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05/20/93 MICHAEL MYRICK

May 20, 1993

IN RE: MICHAEL MYRICK


Appeal from the Superior Court of the District of Columbia; (Hon. Samuel B. Block, Trial Judge)

Before Ferren, Associate Judge, and Newman* and Mack,** Senior Judges. Opinion for the court by Associate Judge Ferren. Concurring opinion by Senior Judge Mack. Dissenting opinion by Senior Judge Newman.

The opinion of the court was delivered by: Ferren

FERREN, Associate Judge : In December 1984, the trial court ordered the involuntary civil commitment of Michael Myrick at Saint Elizabeths Hospital pursuant to D.C. Code § 21-545 (1989). *fn1 The court concluded that Myrick suffered from a mental illness and consequently was likely to injure himself if allowed to remain at liberty. See id. A month later, the court decided that Saint Elizabeths could not meet Myrick's treatment needs and that the only facility capable of doing so was the Brown School's Ranch Treatment Center in Austin, Texas. The court ordered the District of Columbia to arrange for Myrick's placement at the Brown School and to bear the costs of his treatment. The District appealed the court's order on the ground that the District is not liable for the costs of Myrick's care. The District further contended that, even if it must bear the costs of caring for Myrick, the court had no authority to order his placement at a facility outside the District.

After oral argument, we ordered the parties to file supplementary briefs addressing two questions: (1) whether the case was affected by the opinion and order of Judge von Kann in In re D.W.G., 115 Daily Wash. L. Rptr. 2097 (D.C. Super. Ct. June 26, 1987), and (2) whether the case was moot. Judge von Kann's order in D.W.C. made factual findings severely critical of the Brown School, pointing out serious problems concerning misdiagnosis and mistreatment of patients occurring at the facility, but, having no reason to do so, did not specifically address Myrick's placement there. In their briefs the parties agreed that Judge von Kann's opinion and order in D.W.C. had no effect on the question of the costs of Myrick's care and that accordingly the case was not moot.

Myrick's counsel, however, suggested a remand of the record for the trial court to reconsider its Disposition order placing Myrick at the Brown School. On May 26, 1988, we sent the case back to the trial court for that purpose. We further ordered the District to show cause why it had not sought reimbursement for Myrick's care from the federal government as Judge Block had ordered it to do in 1987.

More than three years passed before an order issued from the Superior Court, on September 16, 1991, informing us of a hearing in the matter. At that hearing before Judge Hess, both parties indicated that, "because the Brown School is not a long-term care facility and [Myrick had] received the maximum benefits which the School has to offer," Myrick would soon be moved from the Brown School. The order further indicated that the District had referred the matter of federal government reimbursement for Myrick's treatment to the Property and Collections Division of the D.C. Department of Human Resources, where the matter was pending.

On October 25, 1991, we ordered the parties to show cause why, in light of the intention to transfer Myrick from the Brown School, the case should not be dismissed as moot. Although Myrick's counsel did not object to dismissal on that ground, the District pointed out that, because Myrick was still at the Brown School and because District taxpayers had borne, and would continue to bear, the costs of Myrick's treatment in whatever facility he was placed, the District's appeal of the trial court's original order imposing those costs on the District was not moot. Concluding that cause had been shown as to why the case should not be dismissed as moot, on January 8, 1992, we ordered the parties to file supplemental briefs, since the original briefs in the case had been filed in 1986.

The parties responded with updated briefs. According to the brief for Myrick filed April 3, 1992, Myrick is still at the Brown School, a fact reenforcing our earlier ruling that this case is not moot. For the reasons that follow, we affirm the trial court's original order imposing the costs of Myrick's care on the District of Columbia.

I.

Until May 1983, then 20-year-old Michael Myrick lived with his mother, a German national, and with his father, who was a noncommissioned officer in the United States Army stationed in what was then the Federal Republic of Germany. Myrick went into a coma in May 1983 and was admitted to an American military hospital in West Germany. On the advice of his physicians, Myrick's parents consented to have their son flown to Washington and admitted to Walter Reed Army Medical Center. Soon after his admission into Walter Reed, his doctors transferred Myrick to Saint Elizabeths Hospital. Myrick was committed to Saint Elizabeths' care under the emergency hospitalization provisions of D.C. Code §§ 21-521 through -528 (1989 & 1992 Supp.). On July 1, 1983, acting on the petition of the Superintendent of Saint Elizabeths, the Superior Court extended Myrick's emergency commitment for an additional seven days pursuant to D.C. Code § 21-523. A week later, the Superintendent petitioned the court to begin proceedings for Myrick's indefinite involuntary commitment under D.C. Code §§ 21-541 through -551 (1989).

While the civil commitment proceedings were pending, Myrick remained at Saint Elizabeths. Myrick had been diagnosed initially as suffering from a psychiatric condition. Upon suspicion that Myrick's condition was actually neurological rather than psychiatric, the staff at Saint Elizabeths transferred Myrick, with his father's consent, to the William A. White Program, located on the campus of Saint Elizabeths but in fact a separate division of the National Institutes of Mental Health. *fn2 The purpose of Myrick's transfer was to allow the staff of the White Program to conduct a battery of highly sophisticated neurological tests in order to make a precise diagnosis and an informed recommendation concerning Myrick's future care. The staff of the White Program concluded, after several months of testing, that Myrick was the victim of an extremely rare herpes encephalitis which resulted in brain trauma not unlike the sort associated with strokes, car accidents, or gunshot wounds. In addition, Myrick had suffered hearing impairment as a result of his illness. Because his neurological condition was unlikely to be improved by any psychiatric treatment provided by Saint Elizabeths, the staff recommended that Myrick be placed in a rehabilitative program at the Ranch Treatment Center of the Brown School in Austin, Texas.

In the meantime, the Commission on Mental Health had been conducting periodic examinations of Myrick pursuant to the requirements of D.C. Code § 21-542. Between July 1983 and November 1984, the Commission held a number of hearings and issued several reports on Myrick's condition. In its final report, the Commission concluded that because of severe mental illness, Myrick would be a danger to himself if not hospitalized but that Saint Elizabeths could not "adequately treat" him. The Commission recommended that Myrick be transferred to the Ranch Treatment Center of the Brown School, which the Commission found capable of providing for his care and rehabilitation. The Commission recommended that the District of Columbia bear the costs of Myrick's treatment at the Brown School.

After receiving the Commission's report, the trial court held hearings to determine whether Myrick should be committed for an indefinite period and what conditions should govern such commitment, according to the standards set forth in D.C. Code ยง 21-545. The court ordered Myrick hospitalized, finding that he would be a danger to himself if he were at liberty. In its final order of January 28, 1985, having concluded that it had the statutory authority to order Myrick to be hospitalized at a facility other than Saint Elizabeths if another placement would serve the best interests of the patient and the public, the court ordered the District of Columbia to arrange for Myrick's transfer to the Brown School. The court ordered the District to bear ...


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