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November 21, 1969

Miriam WINTERS, on behalf of herself and all other persons similarly situated, Plaintiff,
Alan D. MILLER, M.D., as Commissioner of Mental Hygiene of the State of New York; Alexander Thomas, M.D., as Director of the Psychiatric Division, Bellevue Hospital Center; Francis J. O'Neill, M.D., as Director of Central Islip State Hospital; and doctors on the staffs of Bellevue Hospital and Central Islip State Hospital whose names are unknown to plaintiff, Defendants

The opinion of the court was delivered by: TRAVIA

TRAVIA, District Judge.

 At the outset, the Court must commend the attorneys representing the parties for their very fine moving and opposing papers, their thorough briefs and their articulate presentation of the facts and law on the oral arguments.

 The facts surrounding this action are thoroughly and with particularity set forth in the papers on file but for the purpose of this memorandum of decision the Court shall set forth those facts which seem to bear more importantly on the issues raised in this case.

 At about 4:00 o'clock P.M. on May 2, 1968, the plaintiff, Miriam Winters, was taken from her room in the King Edward Hotel to Bellevue Hospital, both in New York, New York, on the authority of New York City Police officers, one of whom apparently came from the 18th Precinct and had Badge No. 14010. The "Ambulance Call Report" of the Department of Hospitals indicates that the call was on an emergency basis by police radio.

 Prior to her removal, Miss Winters had been on welfare for about ten years, and had only worked for a short period during her lifetime. She was taught at home for ten years until she was eighteen years old. Both her parents are deceased. Her father was a medical doctor in his lifetime. She is now 59 years old. There is some indication in the record that plaintiff had a previous history of psychiatric treatment at Kings County Hospital.

 On March 21, 1968, before the occurrence of the incidents which are the basis of this case, Dr. Robert Reich, Psychiatric Consultant to the Department of Welfare, Wyckoff Welfare Center, wrote a letter to the Admitting Psychiatrist of Kings County Hospital, the body of which is as follows:

"Miss Miriam Winters of 55 Pierrepont Street, is a 58 year old woman, who is continuing to be disruptive in her hotel. She plays the radio all night and guards the public bathroom claiming it is her own. She has not washed in five years and her appearance is totally dirty and dishevelled. She has been unable to leave her room for some years and the hotel has been sending food to her room. She has refused medical help of any kind. She has been sending letters to the Mayor's Committee demanding a room with a bath, but despite attempts by the department to help her move, she has been unable to leave the hotel room or to clean herself up so that she could be acceptable in a public hotel. There are no relatives who can help her and we feel that in her present condition she is a danger to herself in that if no food is brought to her she will starve, as well as her argumentative behavior and the guarding of the bathroom make it utterly impossible to live with others.
I would, therefore, recommend that she be sent to Kings County Hospital for evaluation and treatment of this chronic problem which has grown worse over the years."

 Some time after Dr. Reich wrote this letter, plaintiff did move from where she had been living to the King Edward Hotel in Manhattan.

 The events leading to the summoning of the police and the calling of the ambulance by the police are not entirely clear from the record. However, plaintiff's allegations that, on May 1 or May 2, 1968, the welfare case worker, a Mr. Karren (or Caron) and the hotel management sought, and failed, to have plaintiff change her room, and then sought the aid of the police, appear uncontradicted. Plaintiff claims that when the police arrived, they failed to give her sufficient identification or to state their reasons for seeking access to her apartment; that she then excluded them; that the room was then forcibly entered; and that plaintiff was taken to the hospital against her will.

 No challenge is made to the legality of the commitment, and it appears to have complied with the New York Mental Hygiene Law, McKinney's Consol. Laws, c. 27, § 78(1) and (3).

 Plaintiff claims that for at least ten years before her commitment, she had been a student and follower of the Christian Science religion. Followers of Christian Science hold that they should not submit themselves to medical treatment of a physical nature though psychological treatment is acceptable.

 Upon her admission to Bellevue, plaintiff alleges, she informed the doctors who treated or spoke to her that she was a Christian Scientist. Dr. H. Blankfeld noted at that time that plaintiff refused to undergo a physical examination. He quoted her as saying, "I am a Christian Scientist and prefer you wouldn't." Notations to this effect appear at several points in the records kept by the hospital, indicating that the hospital should have been aware of plaintiff's claimed beliefs. Central Islip State Hospital, to which plaintiff was transferred on May 13, 1968, pursuant to Mental Hygiene Law § 72, as well as that hospital's doctors, were similarly aware of her claimed beliefs.

 On the "Clinical Summary" sheet at Central Islip State Hospital appears a "Summary of First Admission" in which Dr. Christine Jordan reported that:

"Patient states to be religious but does not go to church. She is of the Protestant faith. 'I am an independant (sic) Christian scientist.'"

 Plaintiff contends, although contested by defendants, that at both Bellevue and Central Islip, against her will, she was given injections of tranquilizers and also against her stated objections, she was given, and she took, various oral medications. She also states that these were taken contrary to her religious beliefs. On several occasions, plaintiff refused oral medication. A note on a hospital form at Central Islip for May 13 indicates that plaintiff was:

"Demanding - refused p.o. meds [oral medication]; Unco-operative [at] times - transfered (sic) 101
F. Urban."

 Later the same evening, plaintiff was found to be more cooperative, though subsequently she again refused the oral medication.

 A Social Service Record Activity Summary by M. Koster, PSW Trainee II, reported, on May 17, 1968:

"Also indignant due to the fact that she is a Christian Scientist and is being forced to take medication. She is constantly berating the hospital and officials for violating her personal rights and privileges as a human being and as a Christian Scientist. She says she will seek court action to get her out and that she would fight these violations, to try and attain a victory on behalf of human rights for an American citizen and specifically for the beliefs of all Christian Scientists."

 On May 18, 1968, it was noted that the plaintiff was,

"Very Lethargic. Taking meds p.o. - Resistive to many procedures because she states she is Christian Science."

 While at Central Islip, it appears that plaintiff was given a smallpox immunization (May 17) and tetanus toxoid immunizations (May 13 and June 14). The hospital records indicate that medication, intramuscular or oral, was given daily while plaintiff was in the hospital.

 Among plaintiff's possessions, held by Central Islip Hospital, was a Medicaid Card, No. 1479709, expiration date December 31, 1968, which must have been obtained on her application for such card. What she would do if it became necessary to use said card is not known.

 While plaintiff was a patient at the two hospitals, a report and diagnosis of her condition was made frequently and proper entries appear in the hospitals' records. On May 2, 1968, Dr. H. Blankfeld reported on plaintiff's Admission Record at Bellevue that plaintiff was:

"[evasive], guarded, suspicious, negative[?]
Speech - Pressured, L.O.A. tangential, irrelevant, illogical
Thought - Delusions of persecution & grandeur
Denies hallucination, suicidal homicidal ideati[?]
Sensor-Clear - Oriented X3
Judgment/Insight - Nil - Spp - CSR - PT."

 It appears that the notation "CSR - PT" was a preliminary finding of chronic schizophrenic reaction - paranoiac type. A nurse's report apparently of the same day indicates that plaintiff was admitted at 6:10 P.M.:

 "* * * in o [no] acute distress," and was placed in bed.

 A social service worker, Lela Zaphirapoulos, reported, also on May 2, 1968, that:

"Pt. [patient] is very verbal, seemingly paranoid, tends to get off the subject to launch into discussions about religion, 'evil.'"

 On May 7, 1968, two physicians, Sandra Grant and Gerald Ollins, examined plaintiff and signed a "two-physicians certificate," cf. N.Y. Mental ...

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