Confidential
Settlement – $3,000,000Facts
The plaintiff, a 38-year-old male at the time of the accident was diagnosed with schizoid affect in 1992, while resident in Alaska. He was prescribed anti-psychotic medication which helped control his condition. He had attempted suicide twice in the year prior to the incident. After each suicide attempt, his medication dosage was adjusted. He was told that his dosage was low but that it could be easily increased if necessary to achieve therapeutic results. In August 2000, the plaintiff and his mother moved to the Los Angeles area. Prior to the move, the plaintiff informed his mental health providers of the move and he was advised to establish mental health care and treatment upon relocating to Los Angeles. The plaintiff did so by contacting a local mental health center. On Oct. 10, 2000, the plaintiff presented to the Mental Health Center for an initial assessment and coordination of care. He complained of depression, hallucinations and gave a history of his suicide attempts. He also advised that he only had a few days worth of medication remaining. The plaintiff was advised to go to one of two hospitals, one of which was the defendant hospital, for an interim prescription, pending evaluation by the center's psychiatrist, scheduled for Oct. 17. He was given a note by the center social worker to take with him to the emergency room, explaining the purpose for his visit and asking for his prescription for Zyprexa to be refilled as it existed. At the time, he was taking 20 mg of Zyprexa daily. On the same day, upon leaving the mental health center, the plaintiff presented to the emergency room at the defendant hospital where he was seen by a physician with no particular psychiatric experience. The defendant gave the ER physician the note and advised him that he needed a refill for the Zyprexa. The plaintiff gave an outline of his medical history. The defendant ER physician gave him a prescription which cut the plaintiff's prescription in half, calling for the plaintiff to take 10 mg daily and not 20 mg. At deposition, the defendant ER physician explained that he reduced the dosage because his custom and practice when writing prescriptions for patients with whom he was not familiar was to write a prescription for an average dose and then instruct the patient to continue taking the medication in the same dose as he previously had taken it. According to the plaintiff's mother, the plaintiff was compliant with prescriptions and apparently the plaintiff did reduce his intake of Zypreza, which lead to the psychotic break which required him to be involuntarily held in the defendant hospital's mental health unit pursuant to Welfare & Institutions Code Section 5150 (involuntary 3-day hold) and later Welfare & Institutions Code, Section 5250 (involuntary 14-day hold). The effect of the decreased level of Zyprexa in the plaintiff culminated on Oct. 21. On that date, the plaintiff presented to the emergency room accompanied by his mother and sister, with complaints of auditory hallucinations and suicidal ideation and suicide plan. He was admitted to that hospital on a 72-hour involuntary hold because he was determined to be a danger to himself. There were no beds available at that facility at the time of his admission, so the plaintiff's mother arranged a transfer to the defendant hospital where there were beds available. On Oct. 21, the plaintiff was transferred and admitted to the mental health unit at the defendant hospital, pursuant to Welfare & Institutions Code section 5150 because he was a danger to himself. At that time, the defendants were made aware of the plaintiff's suicidal ideation, suicide plan, depression and auditory hallucinations. However, he was not placed on suicide precautions and his Zyprexa was withheld until he could be examined by a psychiatrist. On Oct. 22, the plaintiff was examined by the defendant psychiatrist. * * *
Settlement Discussions
The plaintiff demanded the policy limits of all the defendants. The defendant psychiatrist paid his policy limits of $1 million following a mediation. The defendant hospital paid $999,999.99 prior to the start of trial. The defendant ER physician paid his policy limits of $1 million after 15 days of trial, but before the case went to the jury.
Specials in Evidence
$487,111 $6.8 million (present value)
Damages
General damages, $250,000 (MICRA); future wrongful death damages, $250,000.
Other Information
* * * Despite the plaintiff's continuing suicidal ideation and auditory hallucinations, and despite the fact that he was voicing a suicide plan (hanging), the plaintiff was never put on "suicide precautions" and was never considered to be at risk for suicide. In addition, the first dose of Zyprexa 20 mg that the plaintiff was given was administered at 9 a.m. on Oct. 22, 26 hours after being admitted to hospital. On Oct. 24, the defendant psychiatrist extended the plaintiff's involuntary hold to 14 days (pursuant to Welfare & Institutions Code, Section 5250). At that time, the basis for the 14-day hold was the plaintiff's complaints of being tormented by auditory hallucinations and because he continued to be a danger to himself or others. Despite the extension of the involuntary hold period, the plaintiff was still not placed on suicide precautions nor was medication increased despite his mother's repeated requests for an increase in his Zyprexa. The next morning, at approximately 8:30 a.m., and allegedly based on his interaction of the patient on the evening of Oct. 24, the defendant psychiatrist increased the Zyprexa, and ordered 10 mg to be given to the plaintiff. He explained that he wanted to get him to a 30 mg per day level that day. On Oct. 25, the plaintiff was discovered unconscious in the bathroom hanging from the disability bar in the shower stall, having used his long-sleeved shirt as a noose. As a result of the suicide attempt, the plaintiff suffered severe and permanent brain damage due to hypoxia and remains hospitalized and requires 24-hour care.
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