Combative Alzheimer’s Patient Not Liable for Injuries to Nurse

APRIL 19, 2004 VOLUME 11, NUMBER 42

Edmund Gernannt suffered from dementia of the Alzheimer’s type. Confusion and agitation sometimes combined in Mr. Gernannt to make him combative. While most Alzheimer’s patients can be easily redirected and ultimately calmed, Mr. Gernannt’s aggressive tendencies got him committed to the county hospital in Bergen Pines, New Jersey. It was there that he assaulted one of the facility’s nurses.

Mary Berberian, the head nurse on the long-term care ward of the geriatric psychiatric hospital, was on duty on November 11, 1997. She had over twenty years of experience working with demented patients, and she knew Mr. Gernannt’s tendency to lash out at staff members. When Mr. Gernannt pushed open the fire escape door and set off an alarm, she rushed to head him off and return him to the unit.

Another nurse was also on the scene, but Mr. Gernannt began hitting her when she tried to escort him back to the unit. Ms. Berberian then extended her hand to try to coax Mr. Gernannt back into his room, but he responded by first pulling her forward, then shoving her back. As a result, the nurse fell and broke her hip.

Ms. Berberian sued Mr. Gernannt for her injuries. She also named Mr. Gernannt’s guardian, alleging that the guardian should not have authorized transfer of Mr. Gernannt to the unit without physical restraints, and the physician in charge of Mr. Gernannt’s care.

The trial court dismissed the lawsuits against the guardian and the physician, but the jury considered whether Mr. Gernannt’s estate (he died before trial) should pay Ms. Berberian’s damages. The court instructed the jury that it could find the estate liable only if it decided that Mr. Gernannt’s behavior fell below the standard that might be expected of a “reasonably prudent person who has Alzheimer’s dementia.”

The jury found that Mr. Gernannt’s estate should not be liable for damages, and Nurse Berberian appealed. The first appellate court agreed that the trial judge had set the correct standard for the jury to apply, and so the nurse appealed again.

The New Jersey Supreme Court agreed that Ms. Berberian should not recover from Mr. Gernannt’s estate, but on a different theory. According to the state’s highest court Mr. Gernannt owed no duty of care to the professionals assigned to care for him. That result was mandated, said the justices, by the very fact that Mr. Gernannt was involuntarily committed to a treatment facility because of his well-known combative tendencies. Nurse Berberian accepted the risk of injury by choosing her profession, not unlike a fireman’s choice to work in a hazardous field. Berberian v. Gernannt, April 6, 2004.

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