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Raymond v. Wilcox Memorial Hospital

United States District Court, D. Hawaii

April 16, 2019




         For the reasons detailed below, the Court DENIES Defendant Wilcox Memorial Hospital's Motion for Judgment as a Matter of Law, ECF No. 444.


         On June 5, 2015, Plaintiff Cameron Raymond ("Plaintiff") filed a ten-count Complaint against nine named defendants and numerous Doe defendants. Compl., ECF No. 1. Following the voluntary dismissal of two defendants, [1] a stipulation, [2] the disposition of four motions by defendants, [3] the death of one defendant, [4] and a settlement, [5] Defendant Wilcox Memorial Hospital ("Defendant"[6]) was the only remaining defendant, and Plaintiff's claims of assault, battery, and intentional infliction of emotional distress ("IIED") the only remaining claims.[7], [8] Plaintiff's claims arose out of events that took place on June 5 and 6, 2013. See Compl. ¶ 29. Plaintiff alleged that, following his detention by Kaua"i Police Department officers and involuntary transportation to Wilcox Memorial Hospital, see id. ¶ 45, 50, he was injected with Geodon and haloperidol decanoate ("Haldol") against his will, id. ¶¶ 72-78, and suffered a number of ill effects, id. ¶¶ 79-80, 94, 97-103, 110.

         Following jury selection on March 12, 2019, ECF No. 436, jury trial in this matter took place on March 13-15 and 20-21, 2019, ECF Nos. 437, 438, 440, 455, 456. On March 18, 2019, Defendant filed a Motion for Judgment as a Matter of Law ("Motion"), ECF No. 444, as well as a memorandum in support ("Mem. in Supp."), ECF No. 444-1, to which Plaintiff filed an Opposition the following day, ECF No. 453. The Court heard oral argument on the Motion on March 20, 2019, ECF No. 455, but declined to rule thereon until after the verdict had been rendered.

         The jury deliberated on March 21 and 22, 2019, ECF Nos. 456, 461, and on March 22, 2019, returned a verdict in favor of Plaintiff, ECF Nos. 461, 463. Finding Defendant liable for assault, battery, and IIED, the jury awarded Plaintiff $722, 600, comprising $297, 600 in compensatory damages[9] and $425, 000 in punitive damages. ECF No. 463.


         The following is a limited summary of the factual background that was developed at trial.

         On the evening of June 5, 2013, April Raymond (Plaintiff's ex-wife) called 911 to request a welfare check on her two children, who were then in Plaintiff's (their father's) custody. Transcript, Jury Trial Day 4 ("Day 4 Tr."), ECF No. 468 at 86:13-19, 87:6 (testimony of April Raymond). Plaintiff and April Raymond were then in the midst of a custody battle. See, e.g., Transcript, Jury Trial Day 1 ("Day 1 Tr."), ECF No. 448 at 108:14-15, 124:11-17 (testimony of Plaintiff). According to April Raymond, Plaintiff had, in an earlier telephone conversation with her, said alarming things about, inter alia, "the end of the world" and how she would never again hear the children's voices. Day 4 Tr. at 95:5-18. On a Statement Form later submitted to the Kaua"i Police Department, April Raymond wrote that she received "bizarre texts about blood [and] cutting[, t]he end of the world," and how she needed to repent. Def.'s Ex. 2 ("Statement Form") at 1. She also reported that she had "never seen this level of instability," that Plaintiff's parents had "raised concerns about strange behavior," and that Plaintiff stated to her in a phone call at 7:00 p.m. on June 5, 2013 that his family was trying to kill him. Statement Form at 12.

         April Raymond testified that she was concerned for her children and called 911 on the advice of Plaintiff's parents and brother. Day 4 Tr. at 95:19-21, 96:2-7. Plaintiff, on the other hand, testified that April Raymond's 911 call stemmed from his refusal to take the children back to his parents' house, where it was originally planned the children would stay for the night. Day 1 Tr. at 103:2-6, 105:17-19, 106:6-9. According to Plaintiff, his ex-wife fabricated her version of Plaintiff's statements from pieces of previous conversations "for custody purposes." Id. at 124:3-10.

         Officers Isaiah Sarsona and Jerald Kim of the Kaua"i Police Department were dispatched on June 5, 2013, to perform the requested welfare check. See Transcript, Jury Trial Day 3 ("Day 3 Tr."), ECF No. 450 at 79:22-24, 80:8-14 (testimony of Officer Sarsona). At the time, Plaintiff was living in a structure he had constructed on a piece of farm property he owned. Day 1 Tr. at 93:5-11, 94:7-12 (testimony of Plaintiff). The officers made contact with Plaintiff and his sons there. See Day 3 Tr. at 80:18-25, 81:1-2 (testimony of Officer Sarsona). Plaintiff testified that, upon hearing the officers approach, one of his sons was startled and grabbed a machete that was in the structure, but Plaintiff told him to put it down. Day 1 Tr. at 107:17-25, 108:1-4. According to Plaintiff, he was cooperative, speaking first to one officer, who Plaintiff felt was needlessly hostile, and then to the other, who led him off the property to the police car. Id. at 108:5-23, 109:5-9.

         One or both of the officers decided that Officer Sarsona would transport Plaintiff to Wilcox Memorial Hospital's emergency room for an involuntary psychological evaluation. See Def.'s Ex. 58 ("Incident Sheet"); Day 3 Tr. at 81:17-20 (testimony of Officer Sarsona). Once at the police car, Officer Sarsona placed Plaintiff in handcuffs, and possibly ankle shackles, and transported him to Wilcox Memorial Hospital without incident. Incident Sheet; Day 1 Tr. at 42:10-11, 48:12-14 (testimony of Dr. Christopher Elliott), id. at 109:21-25 (testimony of Plaintiff); Day 3 Tr. at 85:9-15 (testimony of Officer Sarsona); Day 4 Tr. at 113:14-16 (testimony of April Raymond). According to the Incident Sheet and Officer Sarsona's testimony, Plaintiff made a number of outlandish statements while in transit to Wilcox Memorial Hospital and once there. See Incident Sheet (e.g., "Me and my two sons are kings of the Book of Mormon"; reference to a "magic sword"); Day 3 Tr. at 85:16-25, 86:1-25, 87:1-11. Plaintiff denied making most of the reported statements. Day 1 Tr. at 171:2-25, 172:1-22.

         Following Plaintiff's removal from his property, his father, Bruce Raymond, went to the Kaua"i Police Department looking for Plaintiff. Transcript, Jury Trial Day 2 ("Day 2 Tr."), ECF No. 449 at 68:11-13 (testimony of Bruce Raymond). There, Bruce Raymond informed a Kaua"i Police Department employee that he thought his son was having psychological problems. Id. at 68:14-21, 74:1-9 (testimony of Bruce Raymond).

         Plaintiff arrived at Wilcox Memorial Hospital at 9:41 p.m. Def.'s Ex. 57 ("Admission Record") at 64. At 9:42 p.m., Plaintiff signed a "Terms and Conditions of Service" Form (the "TCS Form"). Def.'s Ex. 6. The one-page TCS Form contained the following paragraphs, inter alia:


I wish to receive medical care and treatment at Wilcox Memorial Hospital. Accordingly, I consent to the procedures, which may be performed during the hospitalization or clinic visit, including emergency treatment. I authorize and consent to any of the following: X-ray examination, laboratory procedure, other diagnostic procedures, medical or surgical treatment, or other clinical and hospital service's directed by my physician(s) or my physician's(s) assistants, which my physician(s) believes are advisable to evaluate or treat me, and to other services rendered under the general and special instructions of my physician(s).


I understand that I will receive a bill from this medical facility. The physician(s) may also bill me separately for their services provided to me while at this facility. I further understand not all physicians are employees of this medical facility. I understand and agree to pay all charges for services rendered and that I am obligated to pay for services in accordance with the regular rates and terms of this medical facility. This medical facility reserves the right to charge a Late Payment Fee and/or a Returned Check Fee.

TCS Form.[10], [11]

         After signing the TCS Form, Plaintiff, accompanied by Officer Sarsona, was taken to a room and placed on a bed. Day 1 Tr. at 118:5-18 (testimony of Plaintiff). He was assessed by a triage nurse, who found him to be alert, appropriate, calm, cooperative, and oriented to person, time, place, and situation. Day 1 Tr. at 41:1-21 (testimony of Dr. Elliott); Admission Record at 68.

         Dr. Christopher Elliott's shift began at 11 p.m. Day 1 Tr. at 40:18-19 (testimony of Dr. Elliott). Dr. Elliott was not an employee of Defendant, but he runs the Wilcox Memorial Hospital emergency room while working there, he does not bill patients directly for his services, and the nurses working in the Wilcox Memorial Hospital emergency room take direction from him. See Day 1 Tr. at 32:3-4 (testimony of Dr. Elliott); id. at 35:24-25, 36:1-6; id. at 33:13-15; id. at 33:1-3. Sometime prior to 11:27 p.m., Dr. Elliott examined Plaintiff. Admission Record at 67; Day 1 Tr. at 42:16-18 (testimony of Dr. Elliott). The Kaua"i police had spoken to Dr. Elliott, and Dr. Elliott asked Plaintiff about reports of bizarre behavior, including reference Plaintiff had allegedly made to a "magic sword." Id. at 42:22-25, 43:1-4 (testimony of Dr. Elliott). Plaintiff denied having spoken of a magic sword, and also denied having exhibited any other bizarre behavior. Id. at 43:5-8 (testimony of Dr. Elliott); id. at 120:5-15 (testimony of Plaintiff).

         After some time, Plaintiff became upset at Dr. Elliott's line of questioning and refused to speak with him further. Day 1 Tr. at 43:15-17 (testimony of Dr. Elliott); id. at 122:1-8 (testimony of Plaintiff); Admission Record at 67 (Dr. Elliott's note that Plaintiff became "extremely angry at me and refus[ed] to answer further questions"). Plaintiff testified that he was calm during this interaction rather than angry and agitated. Day 1 Tr. at 121:18-23. Dr. Elliott noted, at 11:42 p.m., that it was

difficult to ascertain whether patient actually has had the bizarre behavior claims [sic] by others including allegedly of some sort of face book [sic] posting possibly with the patient holding a machete with some sort of comment about it being a "magic sword." However, patient denies having made any sort of comment and seems to feel angry and upset that others are accusing him of bizarre behaviors that he denies.

         Admission Record at 70-71. Dr. Elliott testified, and his notes in Plaintiff's medical record reflect, that he was unable at that point to complete a review of Plaintiff's systems due to Plaintiff's refusal to speak with him further. Day 1 Tr. at 22- 24; Admission Record at 67.

         Sometime after Dr. Elliott left the room, Madeleine Hiraga-Nuccio, a psychiatric social worker, came in and spoke to Plaintiff. Day 1 Tr. at 122:19-21 (testimony of Plaintiff); see Day 3 Tr. at 46:12-24 (testimony of Madeleine Hiraga-Nuccio); PI.'s Ex. 6 ("Hiraga-Nuccio Progress Note") at 63 (stating that this interview took place at 12 a.m.). According to the Progress Note Hiraga-Nuccio made some time after the interaction,

Plaintiff maintained good eye contact, was awake and alert .... appeared [oriented] to time, place and person. . . . His cognitive ability appears intact. Thought processes are linear and goal-directed with strongly paranoid and moderately grandiose content. He maintains strong delusions about his family and may friends conspiring to harm him and his children .... Patient appears to be experiencing symptoms of psychotic disorder of unknown origin with paranoid features.

         Hiraga-Nuccio Progress Note at 63-64. Hiraga-Nuccio had spoken to Officer Sarsona prior to speaking to Plaintiff, and her Progress Note includes information gathered from outside sources. Day 3 Tr. at 88:13-23 (testimony of Officer Sarsona); see, e.g., Day 4 Tr. at 60:9-17, 61:24-25, 62:1-2.

         After her interview with Plaintiff, Hiraga-Nuccio called Dr. Harold Goldberg to obtain his authorization to admit Plaintiff to Mahelona Medical Center ("Mahelona"). Day 3 Tr. at 62:21-25, 63:1-7, 66:17-18 (testimony of Hiraga-Nuccio); Hiraga-Nuccio Progress Note at 64. Dr. Goldberg was then the medical director of Mahelona, which is a psychiatric facility. See Day 4 Tr. at 5:22-25, 8:15-25, 9:1-7 (testimony of Dr. Goldberg).

         Hiraga-Nuccio also spoke to Dr. Elliott, whose opinions regarding Plaintiff she recorded on a form entitled "Emergency Examination/Hospitalization: Certificate of Physician/Psychiatrist for Admission/Transportation to Psychiatric Facility Pursuant to HRS Chapter 334-59, As Amended."[12] Def.'s Ex. 8 ("MH-4 Form"), at 65. The MH-4 Form certifies that Dr. Elliott had examined Plaintiff and had reason to believe that Plaintiff was mentally ill, imminently and substantially dangerous to others, and in need of further care or treatment. Id. at 65-66. It also states that arrangements had been made for the Kaua"i Police Department to transport Plaintiff to Mahelona. Id. at 66. Dr. Elliott signed the note, writing "Wilcox Memorial Hospital" below his printed name. Id. at 67.

         Hiraga-Nuccio communicated the substance of the MH-4 Form, along with the information she gathered from Plaintiff and from Dr. Elliott, to a Hawai"i state judge named Edmund Acoba. Day 3 Tr. at 64:23-25, 65:1-5 (testimony of Hiraga-Nuccio); see PL's Ex. 8 ("Acoba Order") at 10. At 12:30 a.m. on June 6, 2013, Judge Acoba issued an oral order to Hiraga-Nuccio, memorialized in a written order issued the next day, finding that there was probable cause to believe that Plaintiff was mentally ill, imminently and substantially dangerous to others, and in need of care and/or treatment. Day 3 Tr. at 67:19-25, 68:1, 68:13-16 (testimony of Hiraga-Nuccio); Acoba Order at 10. The Acoba Order directed that Plaintiff be transported to Mahelona "to be held for emergency examination and treatment." Acoba Order at 10; see also Hiraga-Nuccio Progress Note at 64 (noting that "Judge Edmund Acoba authorized involuntary admission to Mahelona[.]").

         At 12:43 a.m., Dr. Elliott ordered that Plaintiff be administered 100 milligrams of Haldol and 20 milligrams of Geodon via injection. Day 1 Tr. at 49:3-5, 49:24-25, 50:1-2 (testimony of Dr. Elliott); Admission Record at 87. According to Dr. Goldberg, Geodon would have been intended to sedate and calm Plaintiff, and Haldol to address psychosis. Day 4 Tr. at 11:13-17. Dr. Elliott testified that he felt that both Geodon and Haldol were necessary for Plaintiff's nine-mile, fifteen-to-twenty-five-minute ride from Wilcox Memorial Hospital to Mahelona. Day 1 Tr. at 79:10-15.

         Nurse Dallen Johns (who was Defendant's employee), entered Plaintiff's room and informed Plaintiff that he was there to administer medication. Day 3 Tr. at 12:22-24, 16:14-16 (testimony of Nurse Johns). Plaintiff informed Nurse Johns that he did not want medication. Day 3 Tr. at 16:18-19 (testimony of Nurse Johns); see Day 1 Tr. at 130:19-21 (testimony of Plaintiff). Nurse Johns testified that Plaintiff also told him that Plaintiff had a magic sword and threatened to use it against Nurse Johns if he tried to administer medications to Plaintiff. Day 3 Tr. at 16:18-21.

         Nurse Johns exited the room and communicated Plaintiff's refusal to Dr. Elliott, who, according to Nurse Johns, informed Nurse Johns that Plaintiff was "on a MH-4 hold" and told Nurse Johns to proceed. Id. at 17:1-7. Nurse Johns testified that Dr. Elliott also told him that Plaintiff "psychologically wasn't stable, and the medication was to help with that," and further testified to his own understanding that Plaintiff "needed this medication because he wasn't of his right mind and had the potential to escalate to being dangerous." Id. at 38:18-21, 41:20-24. Nurse Johns did not tell Dr. Elliott that Plaintiff had threatened him with a magic sword. Id. at 31:1-24 (testimony of Nurse Johns).

         On reentering the room, Nurse Johns told Plaintiff that he had no choice-that the medication would be administered. See, e.g., id. at 40:23-25, 41:1 (testimony of Nurse Johns). Nurse Johns testified that he informed Plaintiff that Dr. Elliott had said that Plaintiff needed the medication for his condition. Id. at 21:4-7. According to Plaintiff, Nurse Johns also told him that a judge had ordered that he be given the medication, Day 1 Tr. at 131:19-20, and that "administering the drugs was standard policy," id. at 188:7-10. Plaintiff nodded his understanding and did not resist receiving the injections. Day 3 Tr. at 37:9-15 (testimony of Nurse Johns); see also Day 1 Tr. at 132:23-24 (testimony of Plaintiff).

         Plaintiff testified that Nurse Johns identified the medications only by name, but that he "had never heard of the drug" and was "very frightened" by how fast he felt the effects. Day 1 Tr. at 133:1-19. Nurse Johns, on the other hand, testified that he told Plaintiff "that the medication was to help him calm down[, ] to help him think a little more clearly[, ] as well as potential side effects, rash, dizziness, nausea, and if he experienced those, to let us know." Day 3 Tr. at 24:20-23. The medication was administered by injection at 1:03 a.m. on June 6, 2013. Admission Record at 87.

         Dr. Elliott testified that he checked on Plaintiff following the administration of medications. Day 1 Tr. at 81:20-25, 82:1. Dr. Elliott's differential diagnosis of Plaintiff was "depression, anxiety, psychosis, schizophrenia, bipolar, toxic or metabolic abnormality, and others." Admission Record at 70; Day 1 Tr. at 61:8-10 (testimony of Dr. Elliott).

         Plaintiff was released from Wilcox Memorial Hospital at 2:04 a.m. on June 6, 2013. Admission Record at 64. Officer Sarsona then transported Plaintiff to Mahelona-a nine-mile, fifteen-to-twenty-five-minute drive-without incident. Incident Sheet; see Day 4 Tr. at 32:18-22. Plaintiff testified that he was going in and out of consciousness during the ride and that he was "very scared." Day 1 Tr. at 134:3-24.

         Around 9 o'clock on the morning of June 6, 2013, Plaintiff spoke to Dr. Goldberg at Mahelona. See Day 1 Tr. at 138:18-19, 139:2-6 (testimony of Plaintiff). Plaintiff testified that he told Dr. Goldberg that he felt "really sick" and "horrible," and that Dr. Goldberg told him that the Haldol would be in his system for at least thirty days. Day 1 Tr. at 140:7-14; see also Goldberg Initial Assessment, PI.' s Ex. 22 at 2 (Dr. Goldberg's note reflecting that he made this statement to Plaintiff). Dr. Goldberg, finding in Plaintiff "no evidence of dangerousness to himself or others," released Plaintiff from Mahelona that morning. See Goldberg Initial Assessment at 2.

         Plaintiff's understanding was that his release was based upon his agreement to certain "stipulations": that he be cared for by his mother (a registered nurse), that he take more medications that Dr. Goldberg would prescribe, and that he return to see Dr. Goldberg periodically. Day 1 Tr. at 139:25, 140:1-5, 140:12-24, 141:14-21. Dr. Goldberg explained to Plaintiff that he had been given Haldol because it was an antipsychotic drug and he had appeared to be psychotic, and that Dr. Goldberg was prescribing Plaintiff with more Haldol-ten milligrams to be taken nightly for ten days-to wean Plaintiff off the initial dose and/or to supplement it. Day 4 Tr. at 17:2-10 (testimony of Dr. Goldberg); id. at 16:19-21; Goldberg Initial Assessment at 2; see Day 4 Tr. at 17:11-18. Dr. Goldberg also prescribed Cogentin "if needed for stiffness or extrapyramidal side effects," which Dr. Goldberg testified were "not unusual side effects from Haldol." Goldberg Initial Assessment at 2; Day 4 Tr. at 21:15-17.

         Dr. Goldberg's discharge diagnosis of Plaintiff was "psychotic disorder, not otherwise specified, with severe paranoia." Goldberg Initial Assessment at 2.

         Plaintiff's brother took him from Mahelona to their parents' house. Day 1 Tr. at 142:18-20 (testimony of Plaintiff). Plaintiff was "miserable"; every muscle in his body ached, he was "cramped up" and "couldn't walk," and he "had to do little baby, baby shuffle steps to get around anywhere." Day 1 Tr. at 143:5-12. Plaintiff testified that his parents cried when they saw his condition. Id. at 143:13-15.

         Further testimony regarding Plaintiff's condition after his visit to Wilcox Memorial Hospital is cited and discussed below. See Sees III and IV.C, infra.

         Plaintiff continued to see Dr. Goldberg after the incident, apparently visiting him seven times. See Def.'s Ex. 55 ("June 13, 2013 Progress Note"); Def.'s Ex. 53 ("July 8, 2013 Progress Note"); Def.'s Ex. 52 ("July 22, 2013 Progress Note"); Def.'s Ex. 51 ("August 12, 2013 Progress Note"); Def.'s Ex. 50 ("Sept. 13, 2013 Progress Note"); Def.'s Ex. 49 ("November 8, 2013 Progress Note"); ...

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