Tort Law: Third Circuit Holds Federal Agency Liable for Deaths Mentally-Ill Patient Caused After Negligent Discharge from Treatment Program – DeJesus v. United States Department of Veterans Affairs

Abstract

Tort Law: Third Circuit Holds Federal Agency Liable for Deaths Mentally-Ill Patient Caused After Negligent Discharge from Treatment Program - DeJesus v. United States Department of Veterans Affairs1 - The United States Court of Appeals for the Third Circuit recently held the U.S. Department of Veterans Affairs (VA) liable under the Federal Tort Claims Act (FTCA)2 when a mentally-ill patient, Alejandro De Jesus, shot himself and four children eighteen hours after the VA released him from a transitional residence program that provides mental and physical health care to homeless veterans. The FTCA overcomes sovereign immunity and makes the federal government liable for tort claims the same manner and to the same extent as a private individual under like circumstances.3 A federal agency's duty under the FTCA stems from state law, which the Third Circuit found the VA violated by discharging and failing to commit De Jesus. DeJesus, an unemployed, homeless Vietnam veteran with substance abuse problems and a history of domestic violence, entered a VA inpatient program in 1997.4 A VA clinical psychologist diagnosed DeJesus with intermittent explosive disorder, a condition characterized by repeated violent outbursts.5 Later, a VA psychiatrist confirmed the diagnosis and prescribed medication to control his condition.6 A second VA psychiatrist, unaware of the first diagnosis, diagnosed DeJesus with only mild depression.7 In response, the VA assigned DeJesus a treatment team for psychotherapy and substance abuse counseling.8 The team's primary therapist a Registered Nursing degree, but no nursing license because she failed the licensing exam.9 Furthermore, she did not have a license to practice therapy; although the VA did not require one.10 After a few months of treatment, the therapist recommended De Jesus for a transitional residence program, but failed to inform the program about his mental health issues or release his VA records, even though the records would have alerted the program that DeJesus had intermittent explosive disorder and suffered from violent outbursts and suicidal ideations.11 While in the program, DeJesus threatened another resident with a knife, leading the VA to recommend his discharge.12 The program acknowledged that, although it no obligation to do so, it dismissed DeJesus because of the VA's recommendation.13 Before DeJesus left, he told his therapist he loved her and gave away his possessions.14 Program staff also found that DeJesus shredded his clothing and his favorite baseball cap.15 Despite the fact that this behavior indicated suicidal intentions, none of the VA staff who participated in DeJesus's discharge followed Pennsylvania's involuntary commitment procedures or the VA's internal emergency psychiatric intervention procedures.16 Eighteen hours after leaving the treatment program, DeJesus charged into his estranged wife Camille's apartment and shot and killed two of their children and two neighbor children before turning the gun on himself.17 Plaintiffs Camille DeJesus and Cheryl Faulk, the mother of the deceased neighbor children, filed this FTCA suit in the United States District Court for the Eastern District of Pennsylvania. They alleged that by negligently discharging and subsequently failing to commit DeJesus, even when he posed an imminent threat, the VA caused the wrongful deaths of their children and Camille's emotional distress.18 Further, plaintiffs claimed that the VA negligently failed to warn them about DeJesus's mental state.19 The district court dismissed the failure to warn claims, but held the VA liable for wrongful death and emotional distress.20 Specifically, the court found the VA grossly negligent in its determination that DeJesus should be discharged [from a VA transitional residence program] . . . and in its failure to commit DeJesus following the discharge.21 Because these violations breached the standard of care established by Pennsylvania law, the court awarded plaintiffs damages both individually and on behalf of their children's estates. …