SUSAN M. MARTIN, AS ADMINISTRATRIX OF THE ESTATE OF DAWN M. MARTIN, AND SUSAN M. MARTIN, INDIVIDUALLY AND IN HER OWN RIGHT, Appellant
HOLY SPIRIT HOSPITAL
from the Order Entered February 1, 2016, in the Court of
Common Pleas of Cumberland County Civil Division at No.
BEFORE: FORD ELLIOTT, P.J.E., SHOGAN, J., AND STEVENS, P.J.E.
M. Martin appeals from the order entered February 1, 2016,
sustaining defendant/appellee's preliminary objections in
the nature of a demurrer and dismissing appellant's third
amended complaint with prejudice. After careful review, we
prior opinion sustaining appellee's preliminary
objections to appellant's first complaint, the trial
court summarized the facts of this matter as follows:
The pertinent facts, viewed in the light most favorable to
[appellant] as the non-moving party, can be summarized as
follows: The decedent, Dawn M. Martin, had a history of
mental health problems. On 17 April 2012, the decedent was
brought by ambulance to [appellee] Holy Spirit Hospital's
Emergency Department (ER) following a suicide attempt. The
decedent sought a voluntary 201 commitment and, as a result of a
"psych diversion" from another hospital, was
transported to [appellee]'s ER. She was placed in an exam
room upon arrival at 9:24 pm. While in the ER, the decedent
had several encounters with hospital personnel; she voiced
her suicidal intent several times during these encounters.
The decedent was not seen by a physician or the crisis
intervention team during her time in the ER before eloping
from the hospital.
At some point during her stay in the ER, the decedent changed
into a hospital gown and slippers. At approximately 10:45 pm,
the decedent left her exam room. She walked past the ER
charge nurse's station and the ER discharge and billing
desk to get to the ER exit door; the decedent then passed
through two ER exit doors and entered the ER lobby. Once in
the lobby, the decedent proceeded past the ER triage
nurses' station to exit the hospital through open sliding
glass doors, still wearing her hospital gown and socks. At no
point did any member of [appellee]'s staff intervene or
question the decedent as she made her exit. The decedent
subsequently walked onto the nearby U.S. Highway State Route
15 where she was struck and killed by passing motor vehicles.
The Commonwealth of Pennsylvania's Department of Health
investigated the April 17thincident and reported
that the decedent was the ninth mental health crisis patient
to elope from the ER without any crisis intervention
evaluation in a 31/2 month period. [Appellee] was cited by
the Commonwealth for having violated regulations involving
patient safety and protection and was issued a fine for [its]
court opinion, 10/18/13 at 2-3 (footnotes omitted).
February 1, 2016, appellee's preliminary objections to
appellant's third amended complaint were sustained, and
the complaint was dismissed with prejudice. The trial court
determined that the Mental Health Procedures Act
("MHPA"), 50 P.S. §§ 7101-7503, applied
to this case, and therefore, appellant had to prove willful
misconduct or gross negligence. The trial court then
determined that at most, appellant's allegations rose to
the level of ordinary negligence. As such, appellee was
entitled to the benefit of the MHPA's limited immunity
provision. This timely appeal followed on February 22, 2016.
On March 7, 2016, appellant was ordered to file a concise
statement of errors complained of on appeal pursuant to
Pa.R.A.P. 1925(b) within 21 days; appellant complied on March
24, 2016, and the trial court filed a Rule 1925(a) opinion on
April 25, 2016.
has raised the following issues for this court's review:
A. Whether the trial court committed an error of law when it
applied the heightened Standard of the [MHPA] to the
admission of decedent, Dawn M. Martin to [appellee], Holy
Spirit Hospital on April 17, 2012?
B. Whether the trial court committed an error of law by
dismissing, with prejudice, [appellant]'s Third Amended
Complaint at the Preliminary Objection phase of litigation by
determining Appellant had not pled sufficient facts to show
gross negligence pursuant to the [MHPA]?
brief at 5.
standard of review we apply when considering a trial
court's order sustaining preliminary objections is well
[O]ur standard of review of an order of the trial court
overruling or granting preliminary objections is to determine
whether the trial court committed an error of law. When
considering the appropriateness of a ruling on preliminary
objections, the appellate court must apply the same standard
as the trial court.
Preliminary objections in the nature of a demurrer test the
legal sufficiency of the complaint. When considering
preliminary objections, all material facts set forth in the
challenged pleadings are admitted as true, as well as all
inferences reasonably deducible therefrom. Preliminary
objections which seek the dismissal of a cause of action
should be sustained only in cases in which it is clear and
free from doubt that the pleader will be unable to prove
facts legally sufficient to establish the right to relief. If
any doubt exists as to whether a demurrer should be
sustained, it should be resolved in favor of overruling the
HRANEC Sheet Metal, Inc. v. Metalico Pittsburgh,
Inc., 107 A.3d 114, 118 (Pa.Super. 2014).
In 1976, the General Assembly enacted the MHPA to provide
procedures and treatment for the mentally ill in this
Commonwealth. The policy of the MHPA is set forth in Section
102, which provides, in pertinent part:
[I]t is the policy of the Commonwealth of Pennsylvania to
seek to assure the availability of adequate treatment to
persons who are mentally ill, and it is the purpose of this
act to establish procedures whereby this policy can be
effected. The provisions of this act shall be interpreted in
conformity with the principles of due process to make
voluntary and involuntary treatment available where the need
is great and its absence could result in serious harm to the
mentally ill person or to others. Treatment on a voluntary
basis shall be preferred to involuntary treatment; and in
every case, the least restrictions consistent with adequate
treatment shall be employed.
Allen v. Montgomery Hosp., 696 A.2d 1175, 1178 (Pa.
1997), quoting 50 P.S. § 7102.
The immunity provision of the MHPA provides in pertinent part
§ 7114. Immunity from civil and criminal liability
(a) In the absence of willful misconduct or gross negligence,
a county administrator, a director of a facility, a
physician, a peace officer or any other authorized person who
participates in a decision that a person be examined or
treated under this act, . . . shall not be civilly or
criminally liable for such decision or for any of its
50 P.S. § 7114(a). Under the MHPA, a
"facility" is "any mental health
establishment, hospital, clinic, institution, center, day
care center, base service unit, community mental health
center, or part thereof, that provides for the diagnosis,
treatment, care or rehabilitation of mentally ill persons,
whether as outpatients or inpatients." 50 P.S. §
7103. "Treatment" is defined as "diagnosis,
evaluation, therapy, or rehabilitation needed to alleviate
pain and distress and to facilitate the recovery of a person
from mental illness and shall also include care and other
services that supplement treatment and aid or promote such
recovery." 50 P.S. § 7104.
Downey v. Crozer-Chester Med. Ctr., 817 A.2d 517,
524 (Pa.Super. 2003) (en banc), appeal denied, 842
A.2d 406 (Pa. 2004).
Our Supreme Court has determined that the immunity provided
by the MHPA extends to institutions, as well as natural
persons, that provide care to mentally ill patients.
Farago v. Sacred Heart General Hospital, 522 Pa.
410, 562 A.2d 300, 303 (1989). Additionally, our Supreme
Court has interpreted § 7114(a) to include not only
treatment decisions, but also, "'care and other
services that supplement treatment' in order to promote
the recovery of the patient from mental illness."
Allen v. Montgomery Hospital, 548 Pa. 299, 696 A.2d
1175, 1179 (1997).
Downey, 817 A.2d at 525. See also Farago v.
Sacred Heart Gen. Hosp., 562 A.2d 300, 303 (Pa. 1989)
("Unquestionably, the clear intent of the General
Assembly in enacting Section 114 of the MHPA was to provide
limited civil and criminal immunity to those individuals and
institutions charged with providing treatment to the mentally
we address appellant's contention that the immunity
provisions of the MHPA do not apply because appellee was not
providing mental health "treatment" to the decedent
at the time of her injury and death. Appellant argues that
the decedent had not yet been evaluated by any physicians,
crisis intervention personnel, or mental health professionals
while in the ER, and no decisions regarding her care or
treatment were made while the decedent was at appellee's
facility. (Appellant's brief at 17.) The decedent had not
been admitted to the hospital and had not been examined by a
physician or psychiatrist in the ER. (Id. at 16.)
Appellant contends that because the decedent was not
receiving "inpatient treatment" while a
"resident" at the facility, the MHPA does not
apply. (Id., citing 50 P.S. § 7103 ("This
act establishes rights and procedures for all involuntary
treatment of mentally ill persons, whether inpatient or
outpatient, and for all voluntary inpatient treatment of
mentally ill persons. "Inpatient treatment" shall
include all treatment that requires full or part-time
residence in a facility.").)
relies primarily on this court's decision in Fogg v.
Paoli Mem'l Hosp., 686 A.2d 1355 (Pa.Super. 1996),
in which this court held that the immunity provisions of the
MHPA did not apply because the defendant-hospital had not
been "treating" the plaintiff-decedent, Edward H.
Fogg, for his mental illness at the time of his injury. We
find Fogg to be factually distinguishable. In that
case, Mr. Fogg's treating psychiatrist arranged for him
to be admitted to the psychiatric wing of Paoli Memorial
Hospital. Id. at 1356. Mr. Fogg had a history of
psychiatric problems including anxiety, depression, and
audio/visual hallucinations. Id. When Mr. Fogg and
his parents arrived at the ER, they were instructed to have a
seat in the waiting room. Id. Mr. Fogg's parents
told the registrar that their son was having hallucinations
and had a bed reserved for his admission in the psychiatric
ward. Id. Mr. Fogg did not receive any medical
treatment and was not seen by any medical personnel.
Id. at 1356-1357.
after repeated inquiries by Mr. Fogg's parents, the
registrar directed them to the hospital admissions desk.
Id. at 1357. The Foggs proceeded down the hallway
unescorted. Id. At the end of the hallway was a
large window, facing west into the setting sun. Id.
Mr. Fogg became agitated and ran down the hallway towards the
setting sun, crashing through ...