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Court rules Carney Hospital not responsible for woman's murder by psych patient it had released on recommendation of his doctor

The death of Mary Miller, 71, at the hands of her knife-wielding upstairs neighbor was tragic, but not the fault of the hospital that released him from its psychiatric ward three weeks earlier on the recommendation of the man's doctor, the Supreme Judicial Court ruled today.

Tu Nguyen's family had brought him to Carney Hospital in January, 2012 because he was exhibiting bizarre, angry behavior, that included threats to kill a relative. A Boston Municipal Court judge signed an order to commit him to a psychiatric unit for up to six months.

But on Jan. 30, the hospital released him after his doctor said medication had brought him under control and he was no longer showing any signs of aggression. On Feb. 21, he broke into Miller's apartment on Codman Hill Avenue in Dorchester and, in front of her eight-year-old granddaughter, stabbed her to death. In 2014, a Suffolk Superior Court jury convicted him of second-degree murder, which means a sentence of life, but with the possibility of eventual parole.

Miller's family sued Carney for negligence, saying it should never have released him, at least not before the six months called for in the Boston Municipal Court order.

But the Supreme Judicial Court said the hospital owes nothing to the family, because under state law, its responsibility to preventing Nguyen from harming others ended when his doctor made a clinical decision he was OK to be released. If anything, the court said, the hospital could have gotten in trouble if it had held him after the doctor reported medication had brought his symptoms under control, under state patient-rights laws.

As the duty to hold "N" followed directly from the order of commitment, when his treating mental health professional determined that he no longer presented a likelihood of serious harm and ordered his release, the hospital no longer had actual control of "N" or the authority to hold him. In the absence of this special relationship, the hospital had no duty to hold, or otherwise to control, "N" three weeks later when he attacked the victim in her home.

Tu Nguyen was sentenced to life in prison in 2014 for the way he

On January 30, 2012, "N"'s treating physician examined him and determined that he no longer presented a serious risk of harm due to his mental illness. The physician noted that his behavior had improved with medication, he appeared to be at his usual "baseline" level of functioning, and his aggression towards other patients had ceased. Accordingly, under the terms of the order of commitment, "N" was released that day.

On February 21, 2012, "N" broke into the home of Miller, his neighbor, and stabbed her to death. Miller's then eight year old granddaughter was present in the apartment at the time; she was not attacked and was physically unharmed.

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Comments

This is a pretty clear case of the attorneys going after the deepest pockets and probably expecting the insurer to settle rather than litigate.

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A friend has been going through this with her brother.

A person becomes acutely mentally ill. They are placed in a hospital and given medications that are somewhat effective, and they recover considerably. They are released. They stop taking their medications and do not comply with follow up. They go off the rails and are readmitted. They are treated. They improve. They are released. They are no longer treated. They go off the rails, They are readmitted ...

Hospitals cannot hold people past a certain point if they have improved with treatment. There is not enough support for people to follow their treatment plans outside the hospitals, but the hospitals cannot use that as a reason to hold a person.

When asylums were closed - and closed for very good reasons - very few states followed up by funding the facilities necessary for treatment and follow up in the community. It gets dumped on family members who are placed at risk and don't have the resources or authority to make it work.

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Quite a few homeless folks are mentally ill (and may also suffer from substance/alcohol abuse). In decades past they would have been warehoused in asylums but with better medications that's hypothetically not necessary. Unfortunately, the mentally ill homeless often have issues with adherence to medication regimens and the ultimate result is homelessness (along with many other problems).

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because it was poorly thought-out, and it consisted of dumping hundreds, if not thousands of patients from the mental hospitals out into the streets without any kind of follow-up care, or other places to go. Moreover, the families, friends and relatives of many mental patients didn't want them around, either. Many, if not most of the homeless, are mentally ill, but sometimes just being homeless can contribute to , if not cause mental illness, as well.

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why asylums shouldn’t have been closed.

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Most of these state hospitals were extremely archaic--and brutal. It's a wonder that anybody survived a lot of these places. Also, it's been found that 75 percent of mentally ill patients don't need to be hospitalized, but can be cared for within their communities, as well. Hospitalization is usually recommended for a mental patient as a very last resort; if they're really a danger to themselves and/or others.

Unfortunately, many, if not most mental patients who are in institutions get worse or stay the same, rather than getting better, due to the general atmosphere of these places.

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who was a patient in Medfield State Hospital, off and on, for many years, the atmosphere (by which you mean?) had very little in deciding whether my loved one got better or not. It was the nature of her mental illness that was the major factor in that decision.

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The Community Health Center were set up to support mentally ill individuals in the community. However there are many mentally ill who cannot, even with medication, navigate the community, and many are not from "The Community" they are living in. Medication alone cannot care for people who have comorbidity, trauma, and experience economic and social marginalization. The system needs to be redesigned, it is a mess, ineffective and heartbreaking.

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Carney is actually the worst hospital in Mass.

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We called the Carney 'Stairway to Heaven'

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The Carnage.

Lots of internal issues. A neighbor of mine had a bullying case with them. Collected 5-digits. Offender was named in the courtroom. Offender was allowed to retire.

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SwirlyGirl is on point. You'd be amazed how many ambulance calls are for "change of mental status" or some other form of mental illness. Small hospitals like Carney keep them for an hour or two, maybe with a light prescription and right back out. MGH and the bigger hospitals don't do much more. It's the new normal.

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This is sort of an intractable problem. On the one hand, it's bad to have violent crazy people walking around free. On the other hand, we've seen the abuse that results from making it too easy for hospitals to incarcerate people against their will. You can't reasonably lock people up indefinitely on the say-so of any random doctor.

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So, was there anything anyone could have done to prevent this?

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and not released so early. The murderer needs to be monitored closely, and to be in the psychiatric ward of a regular hospital.

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