Williamson v. Liptzin

539 S.E.2d 313
Brief Filed: 2/00
Court: Court of Appeals of North Carolina
Year of Decision: 2000

Read the full-text amicus brief (PDF, 129KB)


Whether public policy supports the extension of the law of proximate causation to allow liability in this case concerning negligence by a mental health professional

Index Topic

Duty to Warn/Protect


A student-health psychiatrist at UNC treated a law student with symptoms of psychosis on a short-term basis. At the end of the school year, he gave the student a month's supply of medication and advised him to get follow-up care at his hometown over the summer. There was no further contact and the student did not follow his advice. Eight months later, the student shot and killed several people and was in turn shot by the police. He was found not guilty of murder by reason of insanity. He subsequently sued the psychiatrist for negligent counseling and won a $500,000 verdict. The psychiatrist moved for judgment notwithstanding the verdict or for a new trial, but the trial court denied these motions. The North Carolina Court of Appeals granted review of the case.

APA's Position

APA signed on to a joint amicus curiae brief with the North Carolina Psychological Association, the North Carolina Psychiatric Association, the North Carolina Medical Society, the American Psychiatric Association and the American Medical Association. The brief argued that: (1) from a public policy perspective, an eight month gap is too long to satisfy the legal requirement that any negligence by the psychiatrist was the proximate cause of the alleged injury, particularly in light of the fact that the plaintiff (a) was in short-term, voluntary, outpatient therapy, (b) was competent enough to succeed at a top-ranked law school, (c) never missed an appointment, (d) never met the criteria for civil commitment, (e) had no thoughts of violence until months after the physician-patient relationship had ended, and (f) had indicated he would continue to comply with the instructions of his physician; (2) the result of such broad causation would be to encourage involuntary commitment, adversely affect therapeutic relationships and reduce available care for mental health disorders; and (3) other health care providers may be adversely affected by the broad standard.


The North Carolina Court of Appeals reversed the lower court decision, and ordered that trial judge to enter a directed verdict in favor of the psychiatrist. The opinion stated, "we conclude that given the very specific and novel factual scenario presented by this case, defendant’s alleged negligence was not the proximate cause of plaintiff’s injuries."