Naidu v. Laird

Supreme Court of Delaware, 1988

Facts: The plaintiff, Ann Laird, brought a wrongful death action against Dr. Venkataramana Naidu, a Delaware State Hospital psychiatrist, alleging that he was grossly negligent in releasing a mental patient, Mr. Putney. Five and one‑half months after release, Mr. Putney, while in a psychotic state, killed Ann Laird's husband in an auto accident.

Mr. Putney had an extensive history of paranoid schizophrenia involving many admissions to VA hospitals and seven admissions to Delaware State Hospital. He had a pattern of noncompliance with antipsychotic medication. In one VA record, he was described as dangerous to himself and others, "especially if he should drive an automobile in his present condition." His fifth admission to Delaware State Hospital occurred after he intentionally rammed a police vehicle with his automobile. Prior to one VA admission, he cut his wrist and then drove his car off the road.

The concern of this litigation was Mr. Putney's seventh admission to Delaware State Hospital from March 7‑22, 1977. He signed a voluntary admission form. On March 17, Mr. Putney refused to take his medication. Throughout his stay he was demanding and uncooperative. He requested a discharge against medical advice on March 18. The treatment team released him on March 22, 1977.

Dr. Naidu testified that he did not personally review the records from the six prior hospitalizations at Delaware State Hospital or the VA medical records. He did not even review the complete records from the March 7‑22, 1977 admission; instead he relied on the treatment team for his database.

Upon discharge, Mr. Putney was given a 30-day supply of medication and told that he had an appointment at a VA hospital. After discharge, Putney stopped taking his medication and did not appear for his follow up VA appointment. He moved to New York and his life was unremarkable until September 6, 1977, when, while psychotic, he drove his car into that of Mr. Laird.

At the trial, plaintiff's expert, Dr. Davis, testified that Dr. Naidu was grossly negligent in the treatment and discharge of Mr. Putney. Dr. Davis criticized: 1) the discharge without a program of continuing care; 2) failure to address Putney's noncompliance; 3) failure to consider alternatives such as referrals to an outpatient facility, transfer to a VA hospital, or involuntary commitment to Delaware State Hospital. Dr. Davis opined that Putney was sufficiently dangerous on March 22, 1977 that he could have been involuntarily committed. The jury verdict against Dr. Naidu was 1.4 million dollars.

Issue: On appeal, Dr. Naidu contended that:) no duty required

him to prevent a former patient from causing injury to members of the public at large; and in any event, 2) as a matter of law, his treatment of Putney was not a proximate cause of Mr. Laird's death.

Holding: The Delaware Supreme Court held that the trial court correctly instructed the jury concerning the duty of reasonable care, and did not err in ruling that there existed substantial evidence to support the jury's verdict that Dr. Naidu breached that duty. The Court further held that there was sufficient evidence regarding proximate cause to have it remain a jury issue. It was thus proper for the trial court to refuse to dismiss the case as a matter of law.

Reasoning: In response to Dr. Naidu's proposition that there was insufficient evidence to conclude that Mr. Putney was civilly committable at the time, the Court stated that his past history should have been taken into consideration. Even if the jury were to conclude that Putney was not civilly committable, Dr. Davis testified that other remedial measures regarding supervision after his discharge were not taken.

The Court quoted from McIntosh v. Milano: "A psychiatrist may have a duty to take whatever steps are reasonably necessary to protect an intended or potential victim of his patient when he determines, or should determine, in the appropriate factual setting ...that the patient may present a probability of danger to that person. The relationship giving rise to that duty may be found either in that existing between the therapist and the patient, or in the more broadly based obligation a practitioner may have to protect the welfare of the community."

The trial court correctly stated that Dr. Naidu was chargeable with knowledge that Putney had twice been involved in auto accidents while in a psychotic state, possessed a driver's license at the time of his release, and could be expected to drive on the public roadways. Dr. Davis testified it was "not unforeseeable that Putney would stop taking his medication and would again become a danger to others, especially while driving an automobile."

Dr. Naidu's contention that his treatment was not the proximate cause of Mr. Laird's death relies on the principle of law that remoteness in time or space indicates the likelihood that intervening causes have prevented the defendant's acts from being proximate causes of the harm. However, the Court declined to rule as a matter of law that physical or temporal remoteness should, of itself, bar recovery. In the absence of any proven significant intervening cause, the temporal span in this case was not sufficient to relieve Dr. Naidu of responsibility.

Commentary: This case and Petersen v. State (1983) are two of the most notorious driving case extensions of the Tarasoff doctrine.