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BUNTING v. HUCKSTEP
Factual and Procedural Background
Plaintiff Hargro Bunting filed an action against several state-employed mental health care professionals alleging professional malpractice and negligence resulting in the wrongful death of his wife, Bernice Bunting. Bernice, a patient at Farmington State Mental Hospital, wandered from her assigned ward on December 17, 1984, was struck by a motor vehicle, and subsequently died. Plaintiff's six-count petition alleged that defendants knew of Bernice's propensity to wander and the unsafe, understaffed conditions of the open wards but still assigned her to such a unit. The claims essentially alleged negligent judgment regarding the degree of restraint and supervision during Bernice's detention. The trial court dismissed the action on defendants' motion, citing official immunity. Plaintiff appealed the dismissal.
Legal Issues Presented
- Whether defendants, state-employed mental health professionals, are entitled to official immunity for alleged medical malpractice and negligence related to the wrongful death of a patient.
- Whether statutory immunity under § 632.440 RSMo 1986 bars liability for defendants’ conduct concerning detention, supervision, or conditional release of mental health patients.
- Whether the plaintiff’s allegations of negligent exercise of judgment regarding restraint and supervision fall within the scope of immunity provided by statute or common law.
Arguments of the Parties
Plaintiff's Arguments
- The trial court erred in granting dismissal because defendants are not entitled to official immunity for medical malpractice.
- State ex rel. Eli Lilly Co. v. Gaertner supports that physicians at state-owned mental hospitals can be held liable for malpractice.
Defendants' Arguments
- Defendants claimed entitlement to official immunity shielding them from liability.
- They argued that Sherrill v. Wilson implicitly overruled State ex rel. Eli Lilly Co. to the extent that official immunity applies only to those with statutorily mandated government functions.
Table of Precedents Cited
| Precedent | Rule or Principle Cited For | Application by the Court |
|---|---|---|
| Sherrill v. Wilson, 653 S.W.2d 661 (Mo. banc 1983) | Common law official immunity for state employees performing government functions. | Trial court cited it to support dismissal; defendants argued it implicitly limits official immunity to statutorily mandated duties. |
| Porter v. Maunnangi, 764 S.W.2d 699 (Mo.App. 1988) | Statutory immunity under § 632.440 bars wrongful death claims against state mental health physicians for decisions related to patient discharge. | Cited by trial court and this court to hold that statutory immunity bars plaintiff’s claims based on decisions about detention and supervision. |
| State ex rel. Eli Lilly Co. v. Gaertner, 619 S.W.2d 761 (Mo.App. 1981) | Physicians at state mental hospitals can be held liable for medical malpractice; official immunity limited. | Plaintiff relied on it to argue against immunity; court found it superseded by statute and later case law. |
| Boyer v. Tilzer, 831 S.W.2d 695 (Mo.App. 1992) | Immunity under § 632.440 is not absolute; claims based on bad faith or gross negligence may proceed. | Court noted this standard but found no allegations or inference of gross negligence or bad faith here. |
Court's Reasoning and Analysis
The court accepted the facts alleged in the plaintiff’s petition as true for purposes of the motion to dismiss. Although the plaintiff couched his claims as medical malpractice and negligence, the court found that the alleged negligent conduct was inextricably linked to decisions about detaining, restraining, or supervising Bernice within the mental health facility. The court emphasized the statutory immunity provision in § 632.440 RSMo 1986, which shields mental health care professionals from civil liability for acts performed in good faith and without gross negligence related to detaining, transporting, conditionally releasing, or discharging patients.
The court reasoned that allowing liability for decisions about the degree of restraint or supervision would conflict with the statutory scheme mandating placement in the least restrictive environment consistent with patient interests. The immunity statute was interpreted to encompass discretionary judgments about restraint and supervision, not just detention or discharge decisions. Since the plaintiff did not allege gross negligence or bad faith, the immunity applied, barring the claims. Consequently, the trial court’s dismissal was proper.
Holding and Implications
The judgment of the trial court dismissing the plaintiff's claims against the defendants is affirmed.
The court’s decision directly bars the plaintiff’s malpractice and negligence claims against state mental health professionals based on discretionary decisions about patient detention and supervision under § 632.440 RSMo 1986. No new precedent was established beyond the application of existing statutory immunity. The ruling confirms that mental health professionals acting in good faith and without gross negligence are shielded from civil liability for such decisions, limiting the scope of malpractice claims in this context.
CRAHAN, Judge.
Plaintiff appeals from the trial court's dismissal of his action against defendant state-employed mental health care professionals alleging professional malpractice and negligence resulting in the wrongful death of his wife when she was struck by an automobile after straying from the grounds of a state-operated mental health care facility. We affirm.
On review of an order sustaining a motion to dismiss we accept the facts alleged in plaintiff's petition and reasonable inferences from those facts as true. Porter v. Maunnangi, 764 S.W.2d 699, 700 (Mo.App. 1988). On the evening of December 17, 1984, plaintiff's wife, Bernice Bunting ("Bernice"), a patient at the Farmington State Mental Hospital, wandered from her assigned ward, was struck by a motor vehicle and subsequently died. Plaintiff filed a six count petition alleging medical malpractice and negligence in the treatment of Bernice against Dr. R.A. Huckstep, Dr. Robert Deitchman, Rose Black, Allaene Sales and Patricia Grady, all licensed health care providers who were employed by Farmington State Mental Hospital and were members of Bernice's treatment team. Plaintiff alleged that defendants knew of Bernice's propensity to wander and knew of the unsafe, insecure and understaffed conditions on open wards but nevertheless assigned her to an open unit. Although the specific counts are captioned as claims for professional malpractice or negligence, each count essentially alleges negligent exercise of judgment regarding the degree of restraint and/or supervision incident to Bernice's detention in the mental health facility.
Count I alleging negligent operation of a motor vehicle by Homer McBride was settled and is not before this court. Additionally, Dr. Deitchman died and was dismissed before the trial court ruled on defendants' motion.
Defendants filed a Motion to Dismiss or in the alternative Motion for Summary Judgment, alleging that they are entitled to official immunity. On September 6, 1991, the trial court entered an order sustaining defendants' motion to dismiss, citing Sherrill v. Wilson, 653 S.W.2d 661 (Mo. banc 1983) and Porter v. Maunnangi, 764 S.W.2d 699 (Mo.App. 1988).
On appeal, plaintiff contends that the trial court erred in sustaining defendants' motion to dismiss because defendants are not entitled to official immunity for medical malpractice. According to plaintiff, State ex rel. Eli Lilly Co. v. Gaertner, 619 S.W.2d 761 (Mo.App. 1981), establishes that physicians at state-owned mental hospitals can be held liable to their patients for medical malpractice. Defendants urge that Sherrill, supra, implicitly overrules State ex rel. Eli Lilly Co., to the extent State ex rel. Eli Lilly Co. holds that the common law doctrine of official immunity extends only to individuals with statutorily mandated jobs or duties involving government functions. Compare Sherrill, 653 S.W.2d at 667 with State ex rel. Eli Lilly Co., 619 S.W.2d at 764-65.
We find it unnecessary to determine whether defendants would be entitled to invoke common law official immunity because liability for the specific acts of negligence alleged here has been foreclosed by statute. Specifically, § 632.440 RSMo 1986 provides:
Both State ex rel. Eli Lilly Co. and Sherrill involved conduct which occurred prior to the effective date of § 632.440 and therefore considered only the common law doctrine of official immunity.
632.440. No liability for public officials and certain peace officers. — No officer of a public or private agency, mental health facility, nor the head, attending staff or consultants of any such agency or facility, nor any mental health coordinator, registered professional nurse, licensed physician, mental health professional or any other public official performing functions necessary for the administration of this chapter, . . . shall be civilly liable for detaining, transporting, conditionally releasing or discharging a person pursuant to this chapter . . . so long as such duties were performed in good faith and without gross negligence.
In Porter, cited and relied upon by the trial court, this section was held to bar an action for wrongful death alleging negligence by state mental health physicians in discharging a patient who later committed suicide. 764 S.W.2d at 700. Although the plaintiff's allegations were couched in terms of medical diagnosis and treatment, the court held that the allegations were inextricably linked to the decision to discharge for which the defendants were entitled to immunity under the express terms of the statute. Id.
In this case, plaintiff similarly seeks to circumvent the language of the statute by couching his allegations in terms of medical malpractice or failure to supervise. Yet even according plaintiff the benefit of all reasonable inferences, defendants' liability is inextricably linked to their failure to detain Bernice in a manner that would have imposed greater restraints or supervision of her movements in and about the facility. Whether the alleged negligent conduct is viewed as "detaining" or "conditionally releasing," as set forth in the language of the statute, it is precisely the sort of discretionary judgment the legislature has seen fit to render immune from civil liability.
We recognize that the immunity afforded is not absolute and that it is still possible to state a claim with respect to conduct amounting to bad faith or "gross negligence." See Boyer v. Tilzer, 831 S.W.2d 695 (Mo.App. 1992). Plaintiff does not argue that this standard is satisfied here nor do the allegations in the petition support such an inference.
Chapter 632 RSMo 1986 plainly contemplates a continuum of various degrees of detention, mandating in virtually all instances placement in the least restrictive environment consistent with the best interests of the patient. See, e.g., § 632.385 RSMo 1986. To interpret § 632.440 to provide immunity for detaining or discharging a patient but not for decisions with respect to the degree of restraint or supervision required would inherently conflict with the overall statutory scheme by encouraging an "all or nothing" approach to detention of mental health patients. Thus, we believe that the legislative determination that state mental health care professionals should be shielded from liability for good faith decisions with respect to the detention, conditional release or discharge of mental health patients necessarily encompasses decisions regarding the degree of restraint or supervision imposed on such patients. Accordingly, defendants are immune from liability for the conduct alleged in the petition and the trial court properly sustained defendants' motion to dismiss.
CARL R. GAERTNER, P.J., and CRANE, J., concur.
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