On appeal from the Superior Court of New Jersey, Law Division, Middlesex County, Docket No. L-4452-03.
The opinion of the court was delivered by: Yannotti, J.A.D.
NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION
Before Judges Parker, Yannotti and LeWinn.
Plaintiff Jeffrey Shectman brought this action against defendant Robert Bransfield, M.D., alleging that defendant deviated from accepted standards of psychiatric care by failing to monitor and supervise his response to certain medications and his deteriorating mental condition, and that defendant's deviations resulted in plaintiff's attempt to commit suicide. The matter was tried to a jury, which returned a verdict for plaintiff awarding $250,000 in damages. Judgment was entered in accordance with the jury's verdict and defendant appeals. For the reasons that follow, we reverse.
When this matter was tried, plaintiff was forty-four years old. He has had a long history of mental illness. He was first treated by a psychiatrist when he was fifteen years of age. He was diagnosed with various mental disorders, including schizoaffective and bipolar disorders; obsessive-compulsive disorder; anxiety and mania. At age sixteen, plaintiff attempted to overdose on medication. Plaintiff testified that this was a "suicidal gesture."
Plaintiff began treatment with defendant in 1991, when he was twenty-seven years old. Initially, plaintiff was treated by defendant and other doctors; however, after about a year or two, defendant became plaintiff's only psychiatrist. Between 1991 and 1999, plaintiff saw defendant twice a year. Defendant prescribed drugs, adjusted the medications, and repeatedly advised plaintiff to quit smoking.
Plaintiff testified that in the summer of 2000, he "was going through some rough times." He said that he was "sort of a little paranoid." He could not sleep well and he was not eating properly. Plaintiff stated that "things just started to churn in a bad way." Plaintiff said that defendant prescribed Paxil and, at the time he was taking that medication, he was very agitated. According to plaintiff, defendant did not instruct him to return to the office on any particular date. Defendant told him to "call up when you need another prescription."
At some point, defendant increased the dosage of Paxil but plaintiff said that his condition worsened. Plaintiff testified that, at the time, he was disheveled. He had not showered, shaved, or changed his clothes in a long time. Plaintiff thought he was Jesus or Gandhi. He believed that he "could change people." Plaintiff asserted that there were times when he could not sleep for weeks.
Plaintiff recalled going to see defendant on October 9, 2000. Defendant instructed him to stop taking Paxil and he gave plaintiff samples of another medication called Luvox. Plaintiff said that it took a month for him to stop taking the Paxil; it was his understanding that he was supposed "[t]o stop taking it slowly." Plaintiff stated that defendant did not instruct him to return to the office.
Plaintiff testified that, in the days and weeks after the October 9, 2000 visit to defendant, he "was getting worse and worse." He said that he "was really out of sorts[.]" He lost ten pounds in October 2000 and was down to about 145 or 150 pounds. He did not start taking the Luvox. Plaintiff said that he did not "know what was going on at all."
Plaintiff further testified that on November 4, 2000, he had a thought that he was going to hit his sister. He felt hopeless. He took "a bunch of pills" and lost consciousness several times. The following morning, plaintiff swallowed detergent and washed it down with water. He also stabbed himself twenty-seven times, inflicting injuries to his body, wrist and throat. Plaintiff was taken by ambulance to a hospital, where he remained for several weeks.
Plaintiff's mother, Marilyn Bernice Shectman, testified. Mrs. Shectman said that in June 2000, plaintiff was not doing well. She brought plaintiff to see defendant, who prescribed Paxil. Defendant did not schedule a follow-up visit. In September 2000, plaintiff was seen by defendant for an evaluation in order to "continue his [social security] disability[.]" Mrs. Shectman said that plaintiff was doing terribly at the time. He was disheveled and he was not sleeping or eating well.
On October 9, 2000, Mrs. Shectman called defendant's office for an emergency appointment because she was worried. She said that plaintiff "was getting sicker and sicker and not sleeping[.]" She said that plaintiff was "walking and pacing and talking about religious thoughts and [the] paranoia was terrible." She stated that "it was very scary to have him home[.]" Defendant saw plaintiff that day.
Mrs. Shectman recalled plaintiff pacing in the hallway of defendant's office. She said that plaintiff "was really out of it." Defendant told plaintiff to "decrease and discontinue" the Paxil. Defendant prescribed Luvox and gave plaintiff samples of the drug. Defendant did not provide any instruction on when plaintiff was to return to see him.
Mrs. Shectman said that, in the weeks that followed the October 9th visit to defendant's office, plaintiff's condition deteriorated. Plaintiff lost weight. He paced and walked. He could not watch television. He did not listen to music or leave the house. She said that plaintiff was "very, very, very distraught."
On October 27, 2000, Mrs. Shectman called defendant's office. She realized that plaintiff had never started taking the Luvox and he was not on any anti-psychotic medication. Plaintiff did not, however, see the doctor at that time. Mrs. Shectman called defendant's office on November 1st and asked defendant to authorize the refilling of plaintiff's prescription for Haldol.
Mrs. Shectman said that on the evening of November 5, 2000, she was at home with her husband. They were exhausted after having worked a full day. Plaintiff had been home that day with his grandmother, who was then ninety-two years old. Mrs. Shectman said that plaintiff came down to the living room and said hello, but he was "very, very mysteriously quiet[.]"
At around 11 p.m., Mr. and Mrs. Shectman were about to go to sleep when Mrs. Shectman heard a "terrible moaning and groaning" coming from plaintiff's bathroom. She called out to plaintiff, but he told her not to come in. The door to plaintiff's bathroom was locked but Mr. Shectman opened the door using a tool. They found plaintiff in a pool of blood.
Portions of defendant's deposition testimony were read into the record. Defendant stated that he treated plaintiff from 1991 to 2000. He said that plaintiff had been suffering from obsessive compulsive disorder for many years. In 2000, defendant prescribed various medications to address that condition. Plaintiff had been on a drug called ...