ABSTRACT
Hospitals have a duty to prevent incapacitated patients from hurting themselves. In 2011, James Spearman, a 47-year-old man lacking capacity was briefly left unattended in an emergency department. He tried to leave. Passing through an unsecured door he ascended five flights of stairs onto a flat roof and fell to the courtyard below. Following his fall into the courtyard, he can no longer live independently, needing assistance with all aspects of daily living. The court found that the hospital should have provided direct nursing supervision of this confused patient, and restricted his movements by locking doors. The ‘lowest common denominator’ of the hospital's duty was to take reasonable steps to provide for the safety of vulnerable patients with a mental disorder. Failure to control access to the flat roof was singled out by the judge as a reasonably foreseeable cause of an otherwise avoidable accident.
