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BRAMLETTE v. CHARTER-MEDICAL-COLUMBIA

6/18/1990

Heard April 17, 1990.


Decided June 18, 1990.


This is a medical malpractice action. We affirm in part and reverse in part.


Respondent's decedent, Joe Bramlette, was voluntarily admitted to appellant Charter Rivers Hospital on Monday, May 4, 1987, for psychiatric treatment. Appellant Dr. Pillinger was Bramlette's treating psychiatrist. On Friday, May 8th, Bramlette went off the hospital grounds on a recreational outing with a small group of fellow patients and an occupational therapist, Kim Stroud. On the return trip to Charter Rivers,
At trial respondent produced the following evidence. Joe Bramlette was fifty-one years old at the time of his death in 1987. He was first admitted to Charter Rivers during the previous year for a drug and alcohol abuse problem which he overcame with treatment. In February 1987, Bramlette was fired after only six months on a new job over which he experienced great distress. In April 1987, he began a new job. During a training seminar on Friday, April 30, 1987, Bramlette suffered a severe anxiety attack and was taken to a hospital emergency room. Although he was released that same day, Bramlette's wife and daughter were concerned for his well-being and arranged for him to see Dr. Pillinger at Charter Rivers the following Monday.


During the weekend, Mrs. Bramlette became fearful her husband intended to kill himself. He talked frequently about his life insurance policies and told Mrs. Bramlette she should not worry about losing the house. During a drive through Columbia, Bramlette pointed out two sites where some other person had committed suicide by jumping from a great height.


On Monday morning, Bramlette went to work as usual. By mid-morning, however, he suffered another anxiety attack. He called Mrs. Bramlette and arranged to meet her at their daughter's apartment. The Bramlettes' daughter, Lisa Dudley, was a psychiatric nurse at Charter Rivers. She met Mrs. Bramlette at the apartment and waited with her. Bramlette soon arrived in a very distressed state. He was hoarse and very white and told them he had been screaming in the car during the entire thirty-minute drive to Lisa's apartment. He was extremely agitated and pulled at his clothing and hair.


Lisa called Dr. Pillinger and told him her father was "suicidal" and needed to see Dr. Pillinger before his scheduled appointment that afternoon. Lisa and her mother accompanied
Psychiatric nurse Barbara Higdon assessed Bramlette upon his admission to Charter Rivers and indicated on her patient assessment form: "Suicidal/Homicidal Ideation: Fleeting." Bramlette was placed on suicidal precautions status which means the patient is not allowed off hospital grounds and is observed every fifteen minutes by hospital staff.


Dr. Pillinger examined Bramlette soon after his admission. He ordered Bramlette's patient status changed from suicidal precautions to active observation. Dr. Pillinger diagnosed Bramlette as suffering from atypical depression and ordered assertiveness training and other therapy along with medication. Hospital staff and Dr. Pillinger observed Bramlette appeared less anxious, less depressed, and more hopeful for the future during the next few days following his admission. Bramlette killed himself on the fifth day. Hospital personnel never contacted Lisa or Mrs. Bramlette to obtain a detailed personal history in order to update the hospital's information from Bramlette's first admission for substance abuse.


Respondent produced Dr. Kugler as a psychiatric expert. Dr. Kugler testified it was his opinion Dr. Pillinger had deviated from the accepted standard of practice in these particulars: failing to get a comple

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