Court dismisses case brought by partner denied hospital visitation

In a case with heart-wrenching facts, the federal district court in Miami has ruled that Jackson Memorial Hospital violated no duties of care in denying visitation to the partner and children of a patient who lay dying and in largely ignoring their requests for updates as to the patient's status. In Langbehn v Jackson Memorial Hospital, the court held that Janice Langbehn, who furnished a copy of her health care power of attorney to hospital staff shortly after her partner Lisa Pond was admitted, had no basis to recover in tort for the way that she was treated during the eight hours she spent in the trauma center [ER] waiting area. 

The court accorded no weight to proof of bias behind why Langbehn was treated as she was, and instead acknowledged only a narrow potential zone of liability for situations in which the health care surrogate could show that the denials of information or visitation create medical risk for the patient or that the surrogate would have made different decisions regarding care had she been more fully informed.

Lambda, which represents Langbehn, describes the facts as follows:

While on a family cruise leaving from Miami, Lisa Pond, a healthy 39 year-old, suddenly collapsed. She was rushed to Miami's Jackson Memorial Hospital with her partner Janice and three children following close behind. There, the hospital refused to accept information from Janice about her partner's medical history. Janice was informed that she was in an anti-gay city and state, and she could expect to receive no information or acknowledgment as Lisa's partner or family. A doctor finally spoke with Janice telling her that there was no chance of recovery. Other than one five minute visit that was arranged by a Catholic priest at Janice's request to perform last rites, and despite the doctor's acknowledgment that no medical reason existed to prevent visitation, neither Janice — who provided the hospital with a medical Power of Attorney document — nor their children were allowed to see Lisa until nearly eight hours after their arrival. Soon after Lisa's death, Janice tried to get her death certificate in order to get life insurance and Social Security benefits for their children. She was denied both by the State of Florida and the Dade County Medical Examiner.

The court agreed that the hospital had a duty to inform Langbehn about Pond's condition and to allow her, as the surrogate, to make decisions. However, it found that this duty was not breached because doctors consulted with Langbehn twice (during the eight hours), including once when they sought her permission to use a brain monitor. Because there was no medical need, as determined by the physicians, to provide additional information to Langbehn, the court ruled that the hospital staff had no duty to do so. Further, the court held that the duty to provide any information ceased after last rites were administered because there were no further medical decisions to be made.

The court's reasoning was similarly strained as to visitation. Staff in the ER where Pond was initially taken repeatedly refused Langbehn's requests to see Pond, despite one doctor's statement that there was no medical reason for Pond's family not to be with her. The sole exception was when last rites were administered. Seven hours after she was admitted, Pond was transferred to a non-trauma room in a different part of the hospital, but Langbehn was not told. An hour later, Pond's sister arrived. Hospital staff treated the sister as a legitimate relative, and informed her of Pond's transfer. Together with the sister, Langbehn and the children were then allowed visitation with Pond until she died.

On these facts, the court found no liability because "doctors at a trauma unit do not have a freestanding legal duty, untethered to informed consent..., to allow visitation with a patient who is in critical condition and undergoing treatment ... or to allow visitation with a terminal patient ... who is going to be transferred to a regular room where visitation will be permitted...[D]ecisions as to visitation must be left to the medical personnel in charge of the patient..."

In a similar case, the Washington Court of Appeals ruled that a patient's life partner could sue for outrage and negligent infliction of emotional distress for having been excluded from the patient's room for long periods the night before her death.  Reed v. ANM Healthcare, 147 Wash. App. 1044 (2008). There the physicians had allowed visitation, but a nurse countermanded the order.  The judge distinguished the facts in the Florida case because it was the physicians who barred the visitation that Langbehn sought.

At the very end of his opinion, Judge Jordan noted that "the defendants' lack of sensitivity and inattention" to the plaintiffs "caused them needless distress...[Defendants' actions] exhibited a lack of compassion and was unbecoming of a renowned trauma center...Unfortunately, no relief is available..."

In this case, tragic facts made very bad law, although the public education value of the ruling will probably be enormous. Not only should Lambda appeal, but Florida legislators should swiftly enact provisions that clearly prohibit this kind of conduct.

Comments

[Gloria Bodkin]

That is an incredibly tragic story. My sympathies go out to Ms. Langbehn and her family. That is incredibly disgusting on the part of the Jackson Memorial Host

[Ken]

That is an incredibly tragic story. I m sorry.