
to reopen its case in order to adduce evidence pertinent to
respondent's motion. Speaking to the procedures the
hospital generally ...