Did the hospital owe a duty of care to the friend of a mentally ill patient? Which case won?

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The NSW hospital discharged the mentally ill patient, who killed his friend on their journey back home to Victoria.

Australia Food, Drugs, Healthcare, Life Sciences

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The Facts

Mentally ill man admitted involuntarily to hospital

A Victorian man had a long history of chronic paranoid schizophrenia and was being treated for his illness at Echuca in Victoria.

In July 2004, while in NSW with a friend, the man was involuntarily admitted to and detained in a regional hospital.

Both the psychiatrist and the medical superintendent who saw the man at the hospital recorded their opinion that the man was a "mentally ill person".

Patient discharged from hospital, leading to tragic outcome

The psychiatrist read the man's medical records from the Echuca Community Mental Health Service, as well as speaking with the man, his mother and his friend. It was agreed that the man would spend the night at the hospital and that his friend would drive him to his mother's house the following day for treatment with his usual treatment providers.

The next day the man was discharged from the hospital and travelled with his friend to Echuca. Sadly, in the course of that journey the man killed his friend. Before taking his own life, the man told police that he had acted on impulse, believing that his friend had killed him in a past life.

The family of the friend brought a case against the hospital and the psychiatrist on the basis that, amongst other things, a duty of care was owed to the friend and that the duty was breached by discharging the man into his custody for the drive back to Echuca.

case a - The case for the relatives

case b - The case for the hospital and the psychiatrist

The relevant act of negligence was placing the man into the care of our relative, rather than the act of discharging the mentally ill man.
The hospital and psychiatrist owed a duty of care to our relative in circumstances where it was foreseeable that discharging a mentally ill person into his sole care gave rise to a foreseeable risk of harm.
The hospital and psychiatrist failed to exercise reasonable professional care and skill in deciding that the man could leave the hospital with our relative.

We did not owe the mentally ill man's friend a duty of care.
If a duty of care did exist, there was no breach of that duty. The risk of injury posed by the man was not foreseeable in the circumstances, and in deciding to discharge the man into his friend's care, we acted in accordance with the requisite level of skill and care.
In deciding to discharge the man into his friend's care, we acted in accordance with what would be widely considered as competent practice in Australia by peer professional opinion.

So, which case won?

Cast your judgment below to find out

Vote case A – the case for the relatives
Vote case B – the case for the hospital and the psychiatrist

Iain Miller
Medical negligence
Stacks Goudkamp

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Iain Miller

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