## Facts

- Elizabeth H. Shin was an MIT undergraduate living in an MIT dormitory.
- MIT provided student health and mental-health services through MIT Medical Services and distributed materials describing available physical and mental-health services.
- In February 1999, Shin was hospitalized after an overdose and received inpatient psychiatric treatment; she disclosed a history of mental-health problems and self-harm.
- After discharge, Shin received outpatient mental-health treatment at MIT for about 15 months, including psychiatric medication and at least one period of observation in the MIT infirmary.
- MIT clinicians, administrators, and others received reports over time of suicidal statements, gestures, and self-harm, including worsening concerns shortly before her death.
- Shin died by suicide in her dorm room on April 10, 2000.
- Shin’s parents, individually and as estate administrators, sued MIT, MIT clinicians, and MIT administrators for wrongful death and related claims, including negligence, medical malpractice, breach of contract, and Mass. Gen. Laws ch. 93A violations.
- Defendants moved for summary judgment on multiple counts; the court resolved those motions in a memorandum and order.

## Issues

1. Whether MIT’s informational descriptions of available student medical and mental-health services created enforceable contractual obligations to provide care at a particular level of adequacy.
2. Whether a nonprofit university providing student medical and psychiatric services is engaged in “trade or commerce” under Mass. Gen. Laws ch. 93A for purposes of liability based on alleged inadequacies in those services.
3. Whether psychiatrists who were not the primary treating physicians at the time of death, but who participated in ongoing reviews or supervision, had a physician–patient relationship sufficient to owe a duty of care.
4. Whether university administrators with knowledge of a student’s serious suicide risk could have a “special relationship” giving rise to a duty to take reasonable steps to prevent suicide.

## Decision

- The court granted summary judgment for MIT on the contract-based counts, holding that generalized descriptions of services did not create contractual obligations to provide medical care at a particular standard.
- The court granted summary judgment for MIT on the ch. 93A counts, holding that MIT, as a nonprofit university, was not engaged in “trade or commerce” when providing student medical services incidental to its educational mission.
- The court denied summary judgment for several psychiatrists on principal negligence/malpractice claims where evidence could support a finding of a physician–patient relationship and potential breach of the standard of care.
- The court granted summary judgment in part and denied it in part as to another psychiatrist, allowing certain negligence/malpractice counts to proceed based on triable issues.
- The court granted summary judgment for certain administrators on some counts but denied it on negligence-based counts, concluding a fact-finder could determine a special relationship and a corresponding duty to take reasonable preventive measures.

## Legal Principles

- General, informational descriptions of university-provided health or mental-health services typically do not constitute specific contractual promises enforceable as a contract to provide “adequate” medical treatment.
- A nonprofit university’s provision of student medical and psychiatric services, when incidental to its educational mission, may fall outside “trade or commerce” under Mass. Gen. Laws ch. 93A.
- A physician–patient relationship, and resulting duty of care, can arise from continued involvement in treatment planning or review, even without contemporaneous one-on-one treatment at the time of injury.
- A “special relationship” between university officials and a student may support a duty to take reasonable steps to protect against foreseeable self-harm; foreseeability and the relationship’s scope can present fact questions not suitable for resolution as a matter of law on summary judgment.

## Conclusion

The court rejected attempts to recast student mental-health services as contractual promises or consumer transactions under ch. 93A, but allowed negligence and malpractice claims to proceed where evidence could support a duty arising from clinician involvement in care and from administrators’ alleged special relationship with a student facing a foreseeable risk of suicide.


Shin v. Mass. Inst. of Tech., 19 Mass. L. Rptr. 570 (Mass. Super. Ct. 2005)