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McCord v. Delray Medical Center Inc.

Dr. Lawson Bernstein Testifies Concerning Treatment of Rehab Patient That Ultimately Committed Suicide

The Expert: Dr. Lawson Bernstein, a psychiatrist testifying for the plaintiff and concluding defendants failed to meet their standard of care, and notably failed to recognize red flags that indicated the patient was a suicide risk.

By Dr. Gary F. Gansar, MD, FACS
Senior Physician Medical Director, AMFS

Dr. Lawson Bernstein, a psychiatrist, testifies in a 2014 Florida medical malpractice trial in which plaintiffs claimed that the defendant medical professionals did not properly supervise a rehab patient who ultimately committed suicide.

Bernstein reviews a long list of “Risk Factors for Suicide” to determine which of these factors were applicable in this case. He explains each as he goes along. The decedent in this case had three fourths of these risk factors, many of which were truly “red flags” that should indicate a particularly unsettling warning to those caring for the patient.

  1. The patient was impulsive or had a propensity to act before thinking.
  2. He was experiencing loss because his wife was threatening to leave him.
  3. He had experienced physical illness because he had developed difficulty in using his arms as a consequence of his drug use. Even though the reason for this disability was never discovered, the decedent was convinced that this was real.
  4. As with other end stage drug abusers, his whole world “falls away” leaving him feeling isolated.
  5. He had attempted suicide previously as a teenager.
  6. Clinical depression or other evidence of other mental disorder is considered a substantial risk factor in this case.
  7. He had a history of substance abuse withdrawal.
  8. He had access to lethal methods to harm himself.
  9. His family history of suicide was positive.
  10. Males are more likely to commit suicide, as are Caucasians.

The expert considers these findings to be “red flags” that the patient was at high risk for suicide.

When the patient was seen by the director of the rehab facility the following day, he spent only 15 minutes evaluating, and did not even leave a written or dictated note regarding the patient in his file. The physician’s assistant did write a note, but Bernstein says that the standard of care would have demanded that the defendant spend more than 15 minutes interviewing and evaluating the patient. It would demand that he cosign the PA note and demand that the physician add his own assessment to the PA’s, as his is a more qualified and knowledgeable opinion. None of this was done.

When the expert reviewed the defendant’s deposition testimony, he noted that it became apparent that this doctor was unaware of some of these major risk factors for suicide, factors that he feels “any third year medical student” would be aware of. “You just can’t” take care of these types of patients and “not know this like your own name,” the expert concludes.

The plaintiff’s psychiatric expert was very effective and the case resulted in a settlement.

About the Author Dr. Gary F. Gansar, MD, FACS

Gary Gansar, MD, is residency-trained in general surgery. He served as Chief of Surgery and Staff at Elmwood Medical Center and on the Medical Executive Committee at Touro Infirmary and Mercy Hospital in New Orleans, LA. Dr. Gansar was Board Certified in general surgery while in active practice. He joined AMFS in 2015 as a Physician Medical Director.

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