Florida’s First District Court of Appeal unplugged the rights of victims of the negligent failure to diagnose suicide in the case of Rebecca A. Tuten as the personal representative of James Tuten v. Alexander Fariborzian, Meridian Behavior Healthcare, Inc.

Here are the facts:

On behalf of her husband, Jame’s, estate, Rebecca Tuten sued Dr. Alexander Fariborzian, a psychiatrist, and Meridian Behavioral Healthcare, a psychiatric facility,for his negligent wrongful suicide death in Florida. Mr. Tuten was receiving outpatient care at Meridian for depression and suicidal ideations. He attempted suicide in 2007 and voluntary admitted himself. After only 3 days, he was released on medication. Two months later he again attempted suicide and was admitted in the intensive care unit of a local Florida hospital. After being discharged from the ICU he was readmitted into Meridian, but again after just 3 days of care, he requested to be discharged. This time, Dr. Fariborzian denied his request and a petition was filed to involuntary continue his admission pursuant to Florida’s Baker Act. Dr. Fariborzian supported the petition for the Baker Act.

At the court hearing for the Baker Act procedure, Mr. Tuten requested to be discharged and Dr. Fariborzian certified that he was competent to provide his own consent for release with an order to receive follow-up care. The very next day Mr. Tuten shot his wife and then fatally shot himself.

The court dismissed her first complaint and she amended it to include a count against the doctor for breaching the standard of care when he certified that Mr. Tuten was competent to consent and against the facility for vicarious liability and for improperly discharging him. Procedurally similar to a case we are currently working on, where we represent the family of a nurse suing his own employer/hospital for the negligent care that we believe led to his suicidal death, the Court dismissed Mrs. Tuten’s case and she appealed to Florida’s First District Court of Appeal.

She raised three points on appeal. She argued that the trial court erred in dismissing her complaint under the Baker Act, that both the psychiatrist and facility breached their duty of care and that the court refused to allow her to amend her complaint.

The court dismissed her claim under the Baker Act by holding that a petition for involuntary placement can be withdrawn prior to a hearing and that Dr. Fariborzian opined that Mr. Tuten could decide for himself if he needed to be committed. Essentially, this means that if a psychiatrist petitions a court for the involuntary commitment of a psychiatric patient and then before the hearing decides to change his mind, even if he is wrong about his evaluation, there is no cause of action.

The court dismissed the second count by holding that there is no common law duty requiring the facility or doctor to keep a patient committed against his will once the treating doctor decides that the patient is well enough to make up his own mind regarding commitment . Because, and I quote the court, “the internal workings of the human mind remain largely mysterious.”

The court seems to comfort itself by the fact that Mr. Tuten’s death occurred outside of the hospital’s custody. Using the illogical reasoning of the Chacko court, which apparently gives Florida’s psychiatric hospitals, and their staff unlegislated immunity from liability if one of their suicidal patients pulls the trigger after being discharged, regardless of whether the assessment and discharge was done appropriately.

As a Florida lawyer who sues hospitals and doctors I understand that Mr. Tuten was not in the hospital’s custody when he shot his wife and ended his own life, but I am outraged that this Court seems to give Florida’s corporate medical cartel the comfort of practicing medicine without consequence to the safety and well being of those suffering from depression and suicidal ideations.

Suddenly, the human mind is such an abstract and wondrous mystery that suicides defy prediction or prevention. Somehow, courts are able to divine the intent of parties to contracts or whether or not an accused acted with premeditation. That the court seems to be able to grasp and see through the looking glass of human nature with 20-20 vision. But the suicidal ideations of Mr. Tuten, who already had tried suicide not once but twice before, was not enough for the First District Court of Appeal to simply allow the case to go to a jury to decide? I find it reprehensible that trial and appellate judges, have the audacity to substitute their interpretation of what is reasonable medical and psychiatric care for that of a Florida jury.

If this Alachua County Florida wrongful death case went to a jury and the jury told Mrs. Tuten that her husband had received the appropriate care, I would be disappointed but I would applaud the fact that she had her day in court and that the jury did its constitutionally designed function. This result is unjust and I humbly suggest unconstitutionally deprives not only Mrs. Tuten justice but potentially thousands of Floridian’s affected by the failure to diagnose suicidal ideations and prevent their catastrophic consequences. I realize that not all suicides are predictable or preventable. As a Miami-Dade County patient safety advocate I do not believe that Florida’s doctors and health care providers should not be accountable for failing to diagnose a potentially suicidal patient and giving that patient the appropriate care. It is simply no different to me than failing to diagnose a stroke or pre-term labor. Psychiatric Medicine is a science and not some mystical medieval folk art. I suggest that they spend some time reviewing some of the recent studies published by the National Suicide Prevention Hotline that have identified genetic markers that are important in understanding risk of multiple suicide attempts.

Our Florida psychiatric medical malpractice lawyers express our sincere condolences to the Tuten family and hope that the Florida Supreme Court will hear their case and reverse the First District Court of Appeal’s unjust decision.

§394.467Involuntary inpatient placement.–

(1) CRITERIA.–A person may be placed in involuntary inpatient placement for treatment upon a finding of the court by clear and convincing evidence that:

(a) He or she is mentally ill and because of his or her mental illness:

1.a. He or she has refused voluntary placement for treatment after sufficient and conscientious explanation and disclosure of the purpose of placement for treatment; or
b. He or she is unable to determine for himself or herself whether placement is necessary; and
2.a. He or she is manifestly incapable of surviving alone or with the help of willing and responsible family or friends, including available alternative services, and, without treatment, is likely to suffer from neglect or refuse to care for himself or herself, and such neglect or refusal poses a real and present threat of substantial harm to his or her well-being; or
b. There is substantial likelihood that in the near future he or she will inflict serious bodily harm on himself or herself or another person, as evidenced by recent behavior causing, attempting, or threatening such harm; and
(b) All available less restrictive treatment alternatives which would offer an opportunity for improvement of his or her condition have been judged to be inappropriate.

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