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In re Commitment of M.M.

March 31, 2006


On appeal from Superior Court of New Jersey, Law Division, Camden County, CASC-519-05.

The opinion of the court was delivered by: Grall, J.A.D.




Argued January 19, 2006

Before Judges Stern, Grall and Miniman.

This case requires us to consider the showing necessary to establish "exceptional circumstances" and "good cause" authorizing extension of the statutory deadline for a hearing on civil commitment pursuant to R. 4:74-7(c)(1). See N.J.S.A. 30:4-27.12a. We hold that absent a request by the patient, the circumstances must be atypical, rather than routine, and reasonably unforeseen and unavoidable, rather than within the reasonable control of the state or the court. We further hold that "good cause" exists when the state's interest in extending the time for a hearing due to "exceptional circumstances" substantially outweighs the patient's interest in terminating confinement that is not supported by clear and convincing evidence of the existence of grounds for commitment.

M.M. was admitted to the Camden County Health Service Center from a crisis center on April 2, 2005.*fn1 A hearing on the state's application for her involuntary commitment was scheduled for and held on April 12, 2005.*fn2 At the conclusion of that hearing, the trial judge equivocated about the adequacy of the evidence, directed the state to subpoena M.M.'s husband, adjourned the hearing for fourteen days and continued M.M.'s commitment pending that hearing. On the return date, April 26, 2005, the judge entered an order conditionally extending M.M.'s commitment pending placement pursuant to R. 4:74-7(h)(2) without taking any testimony about her condition. She was discharged to return home on May 10, 2005.

On May 26, 2005, M.M. appealed from the April 12, 2005 order.*fn3 She contends that the judge erred in continuing her temporary commitment beyond the twenty-day statutory period without a sufficient showing of exceptional circumstances and good cause justifying the delay or adequate proof that she was a person in need of involuntary commitment. See N.J.S.A. 30:4-27.12a; R. 4:74-7(c)(1); N.J.S.A. 30:4-27.2m. The state argues that the judge found clear and convincing evidence of M.M.'s need for commitment and that the order reflecting an adjournment was simply not well-drafted.

We conclude that the evidence did not establish exceptional circumstances and good cause for adjournment or provide clear and convincing proof that M.M. was a person in need of involuntary commitment. Accordingly, we reverse.


There were three witnesses at M.M.'s commitment hearing. Dr. Madrack, who is a psychiatrist, a social worker and M.M. testified. A summary of the evidence presented and the judge's findings and conclusions follows.

M.M. is a licensed dental technician. She also has an Associates Degree in Human Services. She had been married for approximately one year prior to her involuntary admission to a crisis center.

Dr. Madrack was "filling in" for Dr. Friedman, who treated M.M. after her admission to the facility from the crisis center on April 2, 2005. Dr. Madrack reviewed M.M.'s records, including a report prepared by Dr. Friedman on April 8.

According to Dr. Friedman's report, M.M. was admitted to the crisis center for stabilization after kicking in a basement window and throwing glass plates at her husband because she believed that he was having an affair with a super model. He noted that M.M. was chronically non-compliant with medications and follow-up. He described M.M. as "paranoid and hypervigilant," "preoccupied," "mood labile," and "lack[ing in] insight into her illness." His diagnosis was "Axis I: 1) Bipolar I disorder; manic õ psychoses 2) ETOH Abuse"; "Axis II: Deferred"; "Axis III: Amennorhea (sic)." He concluded that M.M. was dangerous to others, property and herself. He recommended hospitalization for a period of ninety days.

Dr. Madrack claimed to have seen M.M. twice during her hospitalization, for approximately twenty minutes on each occasion. She described a meeting on the Friday prior to the April 12 hearing, which would have been April 8, and a meeting on April 11 at which she just reminded M.M. about the hearing.

In Dr. Madrack's opinion, M.M. suffered from bipolar disorder and posed a danger to others and property. Her recitation of the basis for that opinion tracked Dr. Friedman's report:

The patient was originally brought in by the police after she kicked in a basement window at her home. This all stems from the fact that she believes that her husband is having an affair with a super model. She also ha[d] been damaging other proper[ty] at the home at that time by throwing dishes and glass plates at her husband and breaking objects in the house. And, there has been a period that she has for a long time been noncompliant with her medications, and she also displays other delusions at this time.

Like Dr. Friedman, Dr. Madrack concluded that M.M. had "little insight into what she had done" prior to her admission "with regard to destruction of property and throwing objects at" her husband. Dr. Madrack admitted, however, that her information about M.M.'s pre-admission conduct was derived solely from her review of M.M.'s records. She explained that

because M.M. had been taken to the crisis center by the police, she assumed that the officers provided some of the information. She did not know whether the police had observed the events, and she reported that M.M. had neither admitted nor denied the conduct during their meetings. None of the reports upon which Dr. Madrack relied were admitted into evidence. When Dr. Madrack saw M.M. on April 8, M.M. was angry and upset with her husband, believed he was having an affair, had thoughts about wanting to get even with him, said he would deserve whatever he got and that she wanted to go home with him.

M.M. testified about her pre-admission conduct. She denied kicking in the basement window and said she may have broken it accidentally while trying to cover her husband's car with a tarp. She also denied throwing or purposely breaking any dishes and explained that her husband sometimes drinks too much and that they sometimes have "spat[s] . . . like most people do when they're newlyweds." She admitted that she let a teacup saucer drop on ...

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