Assessing the Violent Patient: An Additional Case of Legal Implications

(To read the full article, "Assessing Violence in Patients: Legal Implications," please see p22 in the January issue of Psychiatric Times--Ed.)

Lindsey v United States of America (693 F. Supp. 1012 [U.S. Dist. 1988]) concerned a woman stabbed by an acutely psychotic, paranoid patient with schizophrenia who had a long history of mental treatment by the U.S. Department of Veterans Affairs (VA). Eight years earlier, the patient had stabbed his mother, attempted to rape her and later attempted suicide by slashing his own wrists. Lindsey, the stabbing victim, had been a friend of the family for years, and the patient had always been pleasant and friendly to her. Several weeks before the stabbing, the patient had tried to shoot another woman, but the gun did not fire due to its clip having been improperly loaded into said gun. Lindsey knew about this attack, yet still chose to visit the patient alone on four occasions. (The patient's physician had no knowledge of this prior attack.) On Lindsey's last visit, the patient stabbed her multiple times in the chest, breasts, abdomen and legs.

Lindsey sued the United States, alleging a failure of duty to protect on the part of the VA. The court decided, "It is impossible to predict future behavior in paranoid schizophrenics because their behavior may completely change in a matter of minutes" and therefore found in favor of the defense.