## Facts

- Elizabeth M. Von Linden had a long history of depression, including at least two prior suicide attempts.
- After a later suicide attempt, her husband brought her to Mercy’s emergency department; she was admitted to Mercy Hospital’s psychiatric unit and later discharged after a short inpatient stay.
- Approximately two weeks after discharge, Von Linden had an outpatient visit with a Mercy psychiatrist.
- About one week after the outpatient visit (three weeks after discharge), Von Linden died by suicide at home.
- Todd A. Mulhern, individually and as representative of Von Linden’s estate, sued Mercy for wrongful death, alleging negligent psychiatric diagnosis, treatment, and discharge proximately caused the suicide.
- Mercy asserted comparative fault, contending Von Linden’s own conduct, including suicide, constituted fault to be compared with Mercy’s alleged negligence.
- A jury found both Mercy and Von Linden negligent, allocated 90% fault to Von Linden and 10% to Mercy, and returned a defense verdict under Iowa’s modified comparative fault rule barring recovery when claimant fault exceeds 50%.
- The district court denied Mulhern’s motion for new trial challenging the comparative-fault submission and related instructions.

## Issues

1. Whether Iowa Code chapter 668 permits a jury to compare the fault of a noncustodial suicide victim with the negligence of mental health professionals treating her.
2. Whether the district court committed reversible error by instructing the jury on comparative fault in a manner allowing apportionment of fault to the decedent based on suicide.

## Decision

- The Iowa Supreme Court affirmed the judgment for Mercy.
- The court held that, as an outpatient, Von Linden owed a duty of self-care and her suicide could be considered “fault” within Iowa Code chapter 668.
- The court found no reversible error in submitting comparative fault and related instructions to the jury.

## Legal Principles

- Iowa Code chapter 668 defines “fault” broadly to include negligent or reckless acts or omissions “toward the actor,” allowing consideration of a party’s self-harming conduct when it reflects a breach of ordinary care for self-protection.
- A noncustodial mental-health patient receiving outpatient care may owe a duty of self-care; breach of that duty may be compared with a provider’s negligence under Iowa comparative fault law.
- When comparative fault is properly submitted, the jury determines the respective percentages of fault; under Iowa’s modified system, recovery is barred if the claimant’s fault exceeds 50%.
- Jury instructions are not reversible error if, viewed as a whole, they fairly submit the governing law on duty, fault, and causation and permit apportionment consistent with chapter 668.

## Conclusion

The court upheld a defense verdict in a psychiatric-malpractice wrongful-death action by ruling that an outpatient’s suicide can constitute comparative fault under Iowa’s Comparative Fault Act, permitting the jury to apportion responsibility between the patient and the treating provider and barring recovery when the patient’s fault exceeds 50%.


Mulhern v. Catholic Health Initiatives, 799 N.W.2d 104 (Iowa 2011)