Court: District Court of Appeal of Florida; July 14, 1988; Florida; State Appellate Court
The case involves an appeal by Margaret Cross, as Personal Representative of the Estate of Amos Cross, against Lakeview Center, Inc. and Dr. E.K. Allis, following a jury verdict that found the defendants not negligent in the discharge of Peter Todd from University Hospital after his psychiatric treatment. The appellant argues that the trial court improperly admitted testimony from Dr. John Monahan regarding the standard of care and predictions of violent behavior.
Peter Todd, admitted to Baptist Hospital with a gunshot wound, was later transferred to University Hospital's psychiatric ward, where Dr. Allis diagnosed him with an explosive personality. Todd was discharged on September 5, 1980, with a prescription for Thorazine, and shortly thereafter was arrested for shooting at an individual. On September 12, 1980, Todd fatally shot Officer Amos Cross and his father before wounding another officer.
Margaret Cross filed a complaint alleging negligence in Todd's release. The jury trial included testimony from three psychiatrists. Dr. Blackman criticized Dr. Allis for not ordering psychological testing that could have led to a proper diagnosis of inherited schizophrenia. He suggested that Todd's history indicated a likelihood of violent behavior, although he noted the difficulty in predicting specific targets of violence. Dr. Phillips also testified that Todd's post-discharge behavior could be anticipated as problematic, asserting that threats made by patients could indicate potential violence. The economic loss from the incident was stipulated at $350,000.
Lakeview Center, Inc. objected to the deposition testimony of appellant's expert, Dr. Gutman, regarding the foreseeability of violent behavior. Appellant's attorney, Mr. Echsner, countered that the appellees planned to call their own expert on foreseeability, highlighting a potential inconsistency in their objection. Following the denial of the objection, Dr. Gutman testified that it was foreseeable Dr. Allis should have anticipated Mr. Todd's violent behavior, specifically referencing incidents involving gun violence. On cross-examination, Dr. Gutman acknowledged that killing could be classified as an unpredictable act.
Appellees presented Dr. David Tingle, who supported Dr. Allis's treatment of Todd, asserting that the standard of care was met and that further inquiry into Todd's history was unnecessary. Dr. Tingle noted Todd's temper issues but maintained that he did not pose a suicidal or violent threat that warranted extended hospitalization. He conceded that a history of violence suggested potential for future violence, but believed that additional information would not have altered Dr. Allis’s diagnosis or treatment decisions.
Dr. John Monahan, a clinical psychology expert, testified on behalf of the appellees. Appellant objected to his qualifications under Florida law and the reliability of violence prediction as an expert testimony field, but the trial court allowed his testimony. Dr. Monahan confirmed that Dr. Allis adhered to the standard of care in releasing Todd and that explosive personality was a valid diagnosis. He emphasized that a history of violence typically indicates future violence but noted that Todd's father had misrepresented Todd's background to Dr. Allis. Monahan also stated that psychological tests were ineffective for predicting future violence and concluded that Dr. Allis did not deviate from the standard of care by not pursuing additional testing or inquiries.
Dr. Park Elliot Dietz, a psychiatrist and professor at the University of Virginia, testified that Dr. Allis adhered to the standard of care in releasing Todd. While Dietz acknowledged that recent violence can indicate potential future violence, he noted that it does not guarantee that a person will reoffend. He asserted that violence predictions are primarily short-term, limited to 24 hours, and found no justification for further psychological testing of Todd. Dietz confirmed that Todd's criminal history supported Dr. Allis's diagnosis of explosive personality, suggesting Todd might be dangerous but not mentally ill. He stated that temper tantrums alone did not warrant invoking the Baker Act.
Dietz, who has experience evaluating dangerousness in criminal behavior, testified without objection, leading to a jury verdict of no negligence against Dr. Allis in relation to Amos Cross's death. The trial court erred in asserting that Dr. Monahan met Florida Statutes Section 768.45(2)(c)2's expert witness criteria, as Dr. Monahan lacked relevant training or experience to testify on psychiatric standards of care, despite some relevance to psychology. Although Monahan's testimony regarding the utility of psychological testing was admissible, his assertion about Dr. Allis's adherence to the psychiatric standard of care was deemed erroneous. However, this error was considered harmless, as Monahan’s testimony was cumulative to that of Drs. Tingle and Dietz and did not substantially differ from other admitted evidence.
The appeal addresses whether the trial court incorrectly admitted expert testimony on predicting violent behavior. According to Kruse v. State, expert testimony must be established with reasonable reliability. In this case, the appellant, through the testimony of Drs. Blackman, Phillips, and Gutman, inadvertently allowed for rebuttal testimony on the matter, waiving any objection (Chenoweth v. Kemp). The court emphasized its discretion in determining the admissibility of expert testimony, as seen in Hawthorne v. State. The ability to predict violence was a central issue, and both parties provided expert opinions. The trial court's rejection of the appellant's objections to Dr. Monahan's testimony was upheld, as no specific ruling was secured by the appellant. Thus, the court concluded that the trial court did not abuse its discretion in admitting the testimony, resulting in an affirmation of the lower court's decision. Additionally, University Hospital is noted as not being a party to the suit, with no sovereign immunity issues present. The case is distinguished from Durflinger v. Artiles due to differing circumstances.
