On appeal, the appellate court disagreed with the lower court and reversed the ruling. The court noted that to prevail on a charge of false imprisonment, a plaintiff must show both that 1) her personal freedom was curtailed against her wishes, and 2) that her detention was unreasonable and unlawful. The court also noted that everyone agreed as to the first point, so it was the second element regarding the lawfulness of the detention that was the issue. The court had to consider the situations in which it is lawful to detain an individual for a mental health evaluation. According to the state Mental Health Code, treatment may not be performed against a patient’s wishes unless it is “necessary to prevent the patient from causing serious and imminent physical harm.” The court concluded that this should be the deciding factor. The hospital tried to argue that the standard should be whether the hospital had probable cause to believe that the patient might be suicidal , but the court noted that probable cause only applies in the criminal context. “In the mental health context, unlike the criminal context, what makes the detention of an individual lawful is compliance with the provisions of the Mental Health Code,” wrote the court in its decision. The Mental Health Code required, among other things, that a diligent effort be made to persuade the patient to submit to a mental health evaluation voluntarily before deciding to detain her. Because there were material issues of fact as to whether the hospital complied with the Mental Health Code, the appellate court ultimately decided that the case must be sent back to the trial court for a jury to decide whether the hospital had acted appropriately.
Good notetaking is important, but this case shows what can happen when initial notetaking is good but follow-up notes aren’t. Dr P never wrote follow-up notes in the chart indicating that he had spoken with the patient and her husband and that they had denied any suicidal ideation. Dr P even had a conversation with the physician in the emergency department during which he told him about the “self-harm comments,” but he did not mention that he had followed up with the patient and her husband, who told him that the patient was not suicidal but simply frustrated with the pain and disability.
Good notes can protect you from liability, but you must be consistent and document every encounter. If you are going to include comments that a patient made while leaving the office in his or her chart, you must also include notes about what was said during a follow-up call.
Ms Latner, a former criminal defense attorney, is a freelance medical writer in Port Washington, New York.