A majority of a panel of the Georgia Court of Appeals affirmed summary judgment for the defense in a case involving a mental health patient who left the custody of his parents and was found drowned three days later. The majority held that while Plaintiffs proved “cause-in-fact,” there was no genuine issue of fact on proximate cause.

Plaintiffs are the parents of a patient with a long history of non-violent, non-suicidal mental health issues. They lived in Chattanooga. A few days before the event, they were on vacation in North Carolina when the patient stopped taking his medication regularly. He further deteriorated while they were traveling home, so they stopped in Augusta at a hospital. The patient was evaluated and held involuntarily under a “1013” order. Over the next few days, the hospital made efforts to transfer the patient to an inpatient mental health facility, but there were no beds readily available in the state. Over the next few days, the patient was sporadically compliant with medications and hallucinating, but did not express any intent to harm himself or others. After a series of consultations and evaluations, the decision was made to discharge him in the custody of his parents for transportation to a facility close to home.

His parents then took custody of him and went to the medical records building to get a copy of his records. The patient and his mother went inside to sign authorizations and the patient then returned to the car with his father. The patient then exited the car and began walking around. His father asked a security guard for help as they tried to prevent the patient from running away. The patient then ran towards a parking deck and his father called the police for assistance. After an extensive search, he could not be found. A bulletin was put out for him and a sheriff’s deputy found him but did not detain him. The patient was found in a lake three days later and the cause of death was accidental drowning.

Plaintiffs sued and the defendants moved for summary judgment, which the trial court granted, ruling there was an absence of evidence of proximate cause. A majority of a panel of the Court of Appeals affirmed, holding that the patient’s accidental drowning three days later was too remote from his discharge as a matter of law. The majority wrote that Plaintiffs were required to prove both cause-in-fact and proximate cause and that they had established “but for” causation in the sense that keeping the patient at the hospital longer would have “foreclosed all other outcomes outside of the hospital” but that they did not prove proximate cause. Specifically, there was no evidence as to how or why the patient drowned, he was able to swim, it was summer time and warm, and there was nothing inherently dangerous about swimming. The expert witnesses could not draw a conclusion about what caused him to drown. Because the Court could only speculate about what happened, the majority affirmed. The dissent wrote that proximate cause is usually a jury issue and there was expert testimony that the patient’s psychosis meant he was unable to care for his own safety, among other things.

Take-home: this is the first case in a long time in which the Court has held that the claimants proved cause-in-fact but not proximate causation.

The case is Ferguson v. Bowers, ___ S.E.2d ___, 2024 WL 1130362 (Ga.Ct.App. March 15, 2024).