Court Case: 7-1

FACTS: Prosenjit Poddar attended the University of California at Berkley where he met Tatiana Tarasoff. After a New Year's Eve kiss, Poddar thought that Tarasoff wanted to enter into a romantic relationship with him. The feeling was not mutual, which Tarasoff tried to explain to Poddar.Feeling rejected, Poddar became depressed and started to stalk Tarasoff. Poddar eventually sought psychological counseling with Dr. Moore who worked at UC Berkley's Cowell Hospital.

During one of the counseling sessions, Poddar confided to Dr. Moore that he had thoughts of killing Tarasoff. Dr. Moore took the threat seriously and contacted security with the recommendation that he be committed to a psychiatric institution. When security arrived, they detained Poddar, but found him to be rational and calm. Dr. Moore's supervisor ordered Poddar released and told campus security not to subject him to any further detention.

Two months later, Poddar carried out his threat, stabbing and killing Tarasoff. Tarasoff's parents filed a civil lawsuit against the University of California, in part, under respondeat superior; campus employees; Dr. Moore and his supervisor; and campus police. The lawsuit claimed that Dr. Moore had a duty to warn Tarasoff about the possible danger so that she could take appropriate action.

ISSUE: The question that the court struggled with was whether Dr. Moore had a legal duty to warn Tarasoff or would it be a breach of the doctor/patient relationship?

RULE: The court ruled: "When a therapist determines, or pursuant to the standards of his profession should determine, that his patient presents a serious danger of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger."

EMPHASIS: This is more to this case than demonstrating the exception to the doctor/patient relationship. The first is how a judge determined the legal duty that Dr. Moore had.The second, is the emphasis of respondeat superior. The third is how the courts used the Standard of Care, specifically mentioning it in their ruling. And fourth, the establishment of what has become known as a Tarasoff Warning.

If a therapist determines that "a patient presents a serious danger of violence to another" they can send an anonymous warning to that person to ensure that they are in compliance with the Tarasoff ruling.And, by issuing the warning anonymously, they are protecting the doctor/patient relationship.

WARNING: The Tarasoff ruling is not something to be taken lightly.As a beginning healthcare professional, you need to use caution if you are going to utilize such a warning. It is highly suggested that before doing so, you consult with your supervisors. There are times when a healthcare professional issued what they thought was a Tarasoff warning, but the courts ruled otherwise.

Questions:

1. The Tarasoff case allows for the anonymous notification of a problem. But don't you think that Tarasoff would have been able to figure out who it was? Explain your answer.
2. Can you think of any way to get around the anonymous component without the person being able to identify who the other party is?Explain your answer.

Court Case: 7-4

FACTS: In April 2000, an argument over a chair broke out between two patients at Vista Pacific Center, a long-term care psychiatric facility. After the patients were separated, Certified Nursing Assistant Gregory McMillan approached the patients. McMillan ordered one of the patients to his room, walking behind him and continually yelling "Go to your room!" At some point, McMillan hit the patient on the shoulder, grabbed him around the neck, and forced him to the floor. One of the nurses testified that McMillan's "...manner was very threatening and aggressive.He was rigid, staring at the victim, and talking in a loud voice."

After the incident was over, the patient was examined by a medical doctor and a psychiatrist, both determined that the patient did not receive any physical or mental injuries as a result of the incident.

A report was completed by Vista Pacific Center and forwarded to Deborah Davis, a licensed Administrator for Vista Pacific Center.Although McMillan was fired, Davis decided not to report the incident as abuse to the authorities. She testified that because the patient did not have any injuries she did not report. She also testified that a similar incident was described in a professional publication and determined by the Department of Health not to constitute abuse. Davis was charged with failing to report suspected abuse under the state's mandatory reporting law.

In her appeal Davis testified that "... she determined that the allegation of abuse was unfounded. Based on her experience and training, she did not entertain a reasonable suspicion and therefore had no duty to report the incident as suspected abuse."

ISSUE: The question before the court was whether or not a person can use their expertise and training to make the determination of whether abuse occurred, and to identify if reporting is required.

RULE: "[T]he Act does not permit a mandatory reporter to investigate and determine that no abuse occurred, as the defendant contends. On the contrary, the existence of such circumstances triggers the mandatory duty to report the circumstances to a designated outside agency."

EMPHASIS: The main reason for providing this court case is to demonstrate the overall reason for the mandatory reporting requirements: thesuspicion of abuse.

Questions:

1. In its ruling, the court used the terminology "mandatory duty" to apply to the administrator.Does this terminology trigger anything else other than the mandatory reporting? Explain your answer.
2. Take another look at the scenario and go through the steps involved in assault and battery to determine if either has been committed.

Court Case: 7-5

FACTS: After Eric Halko was diagnosed with pulmonary tuberculosis, the Department of Public Health ordered a 6-month confinement order at Mira Loma Hospital. After a month in quarantine, he left the facility in violation of the quarantine order.He was subsequently arrested, tried and convicted, of violating California's health code. Halko was returned to Mira Loma Hospital to serve out the remainder of his quarantine order. When his first quarantine order expired, he subsequently received three additional quarantine order each for six months. Halko spent a total of 24 months in quarantine. Halko filed a habeas corpus petition asking the court to be released from quarantine. [Habeas corpus is a legal recourse related to unlawful detention.] His claim was that he was being unlawfully deprived of his liberty without due process of law.

ISSUE: The question before the court was whether the state of California's public health quarantine order was valid without a judge's ruling on the legal validity of continual quarantine orders.

RULE: "The preservation of the public health is universally conceded to be one of the duties devolving upon the state as a sovereignty, and whatever reasonably tends to preserve the public health is subject upon which the legislature, within its police powers, may take action."

EMPHASIS: One of the issues that was raised in this case, was whether the legislature had the legal authority to write a quarantine law? The court determined that yes, the state legislature had the authority to "create" such a law. However, the judiciary also has a right to "interpret" whether continued quarantine was reasonable and rational under the circumstances.

Questions:

1. 24 months is a long time to spend in quarantine. Why do you think the state kept Halko in quarantine for that long?Explain your answer.
2. Should the state only be authorized to quarantine someone for potentially lethal diseases or any disease that can infect another person? Explain your answer.

7-7

Case Analysis: You are working in a busy doctor's office. After seeing a patient, he writes a lab order for a drug screen.The patient works at the local hospital, primarily providing patient care in the outpatient surgery department.

Question 1: Does the patient/doctor relationship extend to you; and would you be allowed to testify as such in court? Explain your answer.

Question 2:What if you are concerned about the potential for drug abuse? Should you report this person to the hospital? Explain your answer.

Question 3: What if a patient brings a pouch of cocaine into the exam room.Should you report this to the local police department? Explain your answer.