Court of Appeal upholds verdict against St. Paul’s Hospital for patient suicide attempt

In reasons for judgment released today, the Court of Appeal in Paur v. Providence Health Care, 2017 BCCA 161, upheld a verdict finding St. Paul’s Hospital negligent in a case involving an attempted suicide by a mentally ill patient.  The plaintiff in Paur was committed under the Mental Health Act at St. Paul’s Hospital after threatening to kill himself.  After being committed the plaintiff was allowed to go into a bathroom alone, and while inside attempted to hang himself from the bathroom ceiling using his gown.  The patient's life was ultimately saved but he suffered devastating brain injuries.  The Court of Appeal agreed with the trial judge that the Hospital was negligent in not taking the relatively inexpensive step of modifying the bathroom ceilings in the Psychiatric Unit to prevent patients from being able to hang themselves (which was in line with Provincial Government recommendations).  The Court of Appeal wrote:

[4]            For long and detailed reasons indexed as 2015 BCSC 1695, the trial judge dismissed the plaintiff’s claim against Dr. Pickett, the ER physician charged with his care; but found that the hospital had fallen below the applicable standard:

Given the foreseeable risk, the seriousness of the potential harm from hanging, and the relatively low burden of cost to prevent the injury, I find that [the hospital] had a duty to take reasonable steps to either ensure that the bathroom design was changed to be ligature-proof or more easily monitored in advance of suicidal patients being allowed unmonitored access to it, or to institute policies to ensure that suicidal patients could not be in the bathroom unmonitored or uninterrupted for any length of time that could allow for a hanging approaching five minutes before rescue. [At para. 251.]

After finding that ‘but for’ the unsafe environment provided to Mr. Paur, he would not have had the opportunity to hang himself, the Court ruled that the hospital was liable in negligence and as an “occupier” under the Occupiers Liability Act, R.S.B.C. 1996, c. 337 (“OLA”).

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[70]        I agree with the trial judge that the frequency (or infrequency) of suicide attempts is no reason why reasonable steps should not be taken to prevent them occurring in a hospital where patients may be held against their will. No facility will ever be completely safe; the issue is whether it is reasonably safe given the population.

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[74]        In summary, the risks found by the Court to be reasonably foreseeable could have been minimized in a variety of ways, not only by having a ligature-proof ceiling in the Comox Unit bathroom. At the end of the day, the hospital had not, in the trial judge’s view, met the standard on any of these bases.

The full decision can be found here:  http://www.courts.gov.bc.ca/jdb-txt/ca/17/01/2017BCCA0161.htm