WILMINGTON, Del. (Legal Newsline) - Plaintiffs claiming medical negligence caused a loved one to commit suicide must prove their injuries created an “uncontrollable impulse” to kill themselves, not a looser “but for” standard, a Delaware court ruled in the case of a farmer who died after suffering a severe infection.
Refusing the plaintiff’s request for reargument on a central legal question, Superior Court Judge Abigail Legrow ruled that Delaware law was clear on the standard for determining whether suicide was an independent intervening cause in medical wrongful death cases, relieving the defendant of liability.
James Healy Sr. was diagnosed with diabetes in 2015 and became a patient of Dr. Theodore Saad with the Fresenius Kidney Care dialysis clinic. He began dialysis in 2018 and continued working on his farm, until he suffered an infection in April 2019. He was admitted to the hospital, where he developed complications. He returned home with a hospital bed, wheelchair and walker, dependent upon home healthcare workers and his son.
On April 21, 2019, Healy killed himself, leaving behind a note:
"I can[’t] deal with. Any more Doctors and pt. I am sorry I messed up again please forgive me"
James Healy Jr. sued the caregivers who saw his father in the week before he killed himself, claiming they failed to properly diagnose and treat his infection, causing “pain and suffering, disfigurement, disability, and emotional pain.”
The defendants moved to dismiss the case, arguing Healy didn’t have an expert who could testify negligent care caused “mental illness which results in an uncontrollable urge to commit suicide.” Healy argued “uncontrollable urge” wasn’t the standard for wrongful death by suicide cases in Delaware and that it should be the looser “but for” standard in other tort cases. If the “uncontrollable impulse” standard did apply, the plaintiff argued, Healy’s psychiatrist met it by testifying he suffered “unbearably and to such a degree as to override his normal and rational judgment.”
Judge Legrow agreed with the defendants that uncontrollable urge was the standard but refused to dismiss the case, ruling the psychiatrist’s opinion didn’t need to invoke “magical words” to meet the requirements of Delaware law. The plaintiff moved for reargument anyway, in an attempt to include a looser standard for the jury to apply.
The judge refused the request in a Jan. 28 letter. She based her opinion on Porter v. Murphy, a 2001 decision involving suicide that held that suicide is an intervening cause of death, relieving the defendant of liability, if it “only causes a mental condition in which the injured person is able to realize the nature of the act of suicide, and has the power to control it if he so desires.”
Healy originally argued Porter was wrongly decided, then shifted to arguing the court should use the standard the Delaware Supreme Court applied in a workers’ compensation case: If injuries cause “severe pain and despair” that override “normal and rational judgment.” First, the court ruled that Healy wasn’t entitled to reargument because he hadn’t pointed out any conflicts between the court’s earlier ruling and Delaware law.
Even if that wasn’t the case, the court went on, there wasn’t a meaningful difference between the two standards. Workers comp law is more liberal by design, since it eliminates the need for plaintiffs to prove negligence.
“To be clear, in my view, the `uncontrollable impulse’ standard is not different from `but for’ causation,” the judge concluded. “Rather, it is a more precise formulation of the proximate cause standard to be used in suicide cases where the jury necessarily will be called upon to determine whether the suicide is an intervening, superseding cause.”