Cohen v. Maricopa County – 8/16/2011

August 25, 2011

Arizona Court of Appeals Division One Holds That The County Does Not Owe a Duty to Patient After Release From Involuntary Inpatient Treatment.

Appellant Rochelle Cohen’s son, Joseph Eichten, was brought to the hospital six times between July and December 2003 for treatment of an overdose of Soma and cocaine.  Eventually, Eichten was determined to be at risk for suicide and in need of treatment and transferred to the hospital for involuntary treatment.  In December 2003, a petition for involuntary court-ordered treatment was filed, and the court found that a combination of inpatient and outpatient treat was appropriate.  The outpatient treatment component was to be administered and supervised by ValueOptions, Inc., through a contract with the Arizona Department of Health Services. 

Eichten completed inpatient treatment and was discharged from the hospital.  Shortly thereafter, Appellant discovered Eichten passed out with Soma in his pocket.  She called emergency services and Eichten was medically cleared then brought to an urgent care center where Appellant submitted a petition for a mental health detainer.  A ValueOptions physician considered the petition and determined that such detention was not medically indicated.  Eichten returned home.  The next morning, Appellant found Eichten unconscious on the floor of her home.  He was taken to a hospital and pronounced dead, apparently from an overdose of oxycodone.

Appellant filed an action against ValueOptions, Meta Services, and Maricopa County.  Appellant alleged that the County owed non-delegable duties to Eichten and asserted claims for medical negligence, failure to provide emergency psychiatric screening, and violation of the Adult Protective Services Act.  Both Appellant and the County filed motions for summary judgment.  The trial court found that the County owed no duty to Eichten, either direct or non-delegable, once Eichten was released from inpatient care and dismissed the claims against the County with prejudice. 

Appellant appealed, arguing that the County owed a continuing, non-delegable duty of care to Eichten arising out of A.R.S. §§ 36-52636-540.0136-545.06 and the December 2003 order for treatment.  Under these statutes, Appellant contended that the County had a statutory duty to: (1) perform an examination of Eichten, (2) develop an outpatient treatment plan, (3) require and review periodic reports on Eichten’s condition, (4) order a return to inpatient treat for failure to comply with the outpatient treatment plan, and (5) provide screening and evaluation and coordinate the provision of such services.  Appellant argued that the County failed to properly monitor Eichten’s outpatient progress and failed to timely rescind the outpatient treatment plan and reinstate involuntary inpatient care.

The Court of Appeals affirmed the trial court’s grant of summary judgment.  Once Eichten was release from involuntary inpatient care, ValueOptions became solely responsible for managing Eichten’s outpatient treatment plan.  The Court of Appeals therefore held that any statutory duties that arose during Eichten’s outpatient treatment were owed to Eichten by ValueOptions, not the County. 

The Court of Appeals distinguished the opinion relied upon by Appellant, DeMontiney v. Desert Manor Convalescent Center, Inc., 144 Ariz. 6, 695 P.2d 255 (1985).  In DeMontiney, the Court determined that the County had a non-delegable duty to provide care to an involuntarily detained patient.  The Court of Appeals reasoned that, based on DeMontiney, had Eichten died while receiving inpatient involuntary treatment, the County would have had a non-delegable duty concerning his care at that facility.    According to the Court, it is the involuntarily setting –  in which the County has the exclusive ability to control and reduce the risks in the environment –  that necessitates a finding that the County has a non-delegable duty.  The Court held that the County did not have a non-delegable duty to Eichten once he was released from involuntary inpatient treatment. 

Judge Winthrop authored the opinion; Judges Portley and Brodman concurred.