No Liability for Failing to Prevent Intoxicated Man from Leaving ER

A man was admitted to the hospital with suicidal thoughts. He was placed on a one-to-one watch. He improved after receiving medication and was discharged.


Within a month, the same man voluntarily presented to the emergency room while intoxicated and sought entry into a detoxification program. He showed signs of severe intoxication, including red eyes, garbled speech and a strong smell of alcohol. His blood-alcohol content was extremely high: .369%. Nonetheless, he was alert and able to walk. He was seen by an emergency room doctor and was accepted to the detoxification program. No one at the hospital consulted the record of his previous hospital admission when he returned. There was no evidence that he was suicidal when he was admitted into the detoxification program.


About four hours after his arrival, while waiting to be transported to the detoxification program, he removed an IV from his arm and told a nurse he planned to go home in a taxi. She urged him to call a friend to pick him up, and he agreed. The nurse went to tell the emergency room doctor that the man wanted to leave; when she returned, he was gone. The nurse asked the emergency room doctor if she should call the police. The doctor said no, but notified hospital security. The man left unescorted, and was hit by a car an hour or two later.


The man sued the hospital, the emergency room doctor, and the emergency room doctor's professional corporation for negligence and medical malpractice for failing to prevent him from leaving the emergency room. The trial court denied the defendants’ motion for summary judgment. The defendants appealed. The appellate court reversed, and the patient appealed.


The Court of Appeals of New York affirmed the appellate court holding that the hospital and emergency room doctor did not owe the patient a duty to prevent him from leaving the hospital. The hospital and emergency room doctor lacked the authority to involuntarily detain the patient, even though he had suicidal thoughts on his previous hospitalization. New York’s Mental Hygiene Law does not allow the involuntary retention of intoxicated people who come voluntarily or are brought without objection to a hospital or other treatment facility. To restrain the man on these facts would have exposed defendants to liability for false imprisonment. A patient cannot be confined simply because he was having suicidal thoughts a month ago. The emergency room doctor had no duty to call the police. The police could not, on the facts known to the emergency room doctor when the man left the hospital, have forced the man to return.


See: Kowalski v. St. Francis Hosp. and Health Centers, 2013 WL 3197637, 2013 N.Y. Slip Op. 04756 (N.Y., June 26, 2013) (not designated for publication).


See also Medical Law Perspectives, December 2012 Report: When Urgency Leads to Errors: Liability for Emergency Care