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Carney v. Tranfaglia3/26/2003 cticing psychiatry, taking into account the advances in the profession, should have entrusted Poretta with quantities of chloral hydrate pills that he might have anticipated she would use to end her life. As to the standard of care, see Brune v. Belinkoff, 354 Mass. 102, 109 (1968); Stepakoff v. Kantar, 393 Mass. 836, 840-841 (1985). During his cross-examination, the plaintiff's expert read into the record a hospital discharge summary referring to suicidal ideation. There was evidence that in December, 1992, Poretta had been admitted to Salem Hospital for treatment of a self-inflicted laceration of her left wrist with a knife. On December 10, 1992, Poretta again turned up at Anna Jaques Hospital with a chief complaint of "fear of harming herself at home." As part of the plaintiff's case, the jury were shown a video of a deposition of Ralph Epstein, M.D., who was on duty at the emergency room of Union Hospital in Lynn on May 31, 1993, when Poretta had been brought in. At the request of plaintiff's counsel, Dr. Epstein read from his contemporaneous notes, "Patient claims no one cares, wants to see God, wants to die."
During the defendant's case, the defense expert testified on direct examination that " here was not a basis to be concerned that this was a woman at risk of suicide during the period of time that we're talking about." Defense counsel drew out some reinforcement of that opinion. During his cross-examination of the defense expert, plaintiff's counsel put the following questions:
"And isn't it true, doctor, that you have seen in your review of stacks of pages in here numerous references by other medical care providers of their concern about Patricia Carney [Poretta] posing a suicide risk?"
...
"And isn't it true that those concerns about her possibly being suicidal included the final year of her life?"
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"And isn't it true though that some of those concerns about a suicide risk that were reported in the other medical records occurred during the period of time that Dr. Tranfaglia was caring for Ms. Carney [Poretta]?"
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"And you testified that you didn't see anything -- your opinion was that there was nothing in the record that indicated that Patricia Carney [Poretta] would be at an increased risk for taking a deliberate overdose?"
Concerning an appointment with Poretta on October 28, 1993, three days before her death, defense counsel asked Dr. Tranfaglia, "Doctor, as of that last time, did you feel that she was at an increased risk of suicide?" He, with some elaboration, answered, "No."
Evidence of suicidal ideation and a possible attempt repeatedly percolated into the trial. Whether Dr. Tranfaglia adequately assessed the danger that Poretta might take her life was a recurrent minor theme in the evidence, subsidiary to the major theme that Dr. Tranfaglia had not adequately assessed the risk of overuse of chloral hydrate by Poretta because she was an addictive personality. Now it was the turn of plaintiff's counsel to take a disingenuous stance when he pretended shock that suicide should be mentioned in the jury instructions as a possible explanation for Poretta's chloral hydrate intoxication.
For the proposition that suicide may be viewed as an independent intervening cause between an anterior act of negligence and death there is authority. See Daniels v. New York, N.H. & H.R.R., 183 Mass. 393, 398-399 (1903); Freyermuth v. Lufty, 376 Mass. 612, 618-620 & n.6 (1978). Compare Slaven v. Salem, 386 Mass. 885, 886-889 (1982); Restatement (Second) of Torts ยงยง433, 435, 441, 442, 448, 449, 455 (1965). As an abstract statement of law, the judge was on sound
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