## Facts

- Florence A. McGuire, a registered nurse, was hired as a private attendant to care for Dorothy B. Almy, who was mentally ill and under long-term nursing supervision.
- McGuire worked continuous “twenty-four hour duty” and routinely kept Almy locked in her room when not directly supervising her.
- Over approximately fourteen months, Almy experienced episodes of hostility and violence, including threats toward McGuire and property destruction; at times others were needed to subdue her.
- During a violent episode, Almy caused a disturbance in her room and threatened to kill McGuire and a maid if they entered.
- McGuire, the maid, and a relative sought to remove broken items to prevent Almy from harming herself.
- When McGuire approached to disarm Almy—who was holding a raised furniture leg as if to strike—Almy struck McGuire, injuring her.
- McGuire sued in tort for assault and battery.

## Issues

1. Whether an insane person is liable for battery when the evidence permits a finding that she intended the physical act of striking, even if her mental illness affected her understanding or motivation.
2. Whether, as a matter of law, a nurse caring for a mentally ill patient with known violent tendencies assumes the risk of being assaulted, barring recovery for battery.

## Decision

- The Supreme Judicial Court of Massachusetts affirmed judgment for McGuire on a jury verdict.
- The court held that an insane person is liable for intentional torts where she intentionally performs the harmful physical act under circumstances that would create liability for a sane person.
- The evidence permitted a jury finding that Almy was capable of forming, and did form, an intent to strike and injure McGuire, and acted on that intent.
- The court held that McGuire’s knowledge of Almy’s condition did not require a directed verdict on assumption of risk; the jury could find McGuire had not voluntarily accepted the specific risk of this assault while attempting to disarm Almy.

## Legal Principles

- An insane person who intentionally causes harmful or offensive contact is liable for battery in the same circumstances as a sane person if she intended the physical act that produced the contact.
- In determining intent for battery, the law does not further examine the actor’s particular delusions or mental abnormalities to excuse the conduct once intent to do the act is found.
- A caregiver’s general awareness that a patient may become violent does not, by itself, establish assumption of risk as a matter of law; whether the caregiver voluntarily accepted the specific risk of the assault is ordinarily for the factfinder.

## Conclusion

The court upheld liability for battery because the jury could find that the mentally ill defendant intended and carried out the act of striking, and it rejected a categorical rule that a nurse caring for a violent patient necessarily assumes the risk of being assaulted.


McGuire v. Almy, 297 Mass. 323, 8 N.E.2d 760 (Mass. 1937)