Friday, April 10, 2009
C.A.: Treating Psychiatrist Not Liable for Double Murder by Patient
By SHERRI M. OKAMOTO, Staff Writer
The Fourth District Court of Appeal yesterday threw out the medical negligence claims against an Orange County psychiatrist whose autistic teenaged patient shot and killed two people.
As 19-year old William Freund had not displayed any violent tendencies or motives against the victims, Div. Three ruled, Laurence Greenberg owed no duty of care to the victim’s family in treating his patient. The court issued a writ of mandate directing Orange Superior Court Judge Geoffrey T. Glass to grant Greenberg’s motion for summary judgment.
According to the complaint, Freund suffered from Asperger’s Syndrome, a form of autism which negatively affects an individual’s social skills and interactions. His only known friend was a neighbor, Brandon Smith.
Although Smith testified that Freund “never seemed like the violent type,” when Freund was 15 years old, a pediatric neurologist reported Freund was being teased by “bullies at school” and taking out his rage and frustration on his parents by throwing things at them and physically attacking them.
Greenberg treated Freund for three months in 2002, and Freund returned to his care in April 2004.
Noting Freund’s “continued difficulties with irritability and moodiness, related to his depressive disorder[,] propensity to anxiety (‘paranoid anxiety’) and obsessive thinking regarding his inability to form close social relationships,” Greenberg prescribed Freund a medication called Geodon in September 2005.
In October 2005, Freund posted messages on a website called WrongPlanet.net, which hosts an online discussion forum for individuals with what it calls “neurological differences.” Freund’s postings suggested that he was suicidal and had unsuccessfully tried to kill himself.
He said he had no friends, was too anxious to talk to people, and that his father was controlling and abusive.
On Oct. 12, Greenberg noted Freund’s complaints of insomnia and dizziness, as well as reports from Freund’s parents that the teenager was “in and out of reality,” and manifesting “irritability and nastiness.” The psychiatrist prescribed a new regimen of Lexapro, Effexor, Ativan, and Concerta.
Three days later, Freund applied to buy a shotgun.
He subsequently posted messages on WrongPlanet.net about how he was going to cause a lot of damage with his gun and hoped to hunt and “blast things away.”
Freund accused his parents of lying to him, forcing him to take psychoactive drugs, and not caring about his feelings. He also claimed his health was deteriorating from having taken Geodon, and that he was “not getting any better.”
No evidence was introduced at trial indicated that Greenberg or Freund’s parents knew of Freund’s online postings.
Smith testified that he spoke with Freund and his parents outside of their house in late October and noticed that Freund “wasn’t himself.” He said that Freund was “very quiet” and “didn’t say anything,” before going into the house. Freund’s mother had said Freund was “acting a little weird,” but “was quick to change the subject,” Smith claimed.
On Oct. 29, Freund entered Smith’s house with the shotgun and killed Smith’s father and sister. Freund then returned home and killed himself.
An autopsy showed the presence of the drugs Effexor and Celexa in Freund’s blood.
Greenberg denied having prescribed Celexa for Freund, and maintained that the teenager had a history of not complying with prescribed medication regimens.
Smith and his mother later filed a complaint for wrongful death and emotional distress against Greenberg, but Glass sustained Greenberg’s demurrer with leave to amend.
The Smiths then filed an amended complaint for medical negligence alleging that Greenberg had prescribed Freund medications known to have adverse side effects in teenagers, including homicidal and suicidal propensities, which increased the risk that Freund would exhibit violent behavior and caused him to kill the victims.
After his second demurrer was overruled, Greenberg moved for summary judgment, but Glass denied the motion, finding that Greenberg might have owed a duty of care to the Smiths.
Writing for the appellate court, Justice Raymond J. Ikola analogized the case to Calderon v. Glick (2005) 131 Cal.App.4th 224.
Calderon involved a psychotherapeutic patient who falsely believed his former girlfriend had transmitted a fatal blood virus to him and murdered several members of the former girlfriend’s family before committing suicide.
In that case, the Fourth District Court of Appeal held that the psychotherapists owed no duty of care to the former girlfriend and her family because the patient had not communicated any threats of violence against them to his psychotherapists and the psychotherapists had no information indicating that the patient had been violent in the past.
Ikola noted that the Calderon patient’s known preexisting delusion had increased the harm to the victims in that case because the patient had targeted his anger at his former girlfriend. In contrast, Ikola pointed out that Freund was not noticeably deranged and had no known motivation to hurt the Smith family.
While the Calderon defendants had no knowledge of any past violence by their patient and Greenberg arguably knew of Freund’s prior rages against his parents, Ikola reasoned that the Calderon murders were at least as foreseeable as Freund’s shootings.
Because Greenberg’s treatment of Freund was not intended to affect or benefit the Smiths in any way and Greenberg had no way of knowing his patient would attack the Smiths, Ikola concluded, the psychiatrist did not owe then a duty of care when making medical decisions regarding the treatment of his patient.
Presiding Justice David G. Sills and Justice Richard D. Fybel joined Ikola in his opinion.
The case is Greenberg v. Superior Court (Smith), 09 S.O.S.2056.
Copyright 2009, Metropolitan News Company