Bloom v. DuBois Regional Medical Center
1991 Pa. Super. LEXIS 2998, 597 A.2d 671, 409 Pa. Super. 83 (1991)
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Rule of Law:
Under Pennsylvania's Mental Health Procedures Act, gross negligence is conduct that is flagrant and grossly deviates from the ordinary standard of care, which is a higher bar than simple negligence. For a claim of negligent infliction of emotional distress, a plaintiff must have a sensory and contemporaneous observance of the defendant's conduct causing the injury to a close relative, not merely witness the aftermath of the negligence.
Facts:
- On October 24, 1986, Cindy Bloom was voluntarily admitted to the psychiatric unit of DuBois Regional Medical Center.
- Upon her admission, Mrs. Bloom informed the hospital, its psychiatric unit manager Robert DiGilarmo, and psychiatrist Dr. James Fugate of her mental disorder and requested treatment.
- The defendants were allegedly aware that Mrs. Bloom's condition created an unreasonably high probability of self-destructive actions.
- The next evening, Mrs. Bloom's husband came to the hospital to visit her.
- Mr. Bloom found his wife hanging by the neck from shoestrings behind a bathroom door in an apparent suicide attempt.
- Mrs. Bloom survived the attempt but sustained injuries, and Mr. Bloom suffered emotional distress from the discovery.
Procedural Posture:
- Cindy and Mr. Bloom (plaintiffs) filed a multi-count complaint against DuBois Regional Medical Center, Robert DiGilarmo, and Dr. James Fugate (defendants) in a Pennsylvania trial court.
- Defendants filed answers asserting immunity under the Mental Health Procedures Act.
- The trial court granted plaintiffs leave to file an amended complaint but restricted its scope.
- After the amended complaint was filed, all defendants filed preliminary objections seeking to dismiss various claims.
- The trial court granted the defendants' preliminary objections, dismissing all claims against Dr. Fugate entirely, dismissing all of Mr. Bloom's individual claims against all defendants, and striking the amended portions of Mrs. Bloom's claims against the Hospital and DiGilarmo.
- The Blooms (appellants) appealed the trial court's order to the Superior Court of Pennsylvania, an intermediate appellate court.
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Issue:
First, does a complaint alleging a psychiatric facility and its staff failed to diagnose, treat, and protect a patient with a known mental disorder from a suicide attempt sufficiently plead "gross negligence" to overcome the immunity provided by the Mental Health Procedures Act? Second, does a plaintiff state a valid claim for negligent infliction of emotional distress when he does not witness the defendant's negligent failure to act, but instead discovers and observes the injurious aftermath of that negligence?
Opinions:
Majority - Judge Beck
As to the first issue: Yes. A complaint can sufficiently plead gross negligence without using specific legal labels if the alleged facts describe conduct that could be found to be a flagrant deviation from the standard of care. The court defines gross negligence under the Mental Health Procedures Act as substantially more than ordinary carelessness; it must be flagrant conduct that grossly deviates from the ordinary standard of care. Here, the allegations that the defendants, holding themselves out as competent psychiatric care providers, were informed of Mrs. Bloom's mental disorder but completely failed to diagnose her condition and protect her from harm could, if proven, constitute gross negligence. Therefore, dismissing the claims against Dr. Fugate on immunity grounds at the pleading stage was an error, as the determination is a question for the jury. As to the second issue: No. A plaintiff does not state a valid claim for negligent infliction of emotional distress by only observing the aftermath of the defendant's negligence. The court applied the three-part test from Sinn v. Burd, which requires: (1) plaintiff's proximity to the scene, (2) shock resulting from a direct, contemporaneous observance of the accident, and (3) a close relationship between the plaintiff and victim. The court focused on the second prong, clarifying that "contemporaneous observance" requires the plaintiff to witness the defendant traumatically inflicting injury upon the relative. Mr. Bloom did not observe the defendants' negligent omission (the failure to supervise); he only observed the aftermath of his wife's own self-injurious act. This lacks the direct and traumatic impact by the defendant necessary for recovery.
Concurring-in-part-and-dissenting-in-part - Judge Del Sole
As to the second issue: No, the majority is incorrect; Mr. Bloom should be able to state a claim for negligent infliction of emotional distress. The majority's reasoning is illogical because it would require Mr. Bloom to have witnessed the non-distressing negligent acts, such as poor staffing decisions, rather than the traumatic result of that negligence. The profound emotional distress was caused by discovering his wife hanging, an event directly resulting from the defendants' alleged failures. The observance of the defendants' actual negligent acts or omissions is irrelevant; the focus should be on the traumatic discovery of the injury that the negligence caused.
Analysis:
This case provides a key definition for "gross negligence" under Pennsylvania's Mental Health Procedures Act, establishing it as conduct that is "flagrant" and a "gross deviation" from the standard of care, which helps clarify the threshold for overcoming statutory immunity for healthcare providers. More significantly, the ruling strictly construes the "contemporaneous observance" requirement for bystander negligent infliction of emotional distress claims. By requiring the plaintiff to witness the defendant's conduct inflicting the harm, rather than just the resulting injury, the decision narrows the path to recovery, particularly in medical malpractice cases based on negligent omissions where the "tortious act" is often invisible and separated in time from the injury.
