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A New York state psychiatric hospital has been held liable under civil law for a homicide committed by an escaped patient. In an unusual finding of liability, a New York Court of Claims judge held that while the hospital could not be held responsible for medical malpractice in a case where it declared that a man who had killed his nephew was not dangerous, it can be held accountable for failing to notify the family that the patient had subsequently escaped. The patient returned to the family home after the escape and killed his wheelchair-bound father. Judge S. Michael Nadel of Manhattan, in Frazier v. State, 87812, said the Bronx Psychiatric Center was negligent because it failed to notify Ghana Frazier’s family of his escape, as required under 14 NYCRR 541.12. Damages will be assessed following a separate trial. The decision arises out of a series of tragedies involving Frazier, a chronic paranoid schizophrenic who threw his 18-month-old nephew out a fifth floor window in 1981. Following a verdict of not responsible due to mental disease or defect, Frazier was committed to the Mid-Hudson Psychiatric Center, a secure facility, on June 24, 1983. More than three years later, Frazier was declared mentally ill but not dangerous, and was transferred to the non-secure Bronx Psychiatric Center. Frazier escaped from the Bronx facility in January 1988 and remained at large for approximately one year. He was later captured at the home of his sister, after making death threats to various family members, and returned in January 1989 to the non-secure psychiatric hospital. Within nine months, Frazier was granted the privilege of roaming the grounds without an escort. Over the next two years, Frazier was involved in several assaults on other patients, threatened the staff and attempted to escape. 1991 ESCAPE In August 1991, Frazier successfully escaped and appeared unexpectedly at his family’s home in Brooklyn. With his sister and her three young children watching, Frazier stabbed his father to death with a 12-inch butcher knife. This lawsuit, alleging medical malpractice and common law negligence, was filed on behalf of the estate and the children who witnessed the murder of Lemuel Frazier Sr. The malpractice claim was predicated on the allegation that the State neglected to confine Frazier in a secure facility and deviated from accepted standards of psychiatric care by granting unescorted grounds privileges to a patient with a history of assaults and escape. On the common law negligence, two theories were advanced: inappropriate security and failure to notify. Judge Nadel dismissed the malpractice component out of hand. He found that the decision to transfer Frazier to a non-secure facility and the decisions regarding the level of supervision were based on professional medical judgment � and “no evidence was offered to establish that the medical judgment was not based upon an intelligent and careful determination.” The court also found no liability on the negligence claim of inadequate security. Judge Nadel noted that there is no rule or regulation that requires the Bronx Psychiatric Center to be secure, and observed that Frazier “did not evade a faulty security system but rather simply walked out one of the entrances to the facility in order to effectuate his escape.” Consequently, the judge found, the matter is rooted not in a breach of security, but in the level of supervision, which he had already found was based on an intelligent medical evaluation. FAILURE TO NOTIFY But Judge Nadel did find liability on the failure to notify. Evidence showed that the Bronx Psychiatric Center made an unsuccessful effort to notify the family, which had moved since Frazier’s initial confinement. However, given the fact that authorities had found Frazier at the family’s new home after a prior escape, they should have known how to contact the family, and should have done so, Judge Nadel said. “The consequences of the defendant’s failure to notify the family cannot be considered as remote, but rather were eminently foreseeable, based on Ghana Frazier’s assaultive history, his prior escape and attempt to escape, his violent history with family members, and his apprehension at his family’s home on his prior escape,” Judge Nadel wrote. The attorney for the claimants, Michael B. Parson of Manhattan, disagreed with the court on the malpractice claim. “This was absolutely preventable,” Parson said. “There is no question in my mind that this was malpractice. They never, ever should have kept him in that facility.” Parson said Ghana Frazier died of natural causes earlier this year. The State was defended by Assistant Attorney General Victor J. D’Angelo.

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