Health Law Case Brief: In the Matter of C.B.

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By: Sarah E. Lowdon

On March 11, 2013, the Massachusetts Appellate Division of the District Court vacated the commitment of C.B. to Bridgewater State Hospital (“BSH”), holding that he was not a “patient” who could be committed pursuant to G.L. c. 123, § 7.[1]

Prior to February 2012, C.B. had been found incompetent to stand trial on charges pending against him in the West Roxbury Division of the Boston Municipal Court Department.  Since that time, C.B. had been committed to BSH, pursuant to G.L. c. 123, § 16(c).[2]  On February 29, 2012, BSH petitioned the Brockton District Court for recommitment of C.B. under § 16(c), as his commitment order was expiring.  In accordance with the law, the district court began by determining whether C.B. was still incompetent to stand trial.  Finding that he was not, the district court ordered that C.B. be returned to the West Roxbury Division for trial.

Immediately thereafter, C.B. was retained at BSH for transportation to the West Roxbury Division the following day.  While C.B. was awaiting transfer at BSH, the medical director petitioned for C.B.’s recommitment, this time under G.L. c. § 7(b).[3]  When C.B. was taken to the West Roxbury Division the next day his charges were ultimately dismissed and the district court addressed the § 7(b) petition.  C.B. moved to dismiss the petition, arguing that he was not a patient of BSH at the time of the petition.  Relying on the definition of “patient” in G.L. c. 123, § 1,[4] the court denied C.B.’s motion to dismiss and committed him to BSH for six months, pursuant to G.L. c. 123, § 8(b).[5]

Upon review, the Appellate Division considered the extraordinarily broad language of G.L. c. 123, § 1’s “patient” definition and noted that while C.B.—who, on February 29, had “a mental health professional-patient relationship” with “a number of mental health professionals,” including psychiatrists and licensed clinical social workers—could be considered a “patient,” so could almost “anyone who had ever been a patient at BSH.”[6] Accordingly, the court found room in the statute’s definition section to “interpret the statutorily defined terms in the context of a given case,”[7] and determined that even a frequent patient is not a patient between terms of commitment.  The court remarked that this is especially true when a patient’s commitment ends pursuant to a judicial determination that the patient is no longer incompetent to stand trial, and denies a § 16(b) recommitment petition for that reason.  Under this reading of the definition, C.B. could not be a recommitted as a current patient under §§ 7 and 8.[8]

Sarah E. Lowdon is a third-year at New England Law | Boston concentrating in healthcare law and is the Managing Business Editor of the New England Law Review.


[1] In the Matter of C.B., 2013 Mass.App.Div. 42 (2013).

[2] Section 16 allows for a person who has been found to be incompetent to stand trial or not guilty by reason of mental illness, or mental defect, in a criminal proceeding to be hospitalized. G.L. c. 123, § 16.

[3] Section 7 allows for the BSH medical director to petition for the hospitalization of an existing patient “when it is determined that the failure to hospitalize in strict security would create a likelihood of serious harm by reason of mental illness.” G.L. c. 123, § 7(b).

[4] Section 1 defines “patient” for all of chapter 123 as “any person with whom a licensed mental health professional has established a mental health professional-patient relationship.” G.L. c. 123, § 1.

[5] Section 8 outlines the procedural and evidentiary requirements for commitment. G.L. c. 123, § 8(b).

[6] C.B., Mass.App.Div. 42, at *2.

[7] Id. Section 1 states: “The following words as used in this section [and in the remaining sections of G.L. c. 123] shall, unless the context otherwise requires, have the following meanings: . . .” G.L. c. 123, § 1.

[8] The court noted that instead the proper course would have been for the BSH medical director to file for commitment under G.L. c. 123, § 12 for emergency restraint and hospitalization, which would provide the “mental health professional-patient relationship” predicate to then file for recommitment under §§ 7 and 8. C.B., Mass.App.Div. 42, at *2.

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