A law granting immunity to health care providers who treat mental illness should not have been applied to two emergency room doctors who treated a man while he was suffering from an opioid addiction, the Pennsylvania Superior Court has ruled.

A three-judge Superior Court panel determined that two doctors who treated a man transferred from a drug treatment facility should not have been afforded liability protections under the Mental Health Procedures Act. The ruling reversed a decision by the Chester County Court of Common Pleas, but affirmed the lower court’s additional holding that the drug treatment facility should be granted immunity under the MHPA.

The emergency room doctors, James Duncklee and Jennifer Plumb, contended the patient, Andrew Johnson, was suffering from both physical and mental illness, and therefore their treatment should be immune from suit under the MHPA. However, Judge Jack Panella, who wrote the Superior Court’s precedential opinion in Dean v. Bowling Green-Brandywine CRC Health Group, said the act should apply only to treatment Johnson received after he was seen by a psychiatrist at the facility. Although the drug treatment facility provided Johnson care after that point, neither Duncklee, nor Plumb, treated Johnson after he’d been seen by a psychiatrist.

“At the time Dr. Duncklee saw Johnson, there is no evidence that Brandywine or any other medical facility or professional was currently treating him for mental health issues,” Panella said. “Nor is there any evidence that Dr. Duncklee was even aware of Johnson’s psychiatric history.”

Panella, however, acknowledged that the doctors’ argument presented a “novel” issue for the court, and he further said the panel was “troubled” that alcoholism and drug dependency are not included in the current definition of mental illness.

“In light of current scientific research, as well as the recent addition of ‘addiction disorders’ to the American Psychiatric Association’s Diagnostic and Statistic Manual V, we suggest that the Department of Human Services revise this definition,” he said in a footnote.

Attorney Michael McGilvery of Young & McGilvery, who represented Duncklee, said Johnson exhibited bizarre behavior, and his client provided both medical and mental treatment. However, he said he does not plan to appeal.

“We’ll go back and try the case a second time,” he said.

According to Panella, when Johnson was 23 he voluntarily applied to be admitted to the Bowling Green Brandywine Treatment Center to treat his addiction to opiates and benzodiazepines that he had initially been prescribed to treat injuries related to an ATV accident. He made two trips to the emergency room during his stay after he allegedly began hallucinating. Ten days after he was admitted to the facility, he was found unresponsive on the floor of his room. He died soon after.

Johnson’s parents sued Plumb, Duncklee and their practice, as well as the treatment facility, the psychiatrist who treated him and the drug facility’s doctor, who eventually referred Johnson to the psychiatrist. The case went to trial, but the judge eventually granted nonsuit, finding that the plaintiffs failed to show that any of the defendants had been grossly negligent.

According to Panella, in deciding to apply MHPA immunity, the trial court noted that the intake forms said Johnson had a “current mental health diagnosis” of “bipolar, ADHD.” The court also noted that Johnson had to be transferred to the emergency room after hallucinating.

Panella, however, said the intake forms “cut both ways,” and noted that they also said Johnson was neither taking any medications for his mental illness, nor seeing a psychiatrist. The forms also said the reason for his admission to the facility to treat his drug addiction.

Panella agreed with the trial court that the psychiatrist should be immune under the law, and ultimately determined that the facility and the facility’s doctor also both provided treatment that, in part, dealt with Johnson’s mental health and therefore were entitled to protection under the law.

Patrick Mintzer of Buckley, Brion, McGuire & Morris, who represented the plaintiffs; Gary Samms of Obermayer Rebmann Maxwell & Hippel, who represented Plumb and the medical practice; and Daniel Rucket of Rawle & Henderson, who represented Bowling Green, each did not return a call seeking comment.