"Psychiatrist Has Duty to Protect Hospital Nurse from Violent Patient"

"The Supreme Court of Tennessee held in Turner v. Jordan, 957 S.W.2d 815 (Tenn. 1997), that a psychiatrist owed a duty of care to protect a nurse from the violent acts of patients and the psychiatrist's negligence should not be compared with the intentional conduct of the patient in allocating fault. One day after his hospital admission for manic symptoms, Tarry Williams, a patient with bipolar disorder and a history of violent behavior, attacked and severly beat Emma Turner, psychiatric nurse. Earlier in the day, Harold Jordan, MD, the attending psychiatrist, had written a note describing Williams as 'aggressive, grandiose, intimidating, combative, and dangerous,' but also indicating that staff should encourage Williams 'to sign out AMA [against medical advice].' Turner sued Jordan for medical negligence of Dr. Jordan and the alleged intentional conduct of Williams. The jury found Dr. Jordan negligent, allocated 100 percent of the fault to him, and awarded $1,186,000 to the nurse. The trial court approved all of the jury's verdict except the allocation of fault, and it granted Dr. Jordan's motion for a new trial. The Court of Appeals affirmed, but the Supreme Court stated, 'We stress that we are not requiring psychiatrists or physicians to possess perfect judgment or a degree of clairvoyance in determining whether a patient poses a risk of harm to a third person. Instead, we merely hold that a duty of care may exist where a psychiatrist, in accordance with professional standards, knows or reasonably should know that a patient poses an unreasonable risk of harm to a foreseeable, readily identifiable third person' (957 S.W. 2d at 820-821).

Having determined that a duty of care existed, the Supreme Court next turned to the issue of whether the psychiatrist's negligence should have been compared with the patient's intentional act in determining the extent of the psychiatrist's liability to the injured nurse. Disagreeing with the lower courts, the Supreme Court held that 'the conduct of a negligent defendant should not be compared with the intentional conduct of another in determining comparative fault where the intentional conduct is the forseeable risk created by the negligent tortfeasor' (957 S.W.2d at 823). Allowing comparison would penalize plaintiffs by letting negligent defendants reduce their liability and would lessen the incentive of negligent persons to comply with the duty of care. In this case, however, the error of the lower courts in allowing a determination of comparative negligence caused no harm because the jury apportioned 100 percent of the fault to Dr. Jordan. Thus, the Supreme Court simply remanded the case to the trial court for entry of a judgment consistent with the jury's verdict." [J Am Acad Psychiatry Law, Vol 26, No 3, 1998: p. 517-518]