Psychotic patient filing pro se lawsuit

[Trismegistus4]

Today I received a notice that a patient whom I saw as an inpatient a few years ago is filing a lawsuit pro se. It names numerous doctors, the hospital system, EMS, another state, even a retail store (where I'm assuming he was picked up, leading to hospitalization,) accusing us all of kidnapping him, torturing him, waging chemical warfare against him and subjecting him to terrorism, etc. Basically very typical complaints you hear all the time from paranoid, psychotic people who don't think they should have been involuntarily hospitalized.

This is definitely legit in that the court documents/forms are real, stamped by the court and everything. The clerk of courts really did give this guy a case with a case number and everything.

I know I need to make sure I talk to a lawyer myself and that hospital risk management cares about protecting the hospital, not necessarily the doctors. But it occurs to me, why doesn't this kind of thing happen more often, or does it? We've all seen countless psychotic people who are obsessed with the legal system and always complaining their rights are being violated and threatening lawsuits. If anyone who can get it together enough to fill out a few court forms can actually get a case, is this happening all the time? But such cases can't all be going to trial, right? What is the mechanism by which they might be dismissed or dropped?

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[nexus73]

Many states require an expert witness be on board with the plaintiffs case to move forward, or at least a writ of merit from an expert, which would cost at least several hundred dollars and likely more. A lot more than the filing fee for a lawsuit. You need an expert to establish standards of care to win a lawsuit. Without that the case will get thrown out.

 

[Candidate2017]

If anyone who can get it together enough to fill out a few court forms can actually get a case, is this happening all the time? But such cases can't all be going to trial, right? What is the mechanism by which they might be dismissed or dropped?

Your first lawsuit, congrats! If it makes you feel better, he's able to fill out court forms because you picked the right meds and he's compliant with them. Unlikely though.

Anyway, like most employed doctors, you probably never asked your employer for a copy of your malpractice insurance contract (or even know the name of the insurance company). The contract comes in a nice binder, around 200 pages. The contract requires you to notify the insurer immediately or forfeit coverage. Because the patient wins if your lawyer doesn't file a response in X days. So get on that, or at least verify the hospital did it for you.

You will have to report this suit to every hospital job you apply to in the future, as well as insurance companies, and some state boards. On the bright side, your insurance lawyer will likely get this case tossed.

You probably shouldn't post so many details here either.

 

[Trismegistus4]

You probably shouldn't post so many details here either.

Without repeating such details, can you say why, or what details you think it's acceptable to post here? It's not like there was any identifying information in my OP.

 

[nexus73]

It's also likely that without a lawyer whatever gets submitted by the plaintiff will not have a valid cause of action and will get dismissed by a motion from your lawyer. Most doctors don't know the 4 d's of negligence, so most likely the average person doesn't know.

 

[aim-agm]

Many states require an expert witness be on board with the plaintiffs case to move forward, or at least a writ of merit from an expert, which would cost at least several hundred dollars and likely more. A lot more than the filing fee for a lawsuit. You need an expert to establish standards of care to win a lawsuit. Without that the case will get thrown out.

This depends on the claims being made in the suit. If he is alleging malpractice or other claims based on errors in medical care or judgement then he needs an expert. However, in this case the patient may be alleging things that don't necessarily need an expert, and the judge has wide latitude to interpret what he is alleging in pro se cases. Which isn't to say that the suit won't be dismissed, just that it might be a longer, more difficult process than one would expect even if the patient doesn't have an expert witness.

 

[calvnandhobbs68]

This depends on the claims being made in the suit. If he is alleging malpractice or other claims based on errors in medical care or judgement then he needs an expert. However, in this case the patient may be alleging things that don't necessarily need an expert, and the judge has wide latitude to interpret what he is alleging in pro se cases. Which isn't to say that the suit won't be dismissed, just that it might be a longer, more difficult process than one would expect even if the patient doesn't have an expert witness.

Meh it's a pro se lawsuit, especially if he's in a state where there's some kind of explicit statutory immunity for involuntary hospitalization, probably gonna get tossed out really quickly unless the documentation is complete **** or there's something really odd about the case.

 

[comp1]

Definitely second the comment about the patient's organization level to file all of this definitely indicating good treatment choices during the hospitalization. Contact your carrier and it's almost certain to go away, possibly quite quickly depending on the jurisdiction. In terms of why this particular thing doesn't happen often (and it doesn't) is that the vast majority of psychotic people don't get well enough after a hospitalization to do this. Or, if they do, they're actually grateful for the treatment. Or, the particular jurisdiction has specific statutory language prohibiting these sort of cases. Or, a particular judge or clerk recognizes the waste of the court's time. Really, a lot of stars have to align for this sort of issue to arise.

 

[Iamnew2]

Today I received a notice that a patient whom I saw as an inpatient a few years ago is filing a lawsuit pro se. It names numerous doctors, the hospital system, EMS, another state, even a retail store (where I'm assuming he was picked up, leading to hospitalization,) accusing us all of kidnapping him, torturing him, waging chemical warfare against him and subjecting him to terrorism, etc. Basically very typical complaints you hear all the time from paranoid, psychotic people who don't think they should have been involuntarily hospitalized.

This is definitely legit in that the court documents/forms are real, stamped by the court and everything. The clerk of courts really did give this guy a case with a case number and everything.

I know I need to make sure I talk to a lawyer myself and that hospital risk management cares about protecting the hospital, not necessarily the doctors. But it occurs to me, why doesn't this kind of thing happen more often, or does it? We've all seen countless psychotic people who are obsessed with the legal system and always complaining their rights are being violated and threatening lawsuits. If anyone who can get it together enough to fill out a few court forms can actually get a case, is this happening all the time? But such cases can't all be going to trial, right? What is the mechanism by which they might be dismissed or dropped?

Depends on the state. Some states any malpractice case needs to go through a 3 physician committee for evaluation prior to going through - if panel disagrees that there was malpractice, the case is essentially done. otherwise can proceed. anyone can sue anyone for anything. It depends what the person claims, how it's brought up, what kind of expert if any they have, what the records say.

Many times cases are sadly not necessarily won because the doctor did something wrong but because patients questions/concerns were not addressed and led to something else. If the patient complained about anything and it was not addressed and something bad happened, etc - sometimes that can be problematic. Talk to risk first. get your ducks in a row. Read the complaint before freaking out.

 

[whopper]

I'm surprised the court hasn't had someone do a competency evaluation on him. Or maybe they have since I don't know all the details.

 

[Trismegistus4]

I'm surprised the court hasn't had someone do a competency evaluation on him. Or maybe they have since I don't know all the details.

Now I'm paranoid about posting any more information since @Candidate2017 warned me about posting "so many details" as in my OP but has not returned to explain.

 

[calvnandhobbs68]

Now I'm paranoid about posting any more information since @Candidate2017 warned me about posting "so many details" as in my OP but has not returned to explain.

Nah just whenever there's a lawsuit most people will advise you from posting anything about it or putting anything in writing/email about it unless it's with your lawyer because technically it could come out in discovery if the lawsuit got that far. So say something like "basically very typical complaints you hear all the time from paranoid, psychotic people who don't think they should have been involuntarily hospitalized" could be seen as you being dismissive of the patient's concerns by his attorney (which he doesn't have) which they could try to use against you in a case or argue that you had some bias against the patient.

This guy doesn't have a lawyer and it'd be highly unlikely he'll ever get one or that this case will go anywhere. I wouldn't be too too concerned about it but someone with forensic experience may say otherwise.

 

[Trismegistus4]

Nah just whenever there's a lawsuit most people will advise you from posting anything about it or putting anything in writing/email about it unless it's with your lawyer because technically it could come out in discovery if the lawsuit got that far. So say something like "basically very typical complaints you hear all the time from paranoid, psychotic people who don't think they should have been involuntarily hospitalized" could be seen as you being dismissive of the patient's concerns by his attorney (which he doesn't have) which they could try to use against you in a case or argue that you had some bias against the patient.

This guy doesn't have a lawyer and it'd be highly unlikely he'll ever get one or that this case will go anywhere. I wouldn't be too too concerned about it but someone with forensic experience may say otherwise.

Is it common in discovery for the plaintiff to subpoena the defendant's pseudonymous online message board accounts to determine if they have posted anything about the case online?

 

[Merovinge]

Is it common in discovery for the plaintiff to subpoena the defendant's pseudonymous online message board accounts to determine if they have posted anything about the case online?

I can't tell if this is sarcasm or not but I really want to know if this is actually a thing. I hate how much anytime the word lawsuit comes up the response is to be as hush-hush as possible and not discuss it. Gives so much stigma and extra burden to our healthcare workforce dealing with these issues which materially impacts patient's care (as stressed out docs certainly provide worse care).

 

[Trismegistus4]

I can't tell if this is sarcasm or not

It is. I find it very hard to believe that a lawyer would even think of saying "hmm, you're a doctor, I've heard of SDN, so you might be on it, I demand you provide your SDN username so we can smoke out anything bad you may have posted about the patient without using identifying information online."

But I am open to correction from someone who actually knows.

 

[calvnandhobbs68]

Is it common in discovery for the plaintiff to subpoena the defendant's pseudonymous online message board accounts to determine if they have posted anything about the case online?

I mean I have no idea but that's the general concern. Feel free to ask your malpractice insurance about it, I'm sure they have an opinion one way or the other.

 

[Stagg737]

It is. I find it very hard to believe that a lawyer would even think of saying "hmm, you're a doctor, I've heard of SDN, so you might be on it, I demand you provide your SDN username so we can smoke out anything bad you may have posted about the patient without using identifying information online."

But I am open to correction from someone who actually knows.

If you posted something that clearly identified the patient, case, and yourself on here then I'm sure it could be used in court, but how is the lawyer going to prove that?

I'd imagine the points Candidate was referencing as "too much info" was saying he was picked up at a retail store (which I still think is vague enough and you aren't even sure of) and the "accusing us all of kidnapping him...terrorism" part (if those are the actual specifics the last two points may be a bit too specific). Other than that nothing seems to be remotely identifiable other than timestamping the day you received the notice.

 

[clausewitz2]

Conceivably discovery could involve a broad request to produce all online activity on social media, message boards, blogs etc. in which you reference any of the facts of the case, the lawsuit, or clinical situations involving whatever diagnosis you gave the patient. You could then choose to hide your postings, and probably get away with it, but that would be a huge risk and no judge is going to be amused if it ever comes out.

I think the chance of someone without counsel having the idea to do this and knowing how to craft an appropriate query or interrogatory that would actually require you to provide your posts on SDN approaches zero.

Still, I tend to subscribe to the idea that I write nothing on the Internet I would be embarrassed to have read back to me in court or see in the newspaper attached to my name.

 

[whopper]

Now I'm paranoid about posting any more information since @Candidate2017 warned me about posting "so many details" as in my OP but has not returned to explain.

I can't answer to what the above poster was thinking but the more details you put the more likely the person-in-question could say you broke HIPAA or some other legal guideline.

E.g. "I have this patient who is the CEO of Proctor and Gamble." Wow now by process of elimination yeah you didn't give the name but anyone is a few keystrokes away from figuring out the exact person.

More vague but possibly problematic. "I have this patient who is the CEO of a Fortune 500 company." Wow, now this leaves it down to 1 out of 500, but if people know where you practice and there's only 1 Fortune 500 company within the geographic area it very much narrows down who the patient could be. Again a few minutes from being figured out on Google especially if that person has enough publicity and people of concern who can exploit the data.

Even if there were say 5 Fortune 500 companies in the area that still very much narrows down who the person is to the point where one could connect dots and claim you violated HIPAA? "Shortly after my idiot doctor revealed some details about my case several people told me they knew it was me! They said they could figure it out based on the doctor's public statements!"

This has been challenged in court. There was a court case (any forensic fellows willing to name the case?) where the doctor did intentionally not name the patient but mentioned enough about it for the patient to find out, feel their own privacy was violated and sued. The doctor won because the court decided not enough details were given and it was still unspecific enough (and apparently only the patient himself figured out the doctor was talking about him) but the court admitted the amount of information the doctor gave out was "stupid."

 

[Alemo]

any forensic fellows willing to name the case?

Doe v Roe!