## Facts

- Robert and Alice Hamman brought Alice’s adult son, John Carter, to a county hospital psychiatric emergency center due to strange and alarming behavior.
- Carter had a history of serious mental illness and prior psychiatric hospitalization marked by noncompliance and need for seclusion and restraint.
- The psychiatrist on duty, Dr. Manuel Suguitan, conducted a brief interview of Carter and did not review Carter’s prior hospital records.
- Viewing the record favorably to the Hammans (summary judgment posture), Mrs. Hamman reported to the psychiatrist incidents of abnormal and sometimes violent behavior, including Carter possessing photos of decapitated animals.
- The Hammans expressed fear that Carter “would either be killed or kill somebody” and stated they never turned their backs on him.
- Dr. Suguitan declined to admit Carter, released him with a prescription, and allegedly assured the Hammans that Carter was “harmless,” without a structured outpatient plan or detailed safety instructions.
- About two days later, Carter severely beat Robert Hamman at home, causing a heart attack and severe brain damage.
- The Hammans sued the county and Dr. Suguitan for negligent diagnosis and treatment, failure to admit or otherwise control Carter, and negligent assurances of harmlessness.

## Issues

1. Whether a psychiatrist owes a duty of reasonable care to protect foreseeable third persons from a patient’s violent acts even absent a specific threat against an identifiable victim.
2. Whether liability may be based on family members’ reasonable reliance on a psychiatrist’s assurance that a patient is “harmless.”
3. Whether summary judgment was proper given disputes about foreseeability, standard of care, and causation in the risk assessment and discharge decision.

## Decision

- The Arizona Supreme Court reversed summary judgment for the defendants and remanded.
- The court rejected a rule limiting duty to situations involving a patient’s specific threat to a specific identifiable victim.
- The court held that a psychiatrist may owe a duty of reasonable care to protect foreseeable victims of a patient’s violent propensities, including those in close proximity such as family members.
- The court allowed the Hammans to proceed on both (a) a duty-to-protect theory grounded in foreseeability and (b) a theory based on reliance on the psychiatrist’s assurance of harmlessness.
- The court concluded that the existence and breach of duty could not be resolved as a matter of law on this record and required factfinding.

## Legal Principles

- A psychiatrist’s duty to third parties is defined by foreseeable risk arising from the psychiatrist–patient relationship and the information known or reasonably knowable through professional care.
- The duty to protect third persons from a patient’s violence is not confined to cases where the patient communicates a specific threat against a specifically identified victim.
- Foreseeability may be established by the patient’s history, present symptoms, communicated family concerns, and the circumstances placing certain persons (such as household members) at risk.
- Whether the professional standard of care required additional evaluation, review of records, hospitalization, warnings, or other protective steps is generally a fact question commonly informed by expert testimony.
- A psychiatrist’s affirmative assurance that a patient is “harmless” may support liability when negligently made and reasonably relied upon by persons foreseeably exposed to the risk.

## Conclusion

The court held that mental health professionals may owe a duty to protect foreseeable third parties from a patient’s violent conduct even without a specific articulated threat to an identifiable victim, and it reinstated claims based on both foreseeable-risk duty and reliance on assurances, requiring further proceedings on breach and causation.


Hamman v. County of Maricopa, 161 Ariz. 58, 775 P.2d 1122 (Ariz. 1989)