The house fire death of a patient who had been discharged from a hospital the previous night was the subject of a Maine medical malpractice lawsuit recently before the Maine Supreme Judicial Court. There was no question the man’s death did not occur while he was on hospital property or under care of medical staffers. The issue was whether the hospital and other defendants were negligent in discharging the patient, whom plaintiffs asserted lacked the capacity to offer informed consent to that discharge.
In Oliver v. Eastern Maine Medical Center, the state high court affirmed the conclusion of the Superior Court, which found the hospital was not negligent in the discharge, despite the fact it was contrary to instructions given by patient’s children as his court-appointed guardians. The question became whether the patient was mentally fit to authorize his own discharge from the hospital.
Bangor medical malpractice lawyers know these cases can be difficult to prove; it’s clear based on these facts that this was never going to be a straightforward case. All Maine medical malpractice lawsuits have a level of complexity you just won’t see in a typical personal injury or even wrongful death lawsuits. This case was especially difficult because plaintiffs needed to show that not only did hospital staffers breach the applicable standard of care, but also that this causally related to patient’s death at home.
Proving Medical Negligence and Medical Malpractice in Maine
Medical negligence and medical malpractice are often terms used interchangeably. They are slightly different, with medical malpractice being the result of something a medical professional did that caused harm to the patient, while medical negligence is the result of something the health care provider failed to do. In both instances, plaintiffs will be required to show the health care provider breached the standard of care, as evidenced by expert witness testimony from a similarly-situated medical professional who can attest to the accepted health care standards for a provider with the same education, experience, facility type and resources as defendant.
Unlike typical personal injury or wrongful death claims, plaintiffs must file a notice of claim and then, subject to Maine Revised Statutes Title 24, section 2852, have the claim weighed by a pre-trial panel of experts, with intent to weed out claims without merit. These are absolutely not the type of cases one can pursue on his or her own, without assistance from an experienced and knowledgeable medical malpractice attorney.
Is House Fire Death Medical Negligence? Factual Background
Plaintiffs in the present action filed both in their capacity as decedent’s children and also representatives of his estate.
According to evidence presented, plaintiff’s ex-wife and daughter found decedent severely intoxicated at his home in March 2013 and took him to the EMMC in Bangor. They informed staffers he lived alone, had no running water, was an alcoholic suffering from liver-related brain damage and who may suffer from serious alcohol withdrawals (which can be fatal). He’d also recently been the victim of scammers. Staffers were shown photographs of his derelict home, with numerous fire hazards. They also informed the hospital his home had caught fire more than once, and he suffered burns on his hands.
Patient was hospitalized for two full months, and throughout this time, he repeatedly asked to be discharged. He was assigned a one-on-one aide to make sure he didn’t leave. A hospital psychiatrist evaluating him the day after admission noted he had a potentially lethal alcohol addition, from which he suffered significant, slow-to-resolve cognitive impairment, which resulted in his lack of understanding for why he was hospitalized.
A week later, a neuropsychologist found him to be understanding of history, noted his biggest problem appeared to be a faulty water heater (and the fact that his poor motivation/ lack of effort meant he was not able to get it fixed). This fact rendered him incapacitated to manage simple or complex finances independently or make informed decisions about his health.
His children sought – and obtained – guardianship, and a physician’s report for probate court indicated it was recommended patient be placed in secure dementia facility. However, the probate court did indicate that the guardians were authorized to act “only as necessitated by patient’s actual mental and adaptive limitations.”
With treatment, health care officials at the hospital reported patient’s condition began to improve. Prior to his discharge, a neuropsychological exam was conducted by the same doctor as before, his findings “strikingly different” than what he’d concluded from the first exam. Patient was reportedly cooperative, pleasant, friendly, eager to return home and committed to quitting drinking (although he would not commit to therapy or support). The doctor concluded in his report patient was able to manage basic AND complex finance on his own and make informed decisions about his health. Patient was referred to a case manager and discharged.
His guardians disputed these findings, opposed his discharge to anywhere other than a locked facility and wanted a second opinion. No unaffiliated evaluator could be located, and no other exam was conducted. Initially, in-house legal counsel for the hospital concluded the hospital couldn’t discharge without guardians’ consent, an opinion that later changed after counsel re-read the order from probate. He was discharged in mid-May – over the express objections of his guardians.
He left the hospital with a friend. His guardians visited him at his home twice that night. After they left for a final time, around 9 p.m., he died in a fire that destroyed his entire home.
Following a five-day bench trial, the trial court judge concluded the hospital wasn’t negligent because it had not breached the standard of medical care in the patient’s discharge.
Trial and appellate courts had to consider guardianship statutes and the scope of authority of Maine’s probate court. What ultimately helped secure a win for the hospital in this matter was the issuance of a category of guardianship that was “limited,” confined to flexibility in dealing with special circumstances. As noted in 18-A M.R.S. § 5-105, limited guardianship means one has “fewer than all of the legal powers and duties of a guardian.” Had this been full guardianship, the hospital likely would have needed to obtain consent from guardians in order to effect a discharge. The court disagreed with plaintiffs’ assertion that the guardianship order didn’t limit their authority to make health care-related decisions while the order remained in effect.
The case underscores some medical malpractice and wrongful death actions in Maine, and the need for the involvement of an experienced, dedicated injury attorney.
If you are the victim of Bangor medical malpractice, contact Peter Thompson & Associates at 1-800-804-2004 for a confidential consultation to discuss your rights.
Oliver v. Eastern Maine Medical Center, Aug. 21, 2018, Maine Supreme Judicial Court