THE FULTON-DEKALB HOSPITAL AUTHORITY et al.
MILLER, P. J., RICKMAN and REESE, JJ.
Fulton-DeKalb Hospital Authority, o/k/a Grady Memorial
Hospital Corporation, d/b/a Grady Memorial Hospital; Emory
Healthcare, Inc.; and Emory University; Carl Nee-Kofi
Mould-Millman, M.D., and Betsy Kinchen, L.C.S.W.
(collectively, "Grady") seek review of an order of
the State Court of DeKalb County, denying Grady's motion
for summary judgment in this medical malpractice action filed
by Denise Hickson, as Guardian of Maximillian McClain, an
Incapacitated Adult. On appeal, Grady argues that the trial
court erred in finding that, as a matter of law, Grady was
not immune from liability for actions it took in good faith
compliance with the discharge provisions of Chapter 3 of
Georgia's Mental Health Code. For the reasons set forth
infra, we affirm.
the evidence in the light most favorable to Hickson, as the
nonmovant,  the record shows the following facts. In
the early morning hours of January 20, 2013, an ambulance
brought McClain to Grady Memorial Hospital's Emergency
Department ("ED"). McClain had been going
door-to-door through his apartment building, "screaming
and banging on doors[.]" 911 was called, and McClain
became combative with the EMS crew, going so far as to punch
a police officer who was helping the crew. McClain also
kicked the interior compartment of the ambulance and
attempted to break the ambulance equipment.
EMTs administered Versed, a benzodiazepine, to McClain, he
managed to communicate that he was "having a mental
break," and that he could not "control"
himself. McClain also told the EMTs that he had a history of
paranoia and bipolar disorder. McClain arrived at the ED at
approximately 3:13 a.m. and was triaged within five minutes.
triage nurse assessed that McClain was a suicide risk due to
statements he made about hurting himself. At 3:30 a.m., a
one-on-one sitter was assigned to observe McClain and
document her observations every 15 minutes. At approximately
4:29 a.m., Dr. John H. Lloyd was assigned as McClain's
attending ED physician. An initial drug screening was
negative for drugs and alcohol.
to McClain's medical records, McClain reiterated to Dr.
Lloyd that he had a history of bipolar disorder and panic
attacks, and added that he had become suicidal earlier in the
evening and had a plan to end his life. McClain did not
articulate his plan, but said that he had aborted it because
it would set off a chain reaction of other people killing
themselves. Instead of going through with the plan, and even
though it was the middle of the night in January, McLain had
lain down in the front yard of his apartment complex.
a.m., Dr. Lloyd signed a Form 1013 certificate for
Involuntary Mental Health Evaluation ("1013"),
secondary to a "[s]uicidal, bipolar/anxiety"
diagnosis, A 6:48 a.m. entry on McClain's medical chart
confirmed that Dr. Lloyd involuntarily committed McClain for
inpatient treatment on Grady's psychiatric floor. At the
shift change 12 minutes later (7:00 a.m.), Dr. Lloyd's
shift ended, and Dr. Mould- Millman's shift began. When
Dr. Lloyd left, he "did not think that [McClain's]
mental status would clear up and that he could be
the same time as the shift change, McClain was administered a
dose of Ativan, a benzodiazephine that has sedating effects,
that Dr. Lloyd had prescribed. McClain was not transferred to
the psychiatric floor; instead Kinchen, a licensed clinical
social worker working for Grady, "intercepted" and
reassessed him. Kinchen found McClain to be stable and
recommended to Dr. Mould-Millman that he be discharged. At
8:01 a.m., Kinchen entered a note on McClain's chart
mentioning her plan to consult with Dr. Mould-Millman.
minutes later, at 8:07 a.m., Dr. Mould-Millman rescinded the
1013. Dr. Mould-Millman noted on McClain's chart that he
had "reassessed" McClain and found that he had no
current suicidal or homicidal ideations, that he was calm and
cooperative, and that he was able to be safely discharged.
There is no evidence that either Kinchen or Dr. Mould-Millman
contacted Dr. Lloyd before deciding to discharge McClain.
Approximately 11 hours later, McClain attempted to commit
suicide by jumping off a third-floor balcony, severing his
carotid artery and suffering massive brain injuries.
as McClain's guardian, filed suit against Grady and Dr.
Lloyd, alleging claims for medical malpractice against the
individual defendants and vicarious liability against the
other defendants. According to the complaint and supporting
affidavits, the individual defendants grossly breached the
applicable standard of care by failing to: perform a thorough
psychiatric evaluation, thoroughly review McClain's past
psychiatric treatment history; consult and/or coordinate care
with McClain's treating psychiatrist or, alternatively,
more experienced psychologists or psychiatrists; adequately
assess McClain's current psychosocial situation; and
document a safety plan to prevent the recurrence of suicidal
thoughts, plans, or actions.
trial court entered a consent order dismissing without
prejudice Hickson's claims against Dr. Lloyd. Grady moved
for summary judgment, arguing that it was entitled to
immunity under OCGA § 37-3-4, because it had discharged
McClain in good faith and in compliance with the statutory
requirements of Chapter 3 of Title 37.
trial court found that Grady was not entitled to summary
judgment in light of several material issues of fact: whether
placing a medical note reflecting McClain's discharge
constituted good faith compliance with the notice provisions
of OCGA §§ 37-3-4 and 37-3-43 (c); whether the
assessments of McClain by Kinchen and Dr. Mould-Millman were
insufficient and inadequate to the extent that any decision
made thereon would not be in good faith; and whether Grady
failed to meet the applicable standard of care in providing
treatment to McClain, for which it would not be immune under
OCGA § 37-3-4.
trial court entered a certificate of immediate review, and we
granted Grady's application for interlocutory appeal.
This appeal followed.
[The appellate court's] review of the grant or denial of
summary judgment is de novo, and [the appellate court]
view[s] the evidence, and all reasonable conclusions and
inferences drawn from it, in the light most favorable to the
nonmovant. Summary judgment is warranted only where no
genuine issue of material fact exists and the movant is
entitled to judgment as a matter of law.
construing a statute, we look at its terms, giving words
their plain and ordinary meaning, and where the plain
language of a statute is clear and susceptible of only one
reasonable construction, we must construe the statute
according to its terms." "[I]n construing language in
any one part of a statute, a court should consider the entire
scheme of the statute and attempt to gather the legislative
intent from the statute as a whole." Statutory
construction is a question of law, which we review de
these guiding principles in mind, we turn now to Grady's
claims of error.
Grady argues that the trial court erred in concluding that
Hickson's allegations of negligence were not
"actions in connection with" McClain's
discharge, pursuant to OCGA § 37-3-4, and that the court
thus erred in failing to find that Grady was immune from
liability as a matter of law.
2011, House Bill 343, inter alia, "amend[ed] Chapter 3
of Title 37 of the Official Code of Georgia Annotated,
relating to examination and treatment for mental illness, so
as to provide for immunity for hospitals in certain
circumstances; to provide for related matters; to repeal
conflicting laws; and for other purposes." The amendment