MAINESUPREMEJUDICIALCOURT ReporterofDecisionsDecision: 2018ME123Docket: Pen-16-543Argued: December13,2017Decided: August21,2018Panel: SAUFLEY,C.J.,andALEXANDER,MEAD,GORMAN,JABAR,HJELM,andHUMPHREY,JJ.

RANDYN.OLIVER,IIetal.v.

EASTERNMAINEMEDICALCENTERHJELM,J.

[¶1]Inthisactionforprofessionalnegligence,RandyN.Oliver,II(Oliver)

andNicoleJernigan,individuallyandaspersonalrepresentativesoftheEstate

of RandyN. Oliver, appeal, and EasternMaineMedical Center cross-appeals

fromajudgmentoftheSuperiorCourt(PenobscotCounty,A.Murray,J.). See

infran.4. Oliverand Jerniganchallenge thepartof the judgmentconcluding

thatEMMCwasnotnegligentwhenitdischargedtheirfather,RandyN.Oliver

(Randy),becausethedischargewascontrarytotheinstructionstheygaveto

thehospital in their capacity ashis court-appointedguardians. Because the

courtdidnoterrinitsconclusionsthat,atthetimehewasdischarged,Randy

hadregainedcapacitytomakehisownhealth-caredecisionsandthatEMMC’s

dischargeplanmetthestandardofcare,weaffirmthejudgmentontheliability

2

claim. EMMC appeals the court’s denial of its request for costs for expert

witness fees and expenses incurred during the prelitigation screening panel

process.Wealsoaffirmthatdetermination.

I.FACTUALBACKGROUND

[¶2]Thefollowingfactsaredrawnfromthecourt’sfindings,whichare

supportedbycompetentrecordevidence,andfromtheproceduralrecord.See

InreEvelynA.,2017ME182,¶4,169A.3d914.

[¶3]OnMarch21,2013,Randy’sdaughter,NicoleJernigan,andhisex-

wife,PatriciaOliver,foundRandyseverelyintoxicatedinhishomeandtookhim

toEasternMaineMedicalCenterinBangor.JerniganandPatriciatoldEMMC

staff that Randy lived alone in his home, which had no running water and

presentedsignificantsanitationissues.Theyalsoinformedhospitalstaffthat

Randyhadbeendefraudedofmoneybyscammers.

[¶4]RandywasadmittedtoEMMCwithdiagnosesthatincludedhepatic

encephalopathy (liver-related brain damage), possible alcohol withdrawal,

deterioration of functional status, and a neglected state. At the time of the

admission, Randy had burns on his hands. During Randy’s resulting

hospitalization, Jernigan and Patricia provided staff with photographs of

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Randy’shome,whichshowedfirehazardsinside. Jerniganalsotoldthestaff

thatitemsinthehomehadcaughtfiremorethanonce.

[¶5]Randyremainedhospitalizedfornearlytwomonthsonamedical

admission. Throughout that time, he asked to be discharged. Because of

Randy’s expressed and ongoing desire to leave, the hospital assigned him a

one-on-oneaidetopreventhimfromleaving.

[¶6] On March 22, the day after Randy’s admission, a psychiatrist

conductedanemergencypsychiatricevaluationofRandy,duringwhichRandy

expressed a lack of understanding about why he was in the hospital. The

psychiatristconcludedthatRandy’salcoholaddictionwas“potentiallylethal,”

thatRandylikelysufferedfrom“significantcognitiveimpairmentthatwouldbe

slowtoresolve,”andthataguardianmighteventuallyneedtobeappointed.

[¶7] Nearly aweek later, onMarch 28, a neuropsychologist,Anthony

Podraza,examinedRandy.Dr.PodrazafoundthatRandywasa“fairlyaccurate

historian,”althoughRandyreportedthathisbiggestproblemwasafaultywater

heaterathishouse. Dr.Podrazawasunabletocompletethetestingprocess

because of Randy’s poor motivation and lack of effort, but he was able to

conclude that Randy did not have “capacity to manage simple or complex

financesindependently”or“tomakeinformeddecisionsregardinghishealth.”

4

[¶8]OnApril5,OliverandJerniganfiledapetitionintheWaldoCounty

ProbateCourttobeappointedRandy’sco-guardians.Insupportofthepetition,

theysubmittedareportofaphysicianwhohadexaminedRandyonApril1and

concluded that Randy’s prognosis was “probably poor for recovery of

appropriate insight necessary for self care.” The court scheduled a

guardianship hearing for May 7. In the interim, a visitor appointed by the

ProbateCourt,see18-AM.R.S.§5-303(b),(c)(2017),interviewedRandyand

wroteareportrecommendingthataguardianbeappointedandthatRandybe

placedinasecureddementiafacility.

[¶9] OnMay 7, the Probate Court (Longley, J.) held a hearing on the

guardianship petition and,basedon thephysician’s report generatedby the

April 1 evaluation, appointed Oliver and Jernigan as Randy’s co-guardians.

Importantlyforthisaction,theorderstatedthattheguardianswereauthorized

to“actonlyasnecessitatedby[Randy’s]actualmentalandadaptivelimitations

orotherconditionswarrantingthisprocedure.”

[¶10]WiththetreatmentprovidedatEMMC,Randy’sconditionbeganto

improve.1Onthesamedayastheguardianshiphearing,anEMMChospitalist

1OliverandJernigandonotallegethatEMMCfailedtoprovideRandywithpropermedicalcare

duringhishospitalization.

5

who was involved in Randy’s care ordered another neuropsychological

examination after observing Randy and questioning the need for ongoing

inpatient care. Dr. Podraza, who had examined Randymore than a month

earlier, conducted the examination that day. As the court described it,

Dr.Podraza’sfindingsinhissecondevaluationwere“strikinglydifferent”from

those of the March 28 assessment. Dr. Podraza described Randy as “alert,

friendly,pleasant,andverycooperative.”RandyinformedDr.Podrazathathe

was anxious to return to his home and planned to quit drinking although

without therapy or group support. After conducting the examination,

Dr.PodrazaconcludedthatRandyhadcapacityto“managesimpleorcomplex

finances independently” and “make better informed decisions regarding his

health.”Dr.Podrazarequestedthatacommunitycasemanagerbereferredto

RandyasaconditionofhisreleasefromEMMC.

[¶11]AfterDr.Podraza’ssecondneuropsychologicalevaluation,EMMC

concludedthatRandynolongerneededacutemedicalcareandthatthehospital

waspossiblyholdinghimthereagainsthiswill.OliverandJernigan,however,

disputedDr.Podraza’sconclusionthatRandyhadregainedcapacity,opposed

hisdischargefromthehospitaltoanysettingotherthanalockedfacility,and

wanteda secondopinionbutwereunable to findanevaluatornot affiliated

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withEMMC. AlthoughEMMCoffered tohaveRandyevaluatedbyan EMMC

practitioner,OliverandJerniganultimatelyinformedEMMCthattheydidnot

wantanotherevaluation.

[¶12] EMMC’s vice president and in-house legal counsel initially

concluded that EMMC could not discharge Randy without his guardians’

consent.TheattorneythenreconsideredtheissueafterreviewingtheProbate

Court’sguardianshiporderand,basedontheprovisionoftheorderthatlimited

theguardian’sauthoritytomakedecisionsforRandyonlywhenRandyhimself

wasnotcapableofdoingso,recommendedthatEMMCcouldreleaseRandyif

andwhenheregainedcapacity.

[¶13]Duringthistime,Randy’sassignedsocialworkeratEMMCassisted

Randywithfillingoutapetitiontoterminatetheguardianshipandamotionfor

appointmentofcounsel,whichincludedanindigencyaffidavit.AlthoughRandy

independentlyobtained informationneeded for thepaperwork, itwasnever

filedwiththeProbateCourt.

[¶14] On May 16, a certified nurse practitioner at EMMC who was

providing direct care to Randy assessed whether he should be discharged.

Based on his own assessment and his review of Randy’s medical record,

includingDr.Podraza’sopinionfollowinghisMay7assessment,thecertified

7

nursepractitionerconcludedthatRandyhadsufficientcapacitytomanagehis

own affairs and decided to discharge him. The discharge plan included

referralstoRandy’sprimarycareprovider,apainclinic,andcommunitycase

management, and a recommendation to participate in substance abuse

treatment.

[¶15] Thatday,Randy’sEMMC-basedsocialworkerleftamessagefor

OliverinforminghimofEMMC’sdecisiontodischargeRandyandallowhimto

go home that day. The social worker also called and spoke directly with

Jernigan, who, again, told him that neither she nor Oliver had authorized

Randy’sdischarge.ThesocialworkerofferedtoarrangeforataxitotakeRandy

toherresidence,butJernigandeclinedthatoffer.

[¶16]EMMCwentforwardwithitsplantodischargeRandy,andheleft

thehospitalthatdaywithafriend.JerniganandPatriciavisitedRandyathis

home twice that night. When they left Randy for the final time at around

9:00p.m.,hewasintoxicated.Randydiedlaterthatnightastheresultofafire

thatdestroyedhisentirehome.

II.PROCEDURALBACKGROUND

[¶17]OliverandJernigan,individuallyandasrepresentativesofRandy’s

Estate,filedacomplaint,lateramended,againstEMMCintheSuperiorCourtin

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late 2014. Although in its final form the complaint contained a number of

counts,eachofthemwaspredicatedonaclaimofnegligenceexceptforacount

allegingintentionalinflictionofemotionaldistress.2Thecourt(A.Murray,J.)

heldafive-daybenchtrialinJuneof2016.InajudgmententeredonAugust8,

2016,inwhichthecourtsetoutextensivefindingsoffactandathoroughlegal

analysis,thecourtconcludedthatEMMCwasnotnegligentwhenitdischarged

Randyovertheobjectionofhisguardiansandthatthedischargeplanmetthe

standardofcare.Onallcountsoftheamendedcomplaint,thecourttherefore

enteredjudgmentforEMMC.

[¶18]OnAugust15,EMMCfiledabillofcosts,see14M.R.S.§§1501to

1502-C (2017), which included expert witness fees and expenses from the

prelitigation screening panel hearing, see 24 M.R.S. § 2854 (2017). On

August22, Oliver and Jernigan filed a consolidated motion for amended or

additionalfindings,formodificationofthejudgment,andforanewtrial. See

M.R.Civ.P.52,59.OnSeptember20,thecourtdeniedtheirmotion.Afterthe

partiesfiledadditionalargumentoncosts,onNovember18thecourtentered

2 The liability claims comprised a survival action based on EMMC’s alleged negligence, see

18-AM.R.S.§3-817(2017);negligence-basedwrongfuldeathclaimsfordamagestothebeneficiariesofRandy’sestateandforRandy’sconsciouspainandsuffering,see18-AM.R.S.§2-804(2017);andclaimsfornegligentandintentionalinflictionofemotionaldistress.

9

an order awarding some costs to EMMC but not those associated with the

screeningpanelprocess.

[¶19] EMMC filed a notice of appeal on December 2, 2016. SeeM.R.

App.P. 2(b)(3) (Tower 2016).3 On December 8, Oliver and Jernigan filed a

cross-appealand,inthealternative,amotiontoenlargethetimeinwhichtofile

thenoticeofappeal,claimingtheyhadnotreceivednoticeoftheorderdenying

their August 22 motion because the clerk had not sent the order to their

attorney. Without determining whether Oliver and Jernigan’s appeal was

timely,thecourtdeniedthemotiontoenlarge,andOliverandJerniganfileda

separatenoticeofappealfromthatorder.4

III.DISCUSSION

[¶20]TheprincipalissuesonappealareOliverandJernigan’schallenge

tothecourt’sconclusionthatEMMCwasnotnegligentandEMMC’schallenge

tothecourt’sdenialofsomeofitscosts.Beforeconsideringthosecontentions,

weaddressthequestionofwhetherthenoticesofappealwerefiledinatimely

way.

3ThisappealwasfiledbeforeSeptember1,2017;therefore,therestyledMaineRulesofAppellate

Proceduredonotapply.SeeM.R.App.P.1(restyledRules).

4Becausethreenoticesofappealwerefiled,weissuedanorderconsolidatingtheappealsanddesignatingtheEstateofRandyN.Oliver(i.e.,OliverandJernigan)astheappellant.

10

A. TimelinessofAppeal

[¶21]BecauseEMMCandJerniganandOliverfiledtheirnoticesofappeal

more than twenty-one days after the entry of judgment, wemust consider

whetherthenoticesweretimely.

[¶22]Tobetimely,anoticeofappealmustbefiledwithintwenty-one

daysafterthejudgmentisenteredinthedocket,absentexceptionsthatarenot

presenthere.SeeM.R.App.P.2(b)(3)(Tower2016).Here,thejudgmenton

themeritsofthecomplaintwasenteredonAugust8,2016.EMMCthenfileda

timelybillofcostsonAugust15,andthecourtenteredanorderallowingsome

costs and denying others onNovember 18. On December 2—adatewithin

twenty-onedaysaftertheentryofthecourt’sorderoncosts—EMMCfiledits

noticeofappeal.

[¶23] Inacasewherethereareseveraltrialcourt judgmentsorother

dispositiveorders,wewill“revieweachtodetermineatwhatpointthecourt

fullydecidedanddisposedofthewholematterleavingnothingfurtherforthe

consideration and judgment of the trial court.” Coastal Ventures v. Alsham

Plaza,LLC,2010ME63,¶18,1A.3d416(alterationsomitted)(quotationmarks

omitted);seealsoE.PerryIron&MetalCo.v.CityofPortland,2006ME52,¶5,

896A.2d956. Here,at leastastoEMMC,thejudgmentdidnotbecomefinal

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untilNovember18,whenthecourtresolvedtherequestforanawardofcosts.

Until the court issued that order, therewas nothing onwhich EMMC could

present the challenge it pursues here, namely, its contention that the court

erred by denying an award of some of the costs it sought to recover from

Jernigan andOliver. EMMC’s notice of appeal, filedwithin twenty-one days

afterthecourt’sorderoncosts,wasthereforetimely.

[¶24]JerniganandOliverthenfiledacross-appealonDecember8—six

daysafterEMMCfileditsnoticeofappeal.Ifonepartyfilesatimelynoticeof

appeal,anyotherpartyisentitledtofileanoticeofappealwithinfourteendays

afterthefirstnoticeofappealisfiled.M.R.App.P.2(b)(3)(Tower2016).The

noticeofappealfiledbyJerniganandOliverthereforewastimelybecausethe

deadlinefortheirappealismeasuredbythedateofEMMC’sappealandnotthe

datewhenthejudgmentwasentered.5

[¶25] EMMC argues that any issues on appeal are limited to the

November 18 order on costs because the time to appeal as calculated from

August 8—the date when the judgment was entered—had long passed by

December8.TheMaineRulesofAppellateProcedurestate,however,that“[a]n

5BecauseOliverandJernigan’scross-appealwastimely,weneednotaddresstheirrelateddue

processargumentortheirassertionthatthecourtabuseditsdiscretionbydenyingtheirmotiontoenlargethetimetofileanappeal.

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appeal from a judgment,whenever taken, preserves for reviewany claim of

error in the record.” M.R. App. P. 2(b)(4) (Tower 2016) (emphasis added).

JerniganandOliver are thereforepermitted topursue their challenge to the

judgmentonitsmerits.

B. OliverandJernigan’sClaimsagainstEMMC

[¶26] Oliver and Jernigan assert that, by rejecting their claim against

EMMC, the court erred in several respects: by concluding that the Probate

Court’s guardianshiporderdidnotprecludeEMMC fromdischargingRandy,

given the contrary instructions they had given in their capacity as Randy’s

court-appointedguardians;byconcludingthatRandyhadregainedcapacityto

makethedecisiontobedischarged;andbyconcludingthatEMMC’sdischarge

planwasreasonable. We first reviewthestatutory frameworkapplicable to

guardianshipsinthesecircumstancesandthenconsiderthestrandsofOliver

andJernigan’sargumentinturn.

1. GuardianshipStatutes

[¶27]“Wereviewissuesoflawdenovo.”Levesquev.Cent.Me.Med.Ctr.,

2012 ME 109, ¶ 16, 52 A.3d 933. Specifically, when considering issues of

statutoryinterpretation,wewill“examinetheentiretyofthestatute,givingdue

weight to design, structure, and purpose as well as to aggregate language.”

13

Dickauv.Vt.Mut.Ins.Co.,2014ME158,¶22,107A.3d621(quotationmarks

omitted).

[¶28]TheProbateCodeauthorizesthecourttoappointaguardianfor

an incapacitated person.6 See 18-A M.R.S. §§ 5-303, 5-304 (2017). The

appointmentofaguardianaffectstheincapacitatedperson’spersonalliberties.

SeeGuardianshipofCollier,653A.2d898,900(Me.1995).Consequently,when

enteringaguardianshiporder,thecourtisrequiredtoexerciseitsappointment

authority in a way that “encourage[s] the development of maximum self

relianceandindependenceoftheincapacitatedpersonandmake[s]appointive

andotherordersonlytotheextentnecessitatedbytheincapacitatedperson’s

actual mental and adaptive limitations or other conditions warranting the

procedure.” 18-A M.R.S. § 5-304(a). To implement this objective, in

appropriate circumstances a court may—as the Probate Court did here—

appoint a limited guardian,which is a category of guardians “established to

assure flexibility indealingwith special circumstances.” In re James JohnL.,

6TheProbateCodedefines“incapacitatedperson”as“anypersonwhoisimpairedbyreasonof

mental illness, mental deficiency, physical illness or disability, chronic use of drugs, chronicintoxication,orothercauseexceptminoritytotheextentthathelackssufficientunderstandingorcapacity to make or communicate responsible decisions concerning his person.” 18-A M.R.S.§5-101(1)(2017)(emphasisadded).

14

601A.2d 630, 631 (Me. 1992) (quotation marks omitted); see 18-A M.R.S.

§5-105(2017).Section5-105provides:

In any case in which a guardian can be appointed by thecourt,thejudgemayappointalimitedguardianwithfewerthanallof the legalpowersanddutiesofaguardian. Thespecificdutiesandpowersofalimitedguardianshallbeenumeratedinthedecreeor courtorder. Aperson forwhoma limitedguardianhasbeenappointedretainsalllegalandcivilrightsexceptthosewhichhavebeensuspendedbythedecreeororder.7

[¶29]PursuanttotheProbateCode,whenaguardian’sauthorityextends

to health-care decisions, the guardian may “give or withhold consents or

approvals related to medical or other professional care . . . for the ward.”

18-AM.R.S. §5-312(a)(3) (2017). In doing so, however, the guardianmust

“make a health-care decision in accordance with the ward’s individual

7 The Probate Court’s order imposed limitations on the guardian’s authority and cited to

18-AM.R.S. § 5-105 (2017), which is the statutory authority for a court to create a limitedguardianship. From this, it is apparent that the Probate Court intended the guardianship to belimited.Asnotedinthetext,section5-105requiresthecourt,whencreatingalimitedguardianship,to“enumerate[]”the“specificdutiesandpowers”ofthelimitedguardian.Theorderheredidnotdoso.Ratherthanaffirmativelyandspecificallydelineatingtheguardians’dutiesandpowerscreatedbytheorder,itstatedinanon-specificwaythattheguardianswouldhave“custody”ofRandyand“allotherdutiesofaGuardianunderlaw.”Thisstandsincontrasttotheprovisionsof18-AM.R.S.§5-312(2017),which lists, in specific terms, thepowers andduties that a courtmaygrant to aguardian. The order here then purports only to set two limitations on the non-specific grant ofauthoritytotheguardians,namely,thattheguardianswereentitledto“actonlyasnecessitatedby[Randy’s]actualmentalandadaptivelimitationsorotherconditionswarrantingthisprocedure”andthattheguardiansweretoassurethatRandy’srighttovotewas“honor[ed].”

Oliver and Jernigan and EMMC have not challenged the validity of the guardianship order asmeasuredbytherequirementsofsection5-105—somethingthatisunderstandablegiventhatmuchoftheirargumenttothecourtandonthisappealispredicatedonthatorder.Wethereforeassume,without deciding, that the structure of the Probate Court’s guardianship order meets therequirementsofsection5-105.

15

instructions,ifany,andotherwishesexpressedwhilethewardhadcapacity.”

Id.

[¶30]TheProbateCodecontainstheUniformHealth-CareDecisionsAct

(UHDA)asadoptedinMaine,see18-AM.R.S.§§5-801to5-818(2017),which

outlines the obligations of a health-care providerwith regard to a patient’s

health-caredecisions,includingwhereaguardianhasbeenappointedforthe

patient. See id. § 5-807. A person is presumed to have “capacity” tomake

health-caredecisions.Id.§5-811(b).“Capacity”isdefinedstatutorilyas“the

ability to have a basic understanding of the diagnosed condition and to

understand the significant benefits, risks and alternatives to the proposed

health care and the consequences of foregoing the proposed treatment, the

ability to make and communicate a health care decision and the ability to

understand the consequences of designating an agent or surrogate tomake

health-caredecisions.”Id.§5-801(c).Thestatutorypresumptionofcapacity

“mayberebuttedbyadeterminationbytheindividual’sprimaryphysicianor

byacourtofcompetentjurisdiction.”Id.§5-811(b).Aprimaryphysician8who

8 “’Primaryphysician’means aphysiciandesignatedby an individualwith capacityorby the

individual’sagent,guardianorsurrogate,tohaveprimaryresponsibilityfortheindividual’shealthcareor,intheabsenceofadesignationorifthedesignatedphysicianisnotreasonablyavailable,aphysicianwhoundertakestheresponsibility.”18-AM.R.S.§5-801(m)(2017).

16

makesor is informedofadeterminationthatapatienthasregainedcapacity

must “promptlyrecord thedetermination in thepatient’shealth-carerecord

and communicate the determination to the patient, if possible, and to any

person then authorized to make health-care decisions for the patient.” Id.

§5-807(c).Whenapersonisauthorizedtomakehealth-caredecisionsforthe

patient, the provider is required to comply with the decision made by the

surrogate“tothesameextentasifthedecisionhadbeenmadebythepatient

whilehavingcapacity.”Id.§5-807(d)(2).

2. EffectoftheGuardianshipOrder

[¶31] The letters of guardianship appointing Oliver and Jernigan as

guardians for Randy stated, “Unless limitations appear above, [Jernigan and

Oliver]shallhavecustodyof[Randy]andallotherdutiesofaGuardianunder

lawuntil furtherorderofthisCourtoruntil[Randy’s]needforaguardianis

otherwiseterminated.”Thisgrantofauthority,however,wasmadesubjectto

a condition that Oliver and Jernigan “act only as necessitated by [Randy’s]

actual mental and adaptive limitations or other conditions warranting this

procedure.”OliverandJerniganassertthatthislanguageintheorderdidnot

limittheirauthoritytomakehealth-caredecisionswhiletheorderremainedin

17

effectandthattheorderbarredEMMCfromactingonRandy’sowndecisionto

leavethehospital.Wedisagree.

[¶32] The limiting language contained in the guardianship order is

derivedfromsection5-304(a).Thatstatuteisdirectedtothecourt’sexercise

of authority in setting the termsof the guardianship in away thatdoes not

interfere excessively with the ward’s autonomy. Here, however, the court

chose to use that limiting language to define the scope of the guardians’

authority to act on Randy’s behalf. Although Oliver and Jernigan seek to

diminishthesignificanceofthatlimitationbycharacterizingitasaboilerplate

provisionoftheorder,thewordschosenbythecourthaveeffectandmustbe

giventheirplainmeaning,seeBurnellv.Burnell,2012ME24,¶15,40A.3d390.

And as the clear terms of that provision establish, Oliver and Jernigan—as

guardians—wereauthorizedtomakehealth-caredecisionsforRandy“onlyto

the extentnecessitatedby [Randy’s] actualmental andadaptive limitations.”

(Emphases added.) This language is more than precatory. Rather, set in

concreteterms,theordercircumscribedthescopeoftheguardians’authority

andthecircumstancesinwhichtheyhadauthoritytomakedecisionsforRandy.

[¶33]Therefore,thecourtdidnoterrbydeterminingthattheProbate

Court’sguardianshiporderdidnot,asamatterof law,precludeEMMCfrom

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actingonRandy’swishtobedischargedfromin-patienthospitalization.The

nextquestioniswhether,asamatteroffact,Randyhadregainedcapacitythat

wouldactivatethelimitationintheguardianshiporder,therebystrippingthe

guardiansoftheirauthority—whileRandyhadcapacity—tomakehealth-care

decisions for him and correspondingly allowing him to make his own

decisions.9

3. DischargeDecision

[¶34] We “conduct a deferential review [of findings of fact] for clear

error.” Zablotnyv.StateBd.ofNursing,2017ME29,¶18,156A.3d126. “A

finding of fact is clearly erroneous if there is no competent evidence in the

recordtosupportit;ifthefact-finderclearlymisapprehendsthemeaningofthe

evidence;orifthefindingissocontrarytothecredibleevidencethatitdoesnot

representthetruthandrightofthecase.”Youngv.Lagasse,2016ME96,¶8,

143A.3d131(quotationmarksomitted).

[¶35]Here,thecourtfoundthatRandyhadregainedcapacitybyMay16.

Althoughtheevidenceonthatissuewasdisputed,therecordfullysupportsthe

9 Oliver and Jernigan mistakenly equate the effect of Randy’s recovery of capacity with a

terminationoftheguardianshiporderaltogether,whichwouldbecontrolledby18-AM.R.S.§§5-306and5-307(2017).TheguardianshiporderremainedineffecteventhoughRandyregainedcapacity;the guardians’ authority was merely suspended to the extent that their intervention was not“necessitatedby[Randy’s]actualmentalandadaptivelimitations.”

19

court’s ultimate and closely analyzed determination. See Gordon v. Cheskin,

2013ME113,¶12,82A.3d1221(“Wedefertothetrialcourt’sdetermination

ofwitnesses’credibilityanditsresolutionofconflictsintestimony.”).Anumber

of EMMC providers who interacted with Randy during his hospitalization

reached that conclusion and testified to the reasons they determined that

Randyhadcapacity.Forexample,basedontheevaluationconductedonMay7,

Dr.Podraza—whohadthebenefitofhavingassessedRandymorethanamonth

earlierandinfactwasassignedtoconducttheMay7evaluationforthatreason,

andwhoseevaluation,accordingtoexpertwitnessescalledbyEMMC,metthe

standardofcare—concludedthatRandyhadregainedcapacity.Thecourtalso

credited the testimony and conclusion reached by the certified nurse

practitioner,whowasprovidingdirectcareforRandyduringthelastfewdays

ofRandy’s admissionanddetermined thatRandyhad “sufficient insight and

judgmenttomanagehisperson.”

[¶36]Asthecourtalsonoted,Randy’shospitalrecordsshowedthathis

behaviorandengagementwithothersinthehospitalsettingshowedsignificant

improvement—he had become fully oriented, his physical condition had

improved, he was eating and sleeping well, he was engaged in an exercise

program,andhewasattendingtohishygiene.Randy’splanningandbehavior

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leadinguptoandimmediatelyfollowingthedischarge—forexample,arranging

for a ride from a friend rather than from family members who might be

expected to interfere with his discharge, and going to a store to purchase

specific items he needed—are indicative of capacity. Further, two expert

witnesses—apsychiatristandaneuropsychologist—explainedthatRandyhad

capacity tobedischarged. Thecourt’s finding thatRandyhadcapacityasof

May16iswellsupportedbytheevidenceandnotclearlyerroneous.

[¶37]OliverandJerniganassertthattheProbateCourt’sdetermination,

whichwas a predicate to the guardianship order, that Randy had “capacity

conditionswhichwarrantanappointmentofaguardian”barredbothEMMC

and,later,thecourtfromconcludingdifferently.Thiscontentionisundermined

by the very terms of the guardianship order, which framed the guardians’

authorityasafunctionofRandy’s“actualmentalandadaptivelimitationsor

other conditionswarranting thisprocedure.” (Emphasis added.) Theorder

signalsanexpectation,notofstasis,butofadynamicsituationwherechanges

inRandy’scondition—his“actual”levelofcapacity—woulddefinethenature

and extent of the guardians’ authority. This would necessarily call for an

ongoing assessment of Randy’s capacity,which iswhat both EMMC and the

courtproperlydid.

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[¶38]Forthesereasons,thecourtdidnoterrbyconcludingthatEMMC

properly complied with the directive made by Randy—a patient with

capacity—thathebedischarged.10

4. AdequacyofDischargePlan

[¶39] Finally, the parties do not dispute that EMMCwas required to

provideRandywithasafeandreasonabledischargeplan.Thecourtthoroughly

analyzedtheevidenceonthisissue,includingexperttestimonyandevidenceof

theeventsleadinguptoRandy’sdischarge.Onthatbasis,notonlydidthecourt

conclude thatOliverand Jernigandidnotprove that thedischargeplanwas

deficient, but the court found affirmatively that the discharge plan was

reasonable.

[¶40]Thedischargeplanincludedanappointment,madebyEMMC,ata

painclinic;11anappointment,alsomadebyEMMC,forRandytoseehisprimary

care physician four days after discharge; and contact information given to

Randyforcasemanagementservices.Thedischargeplanalsoincludedastrong

10OnceRandy’sprimaryphysicianmadeorlearnedofadeterminationthatRandyhadcapacity,

theproviderwasrequiredtorecordthatdeterminationinRandy’shealth-carerecordandnotifyanypersonwhowasauthorizedtomakehealth-caredecisions forRandy. See18-AM.R.S.§5-807(c)(2017).Thecourtdidnotmakespecificfindingsonthisissue,buttherecordcontainsevidencethatEMMCcompliedwiththisstatutoryrequirement,andOliverandJernigandonotraiseachallengebasedonthisprovision.

11TherecordcontainsevidencethatRandyhadsufferedabackinjurythatcausedhimpain.

22

recommendation toRandy thathestopdrinkingandattendgroupmeetings,

andEMMCofferedsubstanceabusecounseling.Bythetimehewasdischarged,

Randyhadcometoadmitthathewasanalcoholicandstatedthathewouldtry

tostopdrinkingalthoughwithoutsubstanceabusecounselingorattendanceat

groupmeetings.Thecourtfoundthatthisacknowledgementshowedinsight

andsignificantprogressandthat,becauseRandywasmedicallystableandhad

capacitywhenhewasdischarged,EMMCwasobligatedtocomplywithhiswish

to leave, notwithstanding the prospect that he would resume drinking—a

decisionRandywasentitledtomake.

[¶41]Beforehewasdischarged,Randy’snursereviewedthedischarge

planwithhim,andheindicatedthatheunderstood.Finally,thesocialworker

workingwithRandyatthetimeofthedischargenotifiedJerniganthatRandy

wasabouttobereleased.Thecourtconsideredtherelativelyshortamountof

notice provided to Jernigan but concluded, without error, that EMMC was

requiredtoactonRandy’sinsistencetoleavethehospital.

[¶42] Thecourtdidnotcommitclear errorbyconcluding thatEMMC

providedRandywithasafeandreasonabledischargeandwasnotnegligentin

discharginghim.

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C. EMMC’sBillofCosts

[¶43] We turn finally to EMMC’s assertion that the court erred by

denyingitsbillofcostsforexpertwitnessfeesandexpensesincurredduring

the mandatory prelitigation panel proceedings held pursuant to 24 M.R.S.

§§2851-2859(2017).“Wereviewissuesoflawdenovo,”Levesque,2012ME

109,¶16,52A.3d933,butreview“thedecisionofthecourttoawardcostsfor

anabuseofdiscretion,”Polandv.Webb,1998ME104,¶12,711A.2d1278.

[¶44]MaineRuleofCivilProcedure54(d)providesthat“[c]ostsshallbe

allowedasofcoursetotheprevailingparty,asprovidedbystatuteandbythese

rules, unless the court otherwise specifically directs.” Courts have the

discretion toawardreasonableexpertwitness feesandexpensesasallowed

pursuanttotitle16,section251. See14M.R.S.§1502-C(1). Section251, in

turn, gives the court discretion to “allow at the trial of any cause, civil or

criminal,intheSupremeJudicialCourt,theSuperiorCourtortheDistrictCourt,

areasonablesumforeachday’sattendanceofanyexpertwitnessorwitnesses

atthetrial.”16M.R.S.§251(2017)(emphasisadded);seeWebb,1998ME104,

¶ 14, 711 A.2d 1278 (“Those statutory provisions [14 M.R.S. §1502-C and

16M.R.S.§251]authorizeonlyfeesthataredirectlyrelatedtoattendanceat

trial.”). The question here is whether a prelitigation screening panel

24

proceedingheldpursuantto24M.R.S.§§2851to2859isa“trial”withinthe

meaningofsection251.

[¶45]Afterapartyfilesanoticeofclaimofmedicalmalpractice,pursuant

totheMaineHealthSecurityAct,24M.R.S.§2853,“aprelitigationscreening

panelmusthearcasesofallegedmedicalmalpracticebeforeacomplaintisfiled

in court.” Hill v. Kwan, 2009 ME 4, ¶ 2, 962 A.2d 963; see 24 M.R.S.

§§2851-2859, 2903 (2017). That proceeding is not the trial, however, but

rather is a device intended to “encourage early resolution of [meritorious]

claimspriortocommencementofalawsuit.”24M.R.S.§2851(1)(A)(emphasis

added);seealsoGafnerv.DownE.Cmty.Hosp.,1999ME130,¶22,735A.2d969

(“Thepanelscreeningprocessisintendedtobe...anindependentmechanism

for the initial screening of claims of professional negligence.” (emphasis

added)).“Althoughthescreeningpanelisanagencyofthecourts,itcannotbe

consideredaninferiorcourtorquasi-judicialtribunal....”Sherburnev.Med.

MalpracticePrelitigation ScreeningPanel, 672A.2d596,598 (Me.1996); see

also Hill, 2009 ME 4, ¶ 12, 962 A.2d 963 (“The screening panel has no

independent judicial authority—it cannot enter a final judgment, and its

decisionshavenoprecedentialvalue.”).

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[¶46] For that reason, although a prelitigation screening panel

proceedingisadversarialandprovidesaforumforthepartiestopresentthe

meritsoftheircases,thepanelprocessisnota“trial,”whichistheeventthat

triggers the court’s authority to award expert witness fees and expenses

pursuanttosection251.ThecourtthereforedidnoterrbydenyingEMMC’s

request for an award of expertwitness costs generated by the prelitigation

panelproceeding.

IV.CONCLUSION

[¶47] In summary, the courtdid not errbydetermining thatEMMC’s

decisiontodischargeRandyfrominpatienttreatmentwassupportedbythelaw

andthefacts.Further,thecourtproperlydeniedEMMC’srequestforanaward

of costs for expertwitness fees and expenses incurred during the statutory

panelproceeding.

Theentryis:

Judgmentaffirmed.

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PeterClifford,Esq.(orally),andAndrewP.Cotter,Esq.,Clifford&Clifford,LLC,Kennebunk,forappellantsRandyN.Oliver,IIandNicoleJerniganEdwardW.Gould,Esq.(orally),SandraL.Rothera,Esq.,andMariannZ.Malay,Esq.,Gross,Minsky&Mogul,P.A.,Bangor,forappelleeEasternMaineMedicalCenterPenobscotCountySuperiorCourtdocketnumberCV-2013-126FORCLERKREFERENCEONLY