Superior Court of Pierce County. Superior Court Docket No. 93-6-00221-1, 93-6-00718-3, 24409. Date Filed In Superior Court: May 2, 1994. Superior Court Judge Signing: James Marshall.
Seinfeld, C.j., Houghton, A.c.j., Armstrong, J.
SEINFELD, C.J. -- Three patients at Western State Hospital, J.R., W.B., and G.R., challenge their commitments to an additional 180 days of confinement.*fn1 Each claims the petition for commitment was defective because the psychiatrist signing it was not an "examining" psychiatrist, as that term is used in RCW 71.05.320. We conclude
that a treating doctor who has made frequent, ongoing, and recent observations of the patient can qualify as an "examining" psychiatrist. We further conclude that a trial court, upon determining that a petitioning psychiatrist does not qualify as an "examining" psychiatrist, has the discretion to dismiss a petition for commitment without prejudice.
In 1984, Dr. Mohebat Sabeti, a psychiatrist, and Dr. Donald G. Slone, a psychologist, petitioned to commit J.R., a patient at Western State Hospital, to an additional 180 days of confinement. In their supporting affidavit, they stated that J.R. had been diagnosed with dementia and that the disease impaired J.R.'s cognitive, behavioral, and self care functions. They described J.R. as severely impaired and completely unable to provide for his needs, requiring assistance in feeding, toileting, and grooming. They also said that J.R. exhibited assaultive behavior that would interfere with his placement in an extended care facility.
The same two doctors also petitioned to commit W.B. to an additional 180 days of confinement. W.B.'s diagnosis also was dementia and impaired cognitive functioning. He requires full care to meet his essential daily needs -- feeding, toileting, and grooming. The doctors described W.B. as frequently and unpredictably assaultive towards staff and peers, resistant to care, and verbally abusive. As with J.R., W.B.'s assaultive behavior is incompatible with placement in an extended care facility.
At the hearing on J.R.'s petition, Dr. Slone testified; Dr. Sabeti did not. Dr. Slone stated that Dr. Sabeti's last formal evaluation of J.R. occurred on April 4, 1994, 21 days before Dr. Sabeti signed the petition. Dr. Slone testified that he believed that it was Dr. Sabeti's practice to conduct monthly formal evaluations, supplemented by daily evaluations based on Sabeti's observation of and
contact with the patient during his two daily visits. He opined that because Dr. Sabeti was familiar with J.R.'s condition -- his appearance, hygiene, manner, attitude, orientation, memory, communication ability, volitional control and history of assaultive behavior -- Sabeti could form an accurate diagnosis and make a placement determination.
In W.B.'s case, both doctors testified. Dr. Slone stated that W.B. had refused assessment on numerous occasions. Nonetheless, Dr. Slone had observed W.B., reviewed his chart, and spoken with his treatment team in order to form a diagnosis. Dr. Sabeti testified that he sees each of 27 to 32 patients on the ward twice daily, spending about a total of 15 minutes per day with each one. During this time he assesses the changes, if any, in the patient's behavior and notes any medication changes in the patient's chart. Dr. Sabeti stated that he was aware of W.B.'s appearance, hygiene, manner, attitude, orientation, memory, speech, ability to communicate, thought processes, content disorders, perceptions of reality, judgment, insight, cognitive or volitional control and history of assaultiveness.
In both cases, the court commissioner presiding over the hearing dismissed the petitions because there was no evidence that Dr. Sabeti had conducted a formal mental status examination for purposes of the court proceeding. The State appeals the dismissals.
The third case involves G.R., whose diagnosis is chronic undifferentiated schizophrenia. Dr. Roger Jackson, a psychiatrist, and Dr. George Johnston, a psychologist, jointly petitioned to commit G.R. for an additional 180 days of confinement, and both signed a supporting affidavit confirming the need for the commitment.
G.R. has a history of mental illness and suffers from disorientation, auditory hallucinations, and impaired memory and judgment. He was transferred to Western State Hospital because of his extreme assaultive behavior, and he assaulted staff and peers during his hospitalization.
Physical restraints were necessary to prevent additional assaults. This assaultive behavior prevents him from being a candidate for an extended care facility.
At G.R.'s hearing, both Drs. Johnston and Jackson testified. Dr. Johnston based his diagnosis of schizophrenia on his observations of G.R.'s behavior, review of his clinical records, and evaluation of G.R.'s mental condition. He testified that most of the time G.R. is too psychotic to manage his own behavior ...