Case will Clarify Immunity for State-Employed Doctors

George Jinkins was taken to Christ Hospital and diagnosed as being acutely psychotic and exhibiting suicidal behavior.

For weeks, he was hearing voices and through birds were talking to him. He had tried to kill himself by walking in front of cars. His family brought him to the hospital because he had been drinking and exhibiting this behavior.

Hours later, he was transferred to the John J. Madden Mental Health Center, a State of Illinois facility, where a psychiatrist and a psychologist evaluated him for less than an hour, then released him recommending outpatient care. An hour after his release, he committed suicide by shooting himself in the head.

His widow brought a medical malpractice cause of action against the two doctors. The trial court ruled that an action was barred by the doctrine of sovereign immunity.

On appeal, the First District of the Illinois Appellate court reversed, stating that whether a cause of action exists depends upon the issued involved and the relief sought, not the formal designation of the parties involved. Jinkins v. Lee, 337 Ill.App.23d 403, 785 N.E.2d 914 (1st Dist.2003).

The court relied upon well established criteria in determining whether an action must be brought in the Court of Claims when the State of Illinois is involved: when "there are (1) no allegations that an agent or employee of the State acted beyond the scope of his authority through wrongful acts; (2) the duty alleged to have been breached was not owed to the public generally independent of the fact of State employment; and (3) where the complained-of actions involve matters ordinarily within that employee’s normal and official functions of the state." Id., at 920, quoting, Healy v. Vaupel, 133 Ill2d 295, 309, 549 N.E.2d 1240 (1990).

The court agreed with the plaintiff that "the duty the defendants owed to George did not arise from the fact that they were employees of the State; rather, it arose out of the relationship between George as a patient and the defendants as his professional health care providers." Id., at 921.

Justice Thomas E. Hoffman, writing on behalf of the majority, follows Janes v. Albergo, 254 Ill.App.3d 951, 626 N.E.2d 1127 (1st Dist.1993), where the court found that sovereign immunity did not apply because "the doctor’s duties and the patient’s correlative rights are inherent in the doctor-patient relationship and are derived from the standards imposed by the profession itself . . ." Id., 964, regardless of the physician’s employment status.

The court dismissed Christ Hospital on defendant’s motion for summary judgment based on the fact that the hospital merely held the patient until his blood alcohol level dropped and then properly informed the Madden staff of his psychiatric history. Jinkins v. Evangelical Hospitals Corp., 783 N.E.2d 123 (1st Dist.2002). A petition for involuntary admission was prepared on his behalf a Christ Hospital, which the doctors at Madden reviewed. The psychiatrist at Madden, though, failed to fill out additional certification, as required by state law, in order to have him admitted involuntarily.

The case is in accordance with Madden v. Kuehn, 56 Ill.App.3d 997, 372 N.E.2d 1131 (2d Dist.1978), where the court found that the physician was alleged to have breached duties "which every physician owed his patient, rather than obligations incurred solely by virtue of holding a public office." Id., at 1134.

This decision, though, is at odds with Kilcoyne v. Paelimo, 204 Ill.App.3d 139, 562 N.E.2d 231 (1st Dist.1990), where the patient voluntarily admitted himself to a state mental health facility and subsequently discharged himself, after which he killed plaintiff’s father.

The Jinkins court distinguished the duty in Kilcoyne because there it was allegedly owed to a third party, whereas in Jinkins the widow is alleging that the duty was directly owed the patient. The Jinkins court, though, found that, "The resolution of the issue of applicability of the doctrine of sovereign immunity in such a case turns on the source of the duty, not to whom it is owed."

Apparently in an effort to reconcile this discrepancy among the districts, the Illinois Supreme Court granted leave to appeal and is expected to hear the case. Jinkins v. Lee, 204 Ill.2d 660, 792 N.E.2d 307 (decided June 4, 2003).

The reasoning on its face in Kilcoyne appears to be faulty. In the case of Jinkins, had the decedent had enough money or insurance, he could have remained at the private Christ Hospital, where physicians could have evaluated him and involuntarily admitted him.

That is what the physicians at Madden failed to do. It is not a duty emanating from their state employment but, rather, from their position as doctors.

The psychiatrist in Jinkins admitted that he was that patient’s psychiatrist. Both state doctors also admitted that they were obligated to apply the same knowledge and skill of well-qualified health care professionals in the same of similar communities. Experts testified that the evaluation process, standards and procedures are the same to involuntarily commit a patient in a state or a private hospital and that to do so required the training and experience of a psychiatrist.

In essence, the plaintiff is merely asking the court to hold the state-employed doctors to the same standard of care as private physicians when they are performing tasks that are medically related and not unique to their state employment.

It is certain that when the Illinois Supreme Court decides this case, the eyes of the medical community as well as the legal community will be watching.