Santa Cruz v. Northwest Dade Community Health Center, Inc.

The case discussed the limits of a medical facility’s liability for acts committed by an individual treated on an outpatient (loosely defined, an outpatient is a patient who visits a medical center for diagnosis or treatment, but does not stay overnight at the facility. Per contra, an inpatient is admitted for close monitoring of the procedure and/or recovery).

In this case, on 18 August 1986, Oscar Santa Cruz was brought to Northwest Dade by the police pursuant to an ex parte court order describing him as violent and delusional. Oscar was subsequently transferred to a different facility, after which a court order committed him to South Florida State Hospital. While awaiting the transfer to South Florida State Hospital, Oscar escaped and returned to Northwest Dade. Northwest Dade began treating Oscar with medication on an outpatient basis. While undergoing treatment, Oscar shot and injured the plaintiffs – Osmani Santa Cruz, Oscar’s brother and Albert DeLara.

The trial court dismissed the plaintiffs’ complaint for medical failure to state cause of action. The trial court found that the plaintiffs were neither patients of Northwest Dade, nor fit into any of the exceptions to physician/patient requirement.Therefore, there was no basis for the plaintiffs to assert a third party claim against Northwest Dade.

The plaintiffs appealed the decision of the trial court. On appeal, the district court affirmed the trial court’s order and held that: (1) the victim-plaintiffs, who were not patients of the health center themselves, could not maintain a medical malpractice action against the center; and (2) the center owed no duty to the victims to protect them from the patient because he was not in the center’s  custody.

While determining the extent of the duty owed by the medical center in controlling the actions of its patients, the district court’s decision was cushioned on Section 319 of the Second Restatement of Torts which reads,

“[o]ne who takes charge of a third person whom he knows or should know to be likely to cause bodily harm to others if not controlled is under a duty to exercise reasonable care to control the third person to prevent him from doing such harm.”

Reading “one who takes charge”, the court drew a difference between the right and duty of control a medical facility exercises over its committed patients vis-à-vis persons it treats on an outpatient basis. An outpatient, unlike an inpatient, is not within the custody of the medical center. Therefore, the medical center will not be liable for the harmful actions of the outpatient.

“The appellants' complaint for medical malpractice against Northwest Dade was dismissed for failure to state a cause of action. This was a correct ruling by the trial court. There is no recognized basis for these appellants to assert a third party claim against the medical facility. They were not patients of the medical staff at Northwest Dade nor did they fit into any exception to the physician/ patient requirement. Thus, it is clear there was no special relationship between Northwest Dade and the appellants which would support a claim for medical malpractice.” (para 445)

“In this context “one who takes charge” is one who has the right and the duty to control the petitioner's behavior, as would be true in the case of a committed inpatient.” (para 445)