Treating Mental Health Issues: Your Doctor Owes You a “Duty of Care” in Prescribing the Very Best Mental Health Medications.

The Florida Supreme Court recently issued its decision in Chirillo v. Granicz, 41 Fla. L. Weekly S385 (Fla. Aug. 25, 2016), in which it established that under Florida law, a doctor owes a mentally ill patient a “duty of care” in prescribing that patient the correct medications.  Although this case involves tragic facts, it provides vital protections for those who suffer from a mental health illness.  Specifically, it requires that physicians take mental health issues seriously, i.e., that they exercise the reasonable care necessary to protect their patients from self-harm caused by a mental illness.  The decision particularly stresses the ever-important area of prescribing the correct medications, which, as unfortunately shown below, could be the difference between a healthy life and the risk of suicide.

 What Happened? This case involves a wrongful death action involving a medical malpractice claim filed by Robert Granicz (“Granicz”) as personal representative of the estate of his wife, the “Decedent,” who committed suicide after switching antidepressants used to treat her chronic depression.  He claimed that the Decedent’s primary care physician (the “Physician”) breached his duty of care in treating her, resulting in her tragic death.

The Decedent had a history of depression and the Physician switched her medication from Prozac to another antidepressant, Effexor.  After taking Effexor for some time, the Decedent contacted the Physician’s office and told his medical assistant that she stopped taking Effexor because of its side effects, such as not sleeping, mental strain and crying easily, and gastrointestinal problems.  The Decedent also explained the she had not “felt right” for some months, but she provided no indication to her Physician or family that she was contemplating suicide.

In response, the Physician changed the decedent’s medication to the antidepressant Lexapro, providing samples and a prescription, but did not schedule an appointment.  The Decedent picked up the sample and prescription later that day.  The next day, the Decedent’s body was found hanging in her garage.  No note was left for her family.

What was the Physician’s Duty?  At issue is whether Florida law extends a physician’s duty of care to preventing a mentally ill patient’s suicide.

  • The trial court granted summary judgment in the Physician’s favor, finding that the Physician did not have a legal duty to the Decedent because it could not prevent what the trial court characterized as an “unforeseeable suicide” of an “outpatient decedent.”
  • The Second District reversed, holding that the trial court improperly characterized the duty the Physician owed to the decedent. Instead, the district court held that the Physician’s duty was a “general, legal duty,” i.e., “a duty to ‘use the ordinary skills, means and methods that are recognized as necessary and which are customarily followed in the particular type of case according to the standard of those who are qualified by training and experience to perform similar services.’ ” Although “not a duty to prevent her suicide,” the Second District held that this general, legal duty—especially given the facts of this case—extended from the Physician to the Decedent.  The district court also reversed based on its conclusion that their remained genuine issues of material fact regarding foreseeability and proximate cause.
  • The Florida Supreme Court’s Decision: The supreme court agreed with the Second District’s decision, holding that the Physician had a “general duty to treat the patient in accordance with the prevailing standard of care in the medical field.”  The supreme court also agreed that summary judgment was improper because their remained genuine issues of material fact as to the foreseeability of suicide and proximate cause.

The Takeaway:  As previously stated, the legal effect of this decision is that it provides protections for those suffering from mental illness by requiring their physicians to exercise the reasonable care necessary to prescribe them the correct and very best medications, or to refer them to someone who can.  As shown in the tragic facts of this case, it is vital that an individual who suffers from mental health issues receives the right medication, at the right time, before tragedy strikes.  If you suffer from a mental health issue, please be sure to ask questions of your doctor regarding your medication and whether, given your symptoms, it is the very best medication for your condition.

Anthony M. Stella, Esq.
Appellate & Litigation Support Attorney
Lytal, Reiter, Smith, Ivey & Fronrath LLP
515 N. Flagler Drive, Ste. 1000
West Palm Beach, FL 33401
Direct Line: (561) 820-2235
Main Line:   (561) 655-1990
Cell Phone:  (954) 336-7493
Email: astella@foryourrights.com