Florida Supreme Court allows husband’s lawsuit against doctor after wife’s suicide
TALLAHASSEE, FLORIDA – The Florida Supreme Court ruled on Aug. 25 that a Sarasota man, Robert Granicz, may pursue his medical malpractice lawsuit against his late wife’s primary care physician, Dr. Joseph Chirillo, for her 2008 suicide, reported Medscape Medical News in an Aug. 26 article.
“Although the inpatient duty to prevent suicide does not apply here, there still existed a statutory duty … to treat the decedent in accordance with the standard of care,” Justice Patty Quince said in writing the court’s opinion.
Justices unanimously ruled that the case should go to trial, upholding a 2014 decision by the Second District Court of Appeal.
The summary judgement in favor of Chirillo was granted by the First District Court of Appeal, but the decision was later reversed by the Second District Court of Appeal that ruled in favor of Granicz. The Florida Supreme Court ultimately ruled to confirm the decision of the Second District that the case should proceed to trial.
Debra Pinals, M.D., director of the Program in Psychiatry, Law and Ethics at the University of Michigan in Ann Arbor, told Medscape Medical News that malpractice cases involving suicides are not new, but they can have a chilling effect on those who treat people with depression.
“Suicide as a cause of action for malpractice is one of the common reasons that physicians are sued,” she said. “The standard of care related to suicide is something that malpractice cases have been hinging on.”
According to court records, Jacqueline Granicz started taking the antidepressant venlafaxine (Effexor, Pfizer) in 2005, but stopped taking it in 2008.
The records say she called Chirillo’s office the day before she died and told his medical assistant that she had stopped taking the drug because she thought it was causing side effects such as poor sleep and mental strain, and also causing her to cry easily and have gastrointestinal distress. She said she had not “felt right” since late June or July.
After reading the assistant’s note, Chirillo changed her prescription from venlafaxine to a different antidepressant, escitalopram (Lexapro, Forest Laboratories). He didn’t schedule an appointment, but said she could pick up a sample of the drug and a prescription at his office.
Jacqueline Granicz picked up those items that day, but hanged herself the following day.
“The decedent in this case was an outpatient of Dr. Chirillo’s. Therefore, under Florida law, there was no duty to prevent her suicide,” the ruling said. “However, the nonexistence of one specific type of duty does not mean that Dr. Chirillo owed the decedent no duty at all. … Although the inpatient duty to prevent suicide does not apply here, there still existed a statutory duty … to treat the decedent in accordance with the standard of care. We find that the Second District (Court of Appeal) properly evaluated the … case based on the statutory duty owed to the decedent and also properly classified the foreseeability of the decedent’s suicide as a matter of fact for the jury to decide in determining proximate cause.”
Justices Charles Canady and Ricky Polston agreed with the result, but did not sign on to the opinion, which sent the case back to circuit court with instructions to move forward with a trial.
According to court documents, allegations of breach of duty included failing to recognize she was experiencing a change in symptoms, was depressed and was seeking medical intervention. They were also concerned that Chirillo didn’t speak with her directly and that he didn’t refer her to a clinician trained in management of depression. They also said he failed to properly evaluate escitalopram, an antidepressant known to cause suicidal tendencies in some patients.
“Dr. Chirillo owed no duty to prevent the defendant from committing an unforeseeable suicide while she was not in his control,” the doctor’s medical group said.
Although the American Psychiatric Association declined comment, there are individual doctor’s opinions that address concerns for the court’s decision.
“There’s a fine line between how you balance the standard of care with people’s free will on an outpatient basis,” Carolyn Stimel, Ph.D., executive director of the Florida Psychological Association, said in an interview with Medscape Medical News. “Presumably, if this person had been in therapy there would have been somebody monitoring what was going on with their mental state and also dealing with the issue that she had stopped taking her medications.”
She said doctors have a legitimate question in asking what one can do when a patient won’t take medications.
“Ultimately you can’t shove pills down someone’s throat,” Dr. Stimel said. “The thought of doctors being responsible for whether patients kill themselves or not — that’s pretty chilling.”
Filed under: General Problems
If you abuse drugs you become addicted , you abuse alcohol , you become addicted. Time for society to stop blaming others for their choices.
They are tearing families apart..the very foundation of our country. Stop them from doing this to our families !
exactly,,,WHAT THE HELL HAPPENED TO INFORMED CONSCENT??Seriously,,there is now way to control what happens outside thee office,,no-way,,,,Soo wth,,,its all soooo illogical to me,,,it just doesn’t fit,,none of it does..It never use to be this way??/It use to be,,as adult over 18,,,we are suppose to responsibly w/our meds,,and if u were not,,THATS YOUR DAM FAULT,, no-one else,,and somewhere that all changed and it was the wrong change,,,mary
This is a very sad case, but it’s much like the cases of doctors who are prosecuted for patients who die of overdoses (purposely or accidentally) on the prescription opioids (or any other medication) that their doctors prescribed them.
Once a doctor prescribes medication for a patient and that patient leaves the doctor’s office, what the patient does with that medication is beyond the doctor’s control. (Well, not according to the overly-funded, overly-powerful bureaucrats).
This lady’s doctor could not see into the future. He had no idea that she would commit suicide (at least, from what I have read). Now if this doctor cut her off from her medication without notice (forcing her to through cold-turkey withdrawal), that would be a completely different story.
Thank you for these statements..so well done
There are several “chilling” things about this case. Speaking as a medical layman who has studied medical literature for 20 years and communicated with thousands of chronic pain patients, one of those things is that there is credible reason to doubt that a consistent or reliable “standard of care” actually exists for depression and most other mental health issues.
Field testing for the DSM-5 revealed a shambles of imprecise and often overlapping diagnoses for depression, anxiety and other common mental health “disorders”. There is ample reason (as Dr Allen Frances MD, chairman of the working groups which wrote the DSM-IV, points out), that anti-depressants may be over-prescribed in the US to “the worried well”, while people in much more profound crises are under-treated or (worse) incarcerated in the criminal justice system. In both broad categories of people, the side effects of medication can be as disabling as the disorders which they nominally “treat”. In disorders called “psychosis” or “schizophrenia” or “bi-polar disorder”, side effects of long term treatment can become truly disabling.
Many critics of mainstream psychiatry assert that the medicalization of emotional crises has proven to be a profoundly mixed blessing for people in emotional pain. The medical model of “brain disorder” is itself under substantive challenge. However, talking-therapy alternatives can be equally ineffective or even dangerous to client welfare. In a recent “replication” review in which 100 prominent studies of individual and social psychology were repeated by academic groups not affiliated with the original investigators, fewer than half produced statistically significant outcomes consistent with the claims made by the original investigators.
For any family dealing with significant personal crisis in one or more of its members, a recent book may be worth the time to read: “Psychiatry Under the Influence – Institutional Corruption, Social Harms, and Prescriptions for Change” [available on Amazon]. The book summarizes 30+ years of outright frauds committed by pharmaceutical companies who effectively bribed academicians and study authors to torture their data in order to draw conclusions which increased corporate profits and ignored potentially dangerous side effects.
Mainstream psychiatry is now arguably in the midst of an ongoing crisis in public confidence. Many people consider themselves to be victims of those who have coerced them into “treatments” that don ‘t work and very often actively cause harm. The more polarized of these victims might characterize psychiatry as an edifice much in need of being burned to the ground and started over from scratch.
As a attorney,,,why isn’t ,”informed consent,,” via any adult being treated by a real doctor,ie Medical Doctor,not a psychiatrist] argued anymore,,,As a country as a whole,,what the heck happened to ,”free will,”,,??That when u turn 18,,,u can live or die for this country,,,When u turn 18,,,EVERY DECISION u make,,,good or bad,,,is YOUR decision,,,not some doctors fault…At anytime,,,as a adult,,these people could of said..No,,,,do not want that medicine,,,or No,,,I’d prefer to see another Doctor ,,,,Point being,,,why do people try to blame the Doctor,pharmicist,,,heck Winnie the poo,,,,for their own improper decision to abuse that medicine,,,to end their life????mary