Ranked as high as the 6th leading cause of death in the United States by the National Safety Council (13th worldwide), and with over one million
Ranked as high as the 6th leading cause of death in the United States by the National Safety Council (13th worldwide), and with over one million people committing suicide each year world-wide, suicide is far-reaching, complex, and sometimes perplexing for those left behind. Any number of factors might contribute to a person taking their own life, including mental health and/or other social problems. In some cases it is likely impossible to know why a particular person chose to take their own life, and in other cases a person may have left behind a note or some indication as to why they chose to end their life. In the context of a lawsuit for negligence where the defendant is blamed for the suicide death of an individual based on prior negligence, the answer on how to respond and how to dissect the concept of suicide might seem a daunting task.
Torts Must Have a Causal Link
To recover for negligence in Georgia, proof of causation is required. Morris v. Baxter, 225 Ga. App. 186 (483 S.E.2d 650) (1997). The court of appeals held that “[n]egligence is not actionable unless it is the proximate cause of the injury, [and a] wrongdoer is not responsible for a consequence which is merely possible, according to occasional experience, but only for a consequence which is probable, according to ordinary and usual experience.” Id. at 187. This rule is based in fairness , because “negligence is predicated on what should have been anticipated rather than on what happened.” Id. The inquiry is “not whether a defendant’s conduct constituted a cause in fact of an injury, but rather whether the causal connection between the conduct and the injury is too remote for the law to countenance a recovery.” Id.
Generally, Suicide Is An Unforeseeable Event In The Chain of Causation
In Georgia, “[g]enerally, suicide is an unforeseeable intervening cause of death which absolves the tortfeasor of liability.” Appling v. Jones, 115 Ga. App. 301, 303 (1) (154 S.E.2d 406) (1967). Although, “there is an exception to this general rule: Where the tortfeasor’s wrongful act causes the injured party to kill himself during a rage or frenzy, or in response to an uncontrollable impulse, the wrongful act is considered to be the proximate cause of the suicide.” Id.
In the Appling case, a young man killed himself about two hours after a motor vehicle accident, and the Georgia Court of Appeals held that the evidence did not establish an exception to the general rule. Id. The court said that there was too much evidence of the young man’s rational and conscious behavior after the collision, even though there was some evidence of other strange behavior by the young man. Appling, 115 Ga. App. 301. Thus, even a mere two-hour window can mean a suicide is too remote to the original negligence to countenance a recovery by the plaintiff. In another case, the Georgia Court of Appeals also held that the exception did not apply to a man’s suicide because there was no evidence that he was in a rage or frenzy or had an uncontrollable impulse. Dry Storage Corporation et al. v. Piscopo, 249 Ga. App. 898 (550 S.E.2d 419) (2001). In Dry Storage, a man was injured in a rear-end collision automobile accident. Id. The man killed himself after videotaping a suicide note of sorts. Id. In that video, he made some connection between the accident and the suicide by stating that he could no longer live with the pain he suffered from which he attributed to the accident. Id. However, this was not enough for the court to make a causal connection to the suicide as it stated that “[i]n spite of that connection, from a legal point of view, proximate cause means that the suicide must have been a foreseeable result of the negligence of the tortfeasor,” and, citing to the Applingcase, the suicide was an unforeseeable intervening cause of death which absolved the tortfeasor of liability. Id.
Thus, even in a case where there existed video evidence of the person who took his own life stating that he was doing so because of the pain he experienced resulting from the alleged negligence of another, a Georgia court held that a defendant cannot be held liable for that suicide as it was not a foreseeable consequence of the alleged negligence. This foreseeability, however, seemingly gives rise to another exception to the general rule when it comes to medical malpractice.
Negligence in Medical Malpractice Actions Need Only Contribute to Cause the Plaintiff’s Harm
To recover for medical malpractice, “the plaintiff must establish…that the defendant’s negligence either proximately caused or contributed to cause the plaintiff’s harm.” Zwiren v. Thompson, 276 Ga. 498, 500 (578 S.E.2d 862) (2003) (emphasis added). The defendant’s negligence “need not be the sole proximate cause of the death, but only need contribute.” Bell v. Sigal, 254 Ga. 78, 80 (326 S.E.2d 730) (1985). Thus, it seems that it may be possible to bridge the gap between negligence and later suicide in medical malpractice actions.
There Can be a Causal Link Between Prescribed Medication and Suicide
Lately, more and more drugs seem to advertise that one side effect may be suicidal thoughts or actions. Thus, the intersection of malpractice and these medications can open the door to liability for resulting suicides.
That was what happened in the recent case of Romona L. Floyd, Individually, as Surviving Parent of Jessica Ann Ray, deceased, and as Administratrix of the Estate of Jessica Ann Ray, deceased v. United States of America, 2010 U.S. Dist. LEXIS 125247 (2010). In that case, the decedent, a 15-year-old female, received a prescription for Prozac when it was not indicated or appropriate. Id. A nurse practitioner prescribed the medication during a follow-up visit from the emergency room at a clinic in Hartwell, Georgia while the decedent had been experiencing nausea, vomiting, and abdominal pain. Id. The nurse wrote the prescription on a prescription pad that had been pre-signed by the supervising doctor, and in her notes for that visit, the nurse wrote “depression – Prozac.” Id. After ingesting the Prozac, the decedent hanged herself, which resulted in a devastating brain injury that ultimately caused her death. Id.
Of course, the causal link between the ingestion of SSRIs (the Prozac) in pediatric and adolescent patients and suicidality (including the ramifications of how to define that word) was, and in medical malpractice actions must be, accompanied and supported by expert testimony. Id. Importantly, however, the court found the death that resulted from the suicide attempt to have been caused, or at least contributed to, by the medical malpractice of the nurse and doctor. Id. The court analyzed the multitude of factors in the young female’s life which may have had an impact on the suicide attempt, but the court found that those factors were not significant enough, nor credible enough, to detract from the causal link of the ingestion of Prozac by an adolescent patient and suicidal thoughts or actions. Id.
The court seemingly bypassed an analysis of the general rule in Georgia regarding the causation of suicide. It is likely that this was done due to the method of proving causation in medical malpractice cases, and should be taken as an example of how medical malpractice lawsuits can be a different breed of litigation, subject to varying exceptions to general rules in Georgia. Perhaps the key rests in the causal link noted between SSRIs in pediatric and adolescent patients and suicidality. If so, then there may be other scenarios where alleged medical malpractice results in a future suicide and the general rule in Georgia is applicable thereby breaking the causal chain as an unforeseeable intervening event.