Leaving Against Medical Advice: Possible Negligence Does Not Negate Good Faith Immunity

March 2, 2016 | Strategic Insights for Health System


A hospital acted in good faith in discharging a patient who insisted on leaving against medical advice and thus the facility was entitled to state statutory immunity from liability, concluded the Supreme Court of South Dakota.

Facts that suggest negligence do not negate providers' opportunity to claim good faith immunity under the state immunity statute, the court stated, explaining that "negligence and lack of good faith are not equivalent" in affirming summary judgment on behalf of the hospital. The patient had insisted on being discharged against medical advice and later sued for alleged damages sustained when he subsequently overdosed on medications and alcohol and assaulted his neighbors. The patient, whose medical history included HIV disease, depression, anxiety, and multiple suicide attempts, presented to the emergency department (ED) of the defendant hospital after being struck in the head and throat during an altercation. When his throat pain increased, he was intubated, sedated, and admitted to the intensive care unit. After eight hours of intubation, during which a bronchoscopy confirmed that his airway was not compromised, he was extubated and sedatives were discontinued. Approximately two hours later, the patient allegedly began to ask his nurse about discharge...

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