Claim against Case Manager and Health Plan for Rampage Following Release of West Virginia Inpatient Dismissed by Fourth Circuit

Article excerpt

A lawsuit was brought against an entity that managed the behavioral healthcare component of a preferred provider organization (PPO) plan and one of its case managers for their role in the release of a man from an inpatient mental health care facility. The West Virginia man, eight days after his release, murdered his wife and daughter, injured his son, and then committed suicide. He had been hospitalized following the assault of his wife and his attempted suicide after learning his wife was having an affair with another man. Following four days of inpatient treatment for depression, his treating physician determined the man was neither delusional nor psychotic, no longer posed a risk of harm to himself or others, and could not be held against his will under West Virginia law. Arrangements were made for him to receive outpatient care in his community but scheduled appointments were not kept. The case manager was alleged to be negligent in her (1) monitoring of the outpatient treatment, (2) failure to obtain rehospitalization once noncompliance with outpatient treatment services became apparent, and (3) failure to warn family members who were foreseeable victims of the man's mental illness.

The Fourth Circuit ruled the claims were preempted by the federal Employee Retirement Income Security Act (ERISA) and were properly moved from state court to federal court because the defendants were not engaged as treatment providers, did not make any treatment decisions, and were not involved in the treatment decisions made by the man's physicians. …


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