White Ex Rel. Estate of White v. Lawrence
975 S.W. 2d 525, 1998 Tenn. LEXIS 462, 1998 WL 546966 (1998)
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Rule of Law:
A patient's suicide is not a superseding, intervening cause of death that bars recovery for medical malpractice as a matter of law if the suicide was a foreseeable consequence of the doctor's negligence. Furthermore, the patient's intentional act of suicide may not be considered in a comparative fault analysis to reduce the negligent doctor's liability.
Facts:
- Earl R. White suffered from severe depression and alcoholism.
- Beginning in 1990, Dr. William H. Lawrence treated White and was aware of his conditions, noting White had no desire to live and was a 'likely candidate' for suicide.
- In May or June 1993, Dr. Lawrence prescribed the drug Disulfiram ('Antabuse') for White at the request of his wife, Barbara White.
- Dr. Lawrence instructed Mrs. White to secretly grind the medication and place it in her husband's food to discourage his drinking.
- Mrs. White followed these instructions and covertly administered the Antabuse to her husband.
- On July 13, 1993, Earl White began experiencing unpleasant physical symptoms.
- The next day, July 14, 1993, White went to an emergency room complaining of pain and hot flashes. Unaware he was taking Antabuse, he could not inform the staff, was diagnosed with heat exhaustion, and discharged.
- Four hours after being discharged, Earl R. White died by suicide, shooting himself with a pistol.
Procedural Posture:
- Barbara White, as administratrix of her husband's estate, filed a medical malpractice lawsuit against Dr. William H. Lawrence in the state trial court.
- Dr. Lawrence filed a motion for summary judgment, arguing the decedent's suicide was a superseding, intervening cause of death.
- The trial court denied Dr. Lawrence's motion for summary judgment.
- The trial court then granted Dr. Lawrence's request for an interlocutory appeal to the Court of Appeals, an intermediate appellate court.
- The Court of Appeals reversed the trial court and granted summary judgment in favor of Dr. Lawrence.
- The plaintiff, Barbara White, appealed the decision of the Court of Appeals to the Supreme Court of Tennessee.
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Issue:
In a medical malpractice action, does a patient's intentional act of suicide constitute a superseding, intervening cause of death that bars recovery as a matter of law, and can it be used to reduce the defendant doctor's liability under a comparative fault analysis?
Opinions:
Majority - Special Justice Lyle Reid
No. A patient's act of suicide is not a superseding, intervening cause of death as a matter of law if it was a foreseeable consequence of the defendant's negligence, and the patient's intentional act may not be used to reduce the defendant's fault. The crucial inquiry is not the patient's mental capacity but whether the defendant’s negligent conduct made the suicide reasonably foreseeable. If the defendant's conduct was a substantial factor in bringing about the suicide, the chain of causation is not broken. Here, expert testimony established that Dr. Lawrence should have foreseen that secretly administering Antabuse to a depressed, alcoholic patient could cause severe physical and psychological distress leading to suicide, making it a question of fact for the jury. Citing Turner v. Jordan, the court also held that a negligent defendant's fault cannot be compared with the intentional conduct of another where that intentional conduct is the foreseeable risk created by the defendant's negligence. To permit such a comparison would undermine the defendant's duty of care and be fundamentally unfair.
Concurring-in-part-and-dissenting-in-part - Justice Drowota
No, as to the superseding cause issue, but yes, as to the comparative fault issue. While I agree that the decedent's suicide was a foreseeable consequence of the defendant's negligence and therefore not a superseding cause as a matter of law, the decedent's intentional act should be considered in determining relative degrees of fault. The majority's holding departs from the fundamental principle of comparative fault, which is to link liability with fault. The precedent in Turner v. Jordan is distinguishable because it involved comparing a defendant's negligence with the intentional act of a non-party. In this case, the intentional actor (the decedent) is effectively a party, and the trier of fact should be permitted to assess his fault to ensure liability is not disproportionate.
Concurring-in-part-and-dissenting-in-part - Justice Holder
No, as to the superseding cause issue, but the comparative fault issue is not ripe for decision. I concur with the majority's conclusion that the decedent's suicide is not a superseding cause of death as a matter of law. However, the court should not have decided the comparative fault issue because it was not properly pleaded by the defendant nor was it briefed or argued before the court. The defendant should not be able to use the act of suicide to allege the decedent was fifty percent or more at fault, but the majority opinion is unclear whether it precludes the defendant from proving that other factors, including the patient's own pre-existing condition or other negligent acts, contributed to the suicide.
Analysis:
This decision significantly alters tort law regarding suicide by shifting the legal focus from the decedent's mental state to the foreseeability of the act from the tortfeasor's perspective. It overrules prior cases that treated a 'willful, calculated, and deliberate' suicide as an automatic superseding cause, thereby expanding potential liability for medical professionals whose negligence creates a foreseeable risk of self-harm. By prohibiting the comparison of a doctor's negligence with the patient's intentional act of suicide, the court strengthens the professional's duty to prevent foreseeable harm and limits the defenses available in such malpractice cases.
