Wall Street Journal, February 26, 1997 - Dallas Lawyer Makes Suicide Focus of Lawsuits

Mr. Simpson likens the concept of suing over suicide to the way lawsuits over deaths in automobiles have helped make cars safer. "There has been no substantial check on mental-health providers until recently," he says.

By Mary Flood
Staff Reporter of The Wall Street Journal

A Texas lawyer is leading the charge in an increasingly common form of medical malpractice suit: suing therapists when a patient commits suicide.

In the successful cases so far, survivors have gotten money from therapists and other mental-health providers for glaring treatment errors, such as not explaining the side effects of potent drugs, disregarding pleas for help or providing lax supervision of suicidal patients.

Dallas lawyer Skip Simpson-who has gotten his clients money in three of these cases and is involved in a fourth-sees the suits as keeping mental-health providers in line.

"This isn't about some wide-eyed plaintiff's lawyer going nuts," says Mr. Simpson. "I would like to alert professionals to be more on the watch for suicide and to know if they aren't, lawyers are right around the corner."

But the highly emotional cases are complex and controversial, both morally and legally. To surviving loved ones, a suicide lawsuit can provide catharsis along with compensation. On the other hand, some people are suspicious of families who come collecting for an act many people consider solely the responsibility of the person who takes his or her own life. And some therapists contend the suits may lead mental health professionals to be overcautious - or make mistakes in treatment.

Different Approach

Psychiatrists and psychologists have been targets of occasional suicide-related medical-malpractice lawsuits in the past, most often when institutionalized patients either kill themselves upon release or escape from an institution.

But these newer cases largely claim negligence on behalf of people getting outpatient care. It's hard to pinpoint how many suits have been filed, but David Jobes, a clinical psychologist who teaches at Catholic University in Washington, D.C., and specializes in suicide study, says that in the past five years or so it seems the number of such suits is increasing. Even school guidance counselors have been targeted with litigation, he says.

And therapists fear even more suits will be filed because of the prevalence of managed health care. While noting that managed care has made therapy affordable for more people, Dr. Jobes says the health plans also curtail the time patients spend in therapists' care, and favor medication over face-to-face sessions. Both of which, he says, may increase the potential for tragedy.

As the opportunity for suits rises, more lawyers are likely to follow the lead of Mr. Simpson. A former lawyer for the Air Force. the Department of Justice and the Dallas district attorney's office, the 50-year-old Mr. Simpson made a national name for himself in the early 1990s by filing lawsuits claiming therapists implanted so-called repressed memories of abuse and satanism in their patients. He has also been hired to protect the reputations of people accused of abuse based upon such memories, including the family of comedian Roseanne. He is now negotiating a possible settlement in his fourth suicide lawsuit.

He wields a big stick: In Mr. Simpson's first suicide case in 1990, a Fort Worth jury awarded $2.7 million to the survivors of a man who went to a neurologist to treat his migraines. The patient, who was an engineer, was given several drugs to treat the headaches. After taking the medicine, the patient complained to his doctor about feeling despondent: evidence indicated the patient had shown no signs of mental illness before that.

The engineer eventually became so depressed that he covered the floor of a closet with plastic bags, propped a wooden table leaf and pillow against the wall, shut himself in, and shot himself in the head.

"There were no signals that I made that could have enabled you to prevent me from doing what I did." the father of two girls said in a sorrowful audio taped suicide message to his family, which was played for the jury. "Pray for me and maybe God will take me into his world and that I won't go to hell.

Failure to Warn

The jury, which went out for drinks with Mr. Simpson and the widow after the verdict, found that the doctor had a duty to warn his patient of the depressive side effects of the prescribed drugs. Mr. Simpson also argued the neurologist should have sent the patient for mental-health counseling when he complained of depressive symptoms.

After the verdict, the parties entered into a $1.2 million settlement, with the agreement that the defendant wouldn't appeal the case.

Mr. Simpson is currently negotiating a case in Dallas County District Court involving a real-estate broker who jumped off the fourth floor of a Dallas-area parking garage in 1994. The lawsuit alleges that the broker's psychiatrist failed to recognize that the patient was suicidal. (The psychiatrist's attorney says his client met his standard of care.)

Mr. Simpson likens the result of suing over suicide to the way lawsuits over deaths in automobiles have helped make cars safer. "There has been no substantial check on mental-health providers until recently," he says.

Many defense lawyers say that's malarkey. Stephen Grimmer, one of the attorneys on the losing side of the engineer case, says the verdict seemed so wrong that his faith in the justice system was shaken. "That was one of those cases where for several months after I wanted to go drive a taxicab instead of being a lawyer," Mr. Grimmer says.

Michael Lee, a Fort Worth attorney who in 1992 defended a psychiatrist sued by Mr. Simpson, sees the suicide tort cases as "just a way to make an easy buck."

Mr. Lee's client settled for $100,000 with Mr. Simpson's client. For about seven years, the 70 year-old woman had been seeing a psychiatrist specializing in therapy for devout Christians. Then, in December 1990 she received a letter stating her psychiatrist was curtailing his practice and would no longer be her doctor. The woman called to speak to the doctor but was not allowed to talk to him, and was instead told to call a referral service. She shot herself the day after she received the letter.

Mr. Simpson argued the doctor owed it to his patient to at least speak to her about his decision and help her find another Christian psychiatrist.

"To me. it was the same as if he had pulled the trigger," the woman's daughter says of the doctor, whom she blames for the death.

Mr. Lee, the opposing lawyer, says the charges were "without merit."

Practice Defensively

The success of these suits has some therapists worried. Dr. Jobes of Catholic University says that if lawsuits increase, more doctors and clinics might refuse to handle suicidal patients.

Or, he fears, doctors will practice more defensively, making it feel like a battle between them and patients. "I have seen evidence that otherwise competent therapists can start making mistakes when forced to practice defensively." he says.

William Reid, an Austin psychiatrist and former medical director for the state mental-health department, also takes strong issue with some of the lawsuits. "Plaintiff lawyers are looking for ways to get their clients and themselves money," says Dr. Reid, who has served as an expert for both sides in suicide malpractice suits. "But there is a difference between tragedy and malpractice."

In Texas, plaintiffs must prove doctors were more than 50% responsible for a patient's suicide. (In the only suicide lawsuit of Mr. Simpson's decided by a jury - the engineer case - the jury found the doctor 95% responsible.)

Texas medical-malpractice rules passed in 1995 place heavy burdens on plaintiffs lawyers: The laws require not only a two-month warning to a targeted hospital or doctor, but also that plaintiffs lawyers pay for an expert report within three months of filing the lawsuit. Previously, the lawyers could postpone that expert expense and possibly settle the lawsuit without incurring the cost of the report, which can run as high as $30,000.

The high potential cost may deter less well-heeled lawyers from bringing suicide lawsuits - which may mean more business for lawyers such as Mr. Simpson. "Those roadblocks are out there." says Mr. Simpson, but "they won't stop me from filing anything."

To be sure, Mr. Simpson insists money isn't the most important factor for his clients. Suing "gives them some satisfaction of knowing what the facts actually were," he says.

Indeed, some therapists concede that the suits are beneficial in emotional terms. Dr. Jobes says a lawsuit helps assuage the guilt of a grieving family. And surviving family members say these lawsuits aren't so much about money as they are an attempt to vent anger, get answers or set precedent so this doesn't happen again.

"It's like [Ron] Goldman's father has said: It's not about the money," says Wanda Hanes, who once hired Mr. Simpson in a Dallas suicide suit. "It's about the satisfaction of getting to say, 'You S.O.B., you take part of the responsibility.' "

Ms. Hanes's 32-vear-old daughter overdosed on pills obtained from a psychiatrist the day after her psychiatrist approved her release from an emergency room where she was being treated for an earlier overdose. The suit filed in Tarrant County District Court in 1993 alleged the doctor shouldn't have let Ms. Shirley have the pills, and that he shouldn't have let the emergency room send Ms. Shirley home.

Ms. Hanes, who won a settlement for $175,000, says she gained great satisfaction from giving her deposition. Her daughter's psychiatrist attended and, she says, she got a chance to tell him "he's not a God and can't play with people's lives."