United States District Court, D. Hawaii
ORDER DENYING DEFENDANT WILCOX MEMORIAL
HOSPITAL'S MOTION FOR JUDGMENT AS A MATTER OF
C. KAY SR., UNITED STATES DISTRICT JUDGE
reasons detailed below, the Court DENIES Defendant Wilcox
Memorial Hospital's Motion for Judgment as a Matter of
Law, ECF No. 444.
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,  a stipulation,
disposition of four motions by defendants,  the death of one
defendant,  and a settlement,  Defendant Wilcox Memorial
Hospital ("Defendant") was the only remaining
defendant, and Plaintiff's claims of assault, battery,
and intentional infliction of emotional distress
("IIED") the only remaining claims.,  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.
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.
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 and $425, 000 in punitive damages. ECF No.
following is a limited summary of the factual background that
was developed at trial.
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.
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.
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
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.
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).
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,
CONSENT TO TREATMENT
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
TCS Form., 
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.
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).
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
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.
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
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.
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).
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." 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.
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[.]").
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.
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.
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
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).
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.
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.
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.
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.
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
Goldberg's discharge diagnosis of Plaintiff was
"psychotic disorder, not otherwise specified, with
severe paranoia." Goldberg Initial Assessment at 2.
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.
testimony regarding Plaintiff's condition after his visit
to Wilcox Memorial Hospital is cited and discussed below.
See Sees III and IV.C, infra.
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"); ...