In re MH 2010-00029 – 10/6/2010

October 20, 2010

Arizona Court of Appeals Division Two Holds That A Physician’s Examination Via A Video-Conferencing System Does Not Qualify As a “Complete Physical Examination” Under A.R.S. §§ 36-501(14) and 533(B).

After a hearing, the trial court ordered mandatory treatment for appellant under Arizona’s mental-health statutes.  Before the hearing, two psychiatrists examined the appellant. One of them was Dr. Krasevic, who examined the appellant via a video-conferencing system instead of being in the same room as the appellant.  Neither doctor conducted a bodily examination of the appellant.  The appellant appealed the court’s treatment order, arguing that the state failed to meet its burden to have at least two physicians perform examinations of the patient.

The Arizona Court of Appeals vacated, holding that the physicians’ examinations supporting the court’s order did not comport with the statutes governing court-ordered treatment.  Under A.R.S. § 36-533(B), a patient must be evaluated by at least two physicians before the state may file a petition for treatment.  The resulting petition “shall be based upon the physician’s examination of the patient,” and the physicians must testify “as to their personal examination of the patient.”   A.R.S. §§ 36-533(B), 539(B).  Finally, the statute defines an “examination” to include “a complete physical examination.”  A.R.S. § 36-501(14).  Taken together, the Court construed the statutes to require that “two physicians must each personally conduct a ‘complete physical examination’ of the patient.”

The issue thus turned to the meaning of a “complete physical examination.”  Appellant argued that the phrase meant that the physicians had to conduct a “conventional” physical examination.  The State contended that, in the mental health context, a physical examination meant only that the doctor had to make “observations” of the patient’s “demeanor, presentation, ability to communicate,” etc., all of which could be done via “remote visual observation.”  After examining the statutory language, history, and context, the Court agreed with the appellant, holding that the statute required a “physical examination directed at evaluating the patient’s overall medical health.”  For example, the definition of “evaluation” under A.R.S. § 36-501(12) requires that a licensed physician – not a psychologist – analyze both the psychological and medical condition of the patient.  Furthermore, because the statute required a “complete physical examination,” a mere “visual assessment” was insufficient. 

Finally, the Court held that the examinations performed in this case fell short of the statutory requirement.  Dr. Krasevic’s remote examination via a video-conferencing system did not qualify as a “complete physical examination.”  Thus, because the procedures used to obtain court-ordered treatment failed to comply with Arizona’s mental-health statutes, the Court vacated the trial court’s order.

In a brief concurrence, Judge Kelly agreed that the court’s order for treatment should be vacated but contended that the majority’s discussion of the scope of the term “complete physical examination” was unnecessary.  In Judge Kelly’s view, Dr. Krasevic’s examination-via-video-conference plainly did not comply with the statute, and thus the lengthy analysis of what might qualify was extraneous.

Judge Eckerstrom authored the opinion and Judge Vásquez concurred; Judge Kelly concurred in the judgment.