{ "id": 4264471, "name": "KENNETH HOOPER, Special Adm'r of the Estate of Louise Hooper, Deceased, Plaintiff-Appellee, v. THE COUNTY OF COOK et al., Defendants-Appellants (Glenda Edmond-Nolla, Defendant)", "name_abbreviation": "Hooper v. County of Cook", "decision_date": "2006-05-15", "docket_number": "No. 1-03-1842", "first_page": "1", "last_page": "11", "citations": [ { "type": "official", "cite": "366 Ill. App. 3d 1" } ], "court": { "name_abbreviation": "Ill. App. Ct.", "id": 8837, "name": "Illinois Appellate Court" }, "jurisdiction": { "id": 29, "name_long": "Illinois", "name": "Ill." }, "cites_to": [ { "cite": "45 N.E.2d 665", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1942, "opinion_index": 0 }, { "cite": "381 Ill. 300", "category": "reporters:state", "reporter": "Ill.", "case_ids": [ 2558729 ], "year": 1942, "pin_cites": [ { "page": "318" } ], "opinion_index": 0, "case_paths": [ "/ill/381/0300-01" ] }, { "cite": "492 N.E.2d 632", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1986, "pin_cites": [ { "parenthetical": "summary judgment is improper where an issue of material fact exists about causation and foreseeability" } ], "opinion_index": 0 }, { "cite": "143 Ill. App. 3d 28", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 5665791 ], "year": 1986, "pin_cites": [ { "page": "34", "parenthetical": "summary judgment is improper where an issue of material fact exists about causation and foreseeability" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/143/0028-01" ] }, { "cite": "720 N.E.2d 1068", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1999, "pin_cites": [ { "parenthetical": "proximate cause is generally an issue for the trier of fact" } ], "opinion_index": 0 }, { "cite": "188 Ill. 2d 252", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 536099 ], "year": 1999, "pin_cites": [ { "page": "257", "parenthetical": "proximate cause is generally an issue for the trier of fact" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/188/0252-01" ] }, { "cite": "830 N.E.2d 722", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2005, "pin_cites": [ { "parenthetical": "\"[wjhether a duty of care exists is a question of law, appropriately determined by the trial court on a motion for summary judgment\"" } ], "opinion_index": 0 }, { "cite": "357 Ill. App. 3d 1023", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 4135877 ], "year": 2005, "pin_cites": [ { "page": "1027", "parenthetical": "\"[wjhether a duty of care exists is a question of law, appropriately determined by the trial court on a motion for summary judgment\"" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/357/1023-01" ] }, { "cite": "821 N.E.2d 1099", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2004, "pin_cites": [ { "parenthetical": "the question of foreseeability plays a pivotal role not only in the question of the existence of a duty but also in the determination of legal cause" } ], "opinion_index": 0 }, { "cite": "213 Ill. 2d 351", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 8448906 ], "year": 2004, "pin_cites": [ { "page": "395", "parenthetical": "the question of foreseeability plays a pivotal role not only in the question of the existence of a duty but also in the determination of legal cause" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/213/0351-01" ] }, { "cite": "545 A.2d 159", "category": "reporters:state_regional", "reporter": "A.2d", "year": 1988, "opinion_index": 0 }, { "cite": "111 N.J. 451", "category": "reporters:state", "reporter": "N.J.", "case_ids": [ 309554 ], "year": 1988, "opinion_index": 0, "case_paths": [ "/nj/111/0451-01" ] }, { "cite": "522 A.2d 444", "category": "reporters:state_regional", "reporter": "A.2d", "weight": 2, "year": 1987, "pin_cites": [ { "page": "449-50" }, { "page": "449-50" } ], "opinion_index": 0 }, { "cite": "215 N.J. Super. 484", "category": "reporters:state", "reporter": "N.J. Super.", "case_ids": [ 715817 ], "weight": 2, "year": 1987, "pin_cites": [ { "page": "494-95" }, { "page": "494-95" } ], "opinion_index": 0, "case_paths": [ "/nj-super/215/0484-01" ] }, { "cite": "701 N.E.2d 813", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1998, "opinion_index": 0 }, { "cite": "299 Ill. App. 3d 364", "category": "reporters:state", "reporter": "Ill. 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App. 3d", "case_ids": [ 132342 ], "year": 2001, "pin_cites": [ { "page": "643" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/321/0639-01" ] }, { "cite": "680 N.E.2d 407", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1997, "opinion_index": 0 }, { "cite": "288 Ill. App. 3d 32", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 1596906 ], "year": 1997, "pin_cites": [ { "page": "45" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/288/0032-01" ] }, { "cite": "836 N.E.2d 640", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2005, "opinion_index": 0 }, { "cite": "361 Ill. App. 3d 538", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 4259827 ], "weight": 2, "year": 2005, "pin_cites": [ { "page": "556" }, { "page": "556" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/361/0538-01" ] }, { "cite": "605 N.E.2d 493", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1992, "opinion_index": 0 }, { "cite": "152 Ill. 2d 432", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 5602939 ], "weight": 4, "year": 1992, "pin_cites": [ { "page": "455" }, { "page": "455" }, { "page": "456" }, { "page": "455" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/152/0432-01" ] }, { "cite": "821 N.E.2d 757", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2004, "opinion_index": 0 }, { "cite": "355 Ill. App. 3d 230", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 3599657 ], "weight": 4, "year": 2004, "pin_cites": [ { "page": "241" }, { "page": "242" }, { "page": "256" }, { "page": "256" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/355/0230-01" ] }, { "cite": "649 N.E.2d 1323", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1995, "opinion_index": 0 }, { "cite": "165 Ill. 2d 107", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 483569 ], "weight": 4, "year": 1995, "pin_cites": [ { "page": "114" }, { "page": "114" }, { "page": "114" }, { "page": "114" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/165/0107-01" ] }, { "cite": "429 N.E.2d 1242", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1981, "opinion_index": 0 }, { "cite": "102 Ill. App. 3d 397", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 3075714 ], "year": 1981, "pin_cites": [ { "page": "411" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/102/0397-01" ] }, { "cite": "612 N.E.2d 85", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1993, "opinion_index": 0 }, { "cite": "243 Ill. App. 3d 577", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 5106916 ], "weight": 2, "year": 1993, "pin_cites": [ { "page": "581" }, { "page": "581" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/243/0577-01" ] }, { "cite": "763 N.E.2d 720", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2002, "opinion_index": 0 }, { "cite": "198 Ill. 2d 541", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 29951 ], "weight": 5, "year": 2002, "pin_cites": [ { "page": "555" }, { "page": "555-56" }, { "page": "556" }, { "page": "555" }, { "page": "556" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/198/0541-01" ] }, { "cite": "406 N.E.2d 544", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1979, "opinion_index": 0 }, { "cite": "85 Ill. App. 3d 32", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 3194930 ], "year": 1979, "pin_cites": [ { "page": "38" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/85/0032-01" ] }, { "cite": "662 N.E.2d 525", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1996, "pin_cites": [ { "parenthetical": "a special interrogatory to a jury is proper when it concerns the ultimate fact on which the rights of the parties depend" } ], "opinion_index": 0 }, { "cite": "278 Ill. App. 3d 318", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 1156833 ], "weight": 3, "year": 1996, "pin_cites": [ { "page": "322", "parenthetical": "a special interrogatory to a jury is proper when it concerns the ultimate fact on which the rights of the parties depend" }, { "page": "322" }, { "page": "322" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/278/0318-01" ] } ], "analysis": { "cardinality": 980, "char_count": 24024, "ocr_confidence": 0.763, "pagerank": { "raw": 1.7351449797231685e-07, "percentile": 0.7061730239871128 }, "sha256": "dd590f53b2e95692c1bf2c496f9e3473c3d90c47d55cce43ecef0b0e9615eba3", "simhash": "1:83f61f187d2d54f4", "word_count": 3881 }, "last_updated": "2023-07-14T18:50:16.995484+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [], "parties": [ "KENNETH HOOPER, Special Adm\u2019r of the Estate of Louise Hooper, Deceased, Plaintiff-Appellee, v. THE COUNTY OF COOK et al., Defendants-Appellants (Glenda Edmond-Nolla, Defendant)." ], "opinions": [ { "text": "PRESIDING JUSTICE CAHILL\ndelivered the opinion of the court: This appeal arises from a medical negligence action filed by plaintiff Kenneth Hooper, special administrator of the estate of his mother, Louise Hooper (Hooper), and against Cook County, Deepak Kapoor, M.D., a physician at Cook County Hospital, and Glenda Edmond-Nolla, R.N., a nurse at the hospital. Plaintiff alleged in his complaint that defendants were negligent in failing to treat and care properly for Hooper, who committed suicide while she was a patient at the hospital. The jury found in favor of Nolla and against Dr. Kapoor and Cook County, awarding $1,212,000 to plaintiff.\nPlaintiff appealed the exclusion of Nolla from the jury\u2019s negligence findings and the amount of the award but later withdrew that appeal. Defendants Cook County and Dr. Kapoor also appealed, raising a single claim: the trial court erred in its refusal to submit their special interrogatory to the jury. We agree and reverse and remand for a new trial as to Dr. Kapoor and Cook County.\nWe are asked to decide whether the foreseeability of a hospital patient\u2019s suicide was the dispositive jury question in this medical negligence case. Defendants claim that the jury had to believe Hooper\u2019s injury was foreseeable to find that defendants\u2019 conduct was the proximate cause of her death. Defendants argue the trial court committed reversible error in denying a special interrogatory to test the jury\u2019s position on the foreseeability of Hooper\u2019s injury. The special interrogatory proposed by defendants and denied by the court was: \u201cPrior to the death of [Louise] Hooper, was it reasonably foreseeable that she would commit suicide or act in a self-destructive manner on or before December 6, 1997? Yes_No_.\u201d\nThe parties disagree on whether th\u00e9 foreseeability of Hooper\u2019s suicide was the ultimate fact on which the rights of the parties depended. See DiMarco v. City of Chicago, 278 Ill. App. 3d 318, 322, 662 N.E.2d 525 (1996) (a special interrogatory to a jury is proper when it concerns the ultimate fact on which the rights of the parties depend). Defendants claim that unless Hooper\u2019s suicide was foreseeable, their actions cannot be deemed the proximate cause of Hooper\u2019s death. Plaintiff argues that the foreseeability of Hooper\u2019s suicide was but one of the facts that had to be determined by the jury in deciding whether defendants\u2019 actions were the proximate cause of Hooper\u2019s death.\nThese pertinent facts emerged at trial. Hooper was admitted to Cook County Hospital on December 2, 1997, for medical treatment unrelated to this case. At 2 a.m. on December 5, 1997, while Hooper was a patient in the intensive care unit (ICU), she developed symptoms of a form of delirium known as ICU psychosis. She became paranoid, combative and uncontrollable. Betty Shamley, a psychiatric nurse, examined Hooper and found her to have \u201cparanoid ideation\u201d as shown by Hooper\u2019s comments that people were trying to hurt her and invade her privacy. Shamley spoke by telephone to Dr. Kapoor, the attending psychiatrist. They developed a treatment plan that included administering the antipsychotic medication Haldol and transferring Hooper to Ward 24, a medical-surgical ward with a calmer atmosphere than the ICU. The plan called for placing Hooper on \u201cone-to-one nursing p.r.n. for unpredictable behavior.\u201d There was testimony that \u201cp.r.n.\u201d stands for \u201cif necessary.\u201d An earlier order of \u201cbed rest\u201d was changed to \u201cambulatory,\u201d meaning Hooper was allowed to walk around in the ward. Dr. Kapoor did not talk to or examine Hooper.\nIn the evening of December 5, 1997, Hooper reported seeing green and purple lights and movement in the ceiling to a patient who shared her room. At 3:55 a.m. on December 6, 1997, Hooper was found in the bathroom by another patient. Hooper had hung herself by knotting her hospital gown. Although Hooper had a slight pulse, she was unresponsive and unconscious. She later died.\nAt trial, plaintiffs theory was Dr. Kapoor\u2019s failure to conduct a complete mental status examination of Hooper and his failure to order one-to-one nursing care for her caused or contributed to her injury and death. Defendants responded that a medical negligence claim cannot succeed where the defendant fails to guard against something that cannot be foreseen.\nDefendants argued that because the medical experts could not identify the cause of Hooper\u2019s suicide even after her death, Hooper\u2019s suicide must have been unforeseeable. Dr. Alex John Spadoni, a physician specializing in psychiatry, testified as plaintiffs expert witness. He said that a person who was suffering from delirium or ICU psychosis would be at risk of causing harm to herself, including suicide. He opined that defendants\u2019 conduct was a contributing factor in Hooper\u2019s death. Dr. Carl Martin Wahlstrom, a forensic psychiatrist, testified as defendants\u2019 expert witness. He opined that Hooper\u2019s act of hanging herself was an intentional act, not an accident where she hurt herself because of delirium. Dr. Wahlstrom said Hooper\u2019s act involved \u201ca substantial degree of planning.\u201d He answered \u201cno,\u201d over plaintiffs objection, to defendants\u2019 question of whether \u201cthe suicide in this case was reasonably foreseeable.\u201d\nNear the end of the trial, during the jury instruction conference outside the presence of the jury, defendants proposed a special interrogatory to the jury that was discussed by the judge and counsel for the parties:\n\u201cMR. DESIERTO [defense counsel]: Judge, we have also given counsel copies *** [of] some special interrogatories.\nFirst one we\u2019re proposing is[:] prior to the death of *** Hooper was it reasonably foreseeable that she would commit suicide or act in a self-destructive manner on or before December 6th.\nJudge, proximate cause is a question of fact and foreseeability is part of the proximate cause and yesterday *** you allowed the testimony of\u2014\nTHE COURT: Sure.\nMR. DESIERTO: \u2014Dr. Wahlstrom as to the foreseeability aspect of the act.\nAnd therefore this is a question of fact that the jury has a right to consider.\nMR. ROGERS, JR. [plaintiffs counsel]: Such a favorable finding on that question!,] thought,] wouldn\u2019t be inconsistent with a verdict for the plaintiff, your honor.\nIt has to challenge the entirety of proximate cause.\nTHE COURT: Anything else at this time?\nMR. DESIERTO: No.\nMR. ROGERS, SR. [plaintiffs counsel]: Doesn\u2019t address \u2014 the language doesn\u2019t address the suicide being unpredictable behavior.\nTHE COURT: All right. The Court will refuse as tendered.\u201d\nDefendants\u2019 sole argument on appeal is that the trial court\u2019s refusal to tender their special interrogatory to the jury was an error that caused prejudice and denied defendants a fair trial. Defendants contend that \u201c[i]f the jury had determined as a matter of fact that Hooper\u2019s suicide was not reasonably foreseeable, then the court would have had to enter judgment in favor of the defendants *** because causation was not proven.\u201d\nPlaintiff argues that defendants\u2019 proposed interrogatory was improper because it focused only on the foreseeability component of proximate cause while ignoring the other elements of proximate cause, including defendants\u2019 negligent care in failing to prevent a psychotic patient from engaging in impulsive, unpredictable acts.\nThe law governing special interrogatories appears in section 2 \u2014 1108 of the Code of Civil Procedure:\n\u201cUnless the nature of the case requires otherwise, the jury shall render a general verdict. The jury may be required by the court, and must be required on request of any party, to find specially upon any material question or questions of fact submitted to the jury in writing. Special interrogatories shall be tendered, objected to, ruled upon and submitted to the jury as in the case of instructions. Submitting or refusing to submit a question of fact to the jury may be reviewed on appeal, as a ruling on a question of law. When the special finding of fact is inconsistent with the general verdict, the former controls the latter and the court may enter judgment accordingly.\u201d 735 ILCS 5/2 \u2014 1108 (West 2000).\nWe review a trial court\u2019s denial of a request for a special interrogatory de novo as a question of law. 735 ILCS 5/2 \u2014 1108 (West 2004); DiMarco, 278 Ill. App. 3d at 322.\nA special interrogatory requires a jury to determine one or more specific issues of ultimate fact. Gasbarra v. St. James Hospital, 85 Ill. App. 3d 32, 38, 406 N.E.2d 544 (1979). A special interrogatory is proper when it concerns the ultimate fact on which the rights of the parties depend. DiMarco, 278 Ill. App. 3d at 322. A special interrogatory serves as a check on the jury\u2019s general verdict. Simmons v. Garces, 198 Ill. 2d 541, 555, 763 N.E.2d 720 (2002). \u201cSpecial findings are inconsistent with a general verdict only where they are \u2018clearly and absolutely irreconcilable with the general verdict.\u2019 \u201d Simmons, 198 Ill. 2d at 555-56, quoting Powell v. State Farm Fire & Casualty Co., 243 Ill. App. 3d 577, 581, 612 N.E.2d 85 (1993). \u201cIf a special interrogatory does not cover all the issues submitted to the jury and a \u2018reasonable hypothesis\u2019 exists that allows the special finding to be construed consistently with the general verdict, they are not \u2018absolutely irreconcilable\u2019 and the special finding will not control.\u201d Simmons, 198 Ill. 2d at 556, quoting Powell, 243 Ill. App. 3d at 581.\nA trial court can refuse to submit a special interrogatory to a jury only if the form of the interrogatory is improper. Stack v. Sears, Roebuck & Co., 102 Ill. App. 3d 397, 411, 429 N.E.2d 1242 (1981). A special interrogatory is in proper form if it relates to an ultimate issue of fact on which the parties\u2019 rights depend and if an answer to the interrogatory would be inconsistent with a general verdict that the jury might return. Simmons, 198 Ill. 2d at 555. The interrogatory need not contain all of the elements of negligence if it focuses on one element that is dispositive of the claim. Simmons, 198 Ill. 2d at 556. Here, the interrogatory focused on the proximate cause of Hooper\u2019s death.\nProximate cause is one of three elements a plaintiff must prove to succeed in a negligence action: (1) the defendant owed a duty of care; (2) the defendant breached that duty; and (3) the plaintiff\u2019s resulting injury was proximately caused by the breach. Espinoza v. Elgin, Joliet & Eastern Ry. Co., 165 Ill. 2d 107, 114, 649 N.E.2d 1323 (1995). Whether the defendant owed a duty to the plaintiff is a question of law to be decided by the court. Espinoza, 165 Ill. 2d at 114. Whether the defendant breached his duty and whether the breach was the proximate cause of the injury is a factual question for a jury to decide, as long as there is a genuine issue of material fact about breach and causation. Espinoza, 165 Ill. 2d at 114.\nA claim of medical malpractice is proven when the plaintiff shows there was a standard of care by which to measure the defendant\u2019s conduct, the defendant negligently breached that standard of care and the defendant\u2019s breach was the proximate cause of the plaintiffs injury. Northern Trust Co. v. University of Chicago Hospitals & Clinics, 355 Ill. App. 3d 230, 241, 821 N.E.2d 757 (2004). A plaintiff must prove these elements by presenting medical expert testimony. Northern Trust, 355 Ill. App. 3d at 242.\nProximate cause is a question of fact to be decided by a jury. Espinoza, 165 Ill. 2d at 114. There are two requirements for a showing of proximate cause: cause in fact and legal cause. Lee v. Chicago Transit Authority, 152 Ill. 2d 432, 455, 605 N.E.2d 493 (1992). See also Knauerhaze v. Nelson, 361 Ill. App. 3d 538, 556, 836 N.E.2d 640 (2005). We are concerned here with legal cause. Legal cause is established if an injury was foreseeable as the type of harm that a reasonable person would expect to see as a likely result of his or her conduct. Lee, 152 Ill. 2d at 455. Although the foreseeability of an injury will establish legal cause, the extent of the injury or the exact way in which it occurs need not be foreseeable. Knauerhaze, 361 Ill. App. 3d at 556, citing Colonial Inn Motor Lodge, Inc. v. Gay, 288 Ill. App. 3d 32, 45, 680 N.E.2d 407 (1997). By requiring a legal cause to be attributed to an injury, the law sets limits on how far a defendant\u2019s legal responsibility should extend for the actions of the defendant who, in fact, caused the injury. Lee, 152 Ill. 2d at 456. By asking for a special interrogatory on the question of foreseeability, defense counsel here sought an assurance from the jury that it found Hooper\u2019s suicide to be the type of injury that a reasonable person would expect to see as a likely result of defendants\u2019 conduct.\nNeither party has cited, nor have we found, a state case that deals with the specific issue raised here: whether a jury\u2019s negative answer to a special interrogatory on foreseeability would have foreclosed a general verdict of negligence. Defendants cite Kleen v. Homak Manufacturing Co., 321 Ill. App. 3d 639, 643, 749 N.E.2d 26 (2001), for the general rule that where a suicide was not reasonably foreseeable as a likely consequence of the. defendant\u2019s conduct, then legal cause has not been established. Defendants argue that the federal Seventh Circuit\u2019s judgment in Jutzi-Johnson v. United States, 263 F.3d 753, 755-56 (7th Cir. 2001), provides guidance here. While JutziJohnson is not a medical negligence case, the facts parallel those here. There, a prisoner showed abnormal behavior before committing suicide, but the prison staff did not arrange for him to see the jail psychologist. Jutzi-Johnson, 263 F.3d at 755. The district court after a bench trial found in favor of the prisoner\u2019s estate and awarded monetary damages. Jutzi-Johnson, 263 F.3d at 754. The appellate court reversed the judgment, concluding that the ultimate question in the case was: \u201cwhether [the prisoner\u2019s] suicide was a foreseeable consequence of the negligence of his jailers in responding ineffectually to his abnormal behavior.\u201d Jutzi-Johnson, 263 F.3d at 756. The court found it to be \u201csheer conjecture that an interview with the jail psychologist would have produced sufficient information to have enabled the psychologist to infer that [the prisoner] was a suicide risk and place him on suicide watch.\u201d Jutzi-Johnson, 263 F.3d at 756-57.\nWe believe the ultimate, controlling question here is whether Hooper\u2019s self-destructive behavior was a foreseeable consequence, or legal cause, of defendants\u2019 negligence in responding ineffectually to her abnormal behavior. As we have shown, foreseeability is the factual finding necessary to establish legal cause. Lee, 152 Ill. 2d at 455.\nWe see no reason to depart from the rule that foreseeability is the prerequisite for establishing legal cause. Without foreseeability, legal cause cannot be established. Without legal cause, proximate cause cannot be established. Without proximate cause there can be no negligence. Foreseeability was the only subject of defendants\u2019 special interrogatory. We believe that the requested interrogatory would have addressed the material issue of ultimate fact on which the rights of the parties depended. A negative answer would have been irreconcilable with the general verdict against defendants. The interrogatory should have been allowed.\nPlaintiff relies on Northern Trust, 355 Ill. App. 3d at 256, to argue that a negative answer to the proposed interrogatory would not have been inconsistent with a general verdict against defendants. In Northern Trust, the court found that three proposed special interrogatories were improper in form either because they sought mere findings of evidentiary fact or because neither an affirmative nor a negative answer would have been dispositive of the claim. Northern Trust Co., 355 Ill. App. 3d at 256.\nHere, the requested interrogatory was in proper form. It sought the jury\u2019s decision on foreseeability, an inquiry necessary to establish proximate cause. An affirmative answer would have established defendants as the legal cause of Hooper\u2019s death. A negative answer would have shown that the jury believed defendants were not the legal cause of Hooper\u2019s death.\nPlaintiff also argues that Winger v. Franciscan Medical Center, 299 Ill. App. 3d 364, 374, 701 N.E.2d 813 (1998), supports the trial court\u2019s rejection of defendants\u2019 special interrogatory. In Winger, the trial court granted motions for summary judgment by the defendants, a physician and a hospital, who were named in a complaint for damages arising from the suicide of a depressed patient. Winger, 299 Ill. App. 3d at 367. The appellate court reversed, finding there were questions of fact to be decided by a jury: whether the suicide was foreseeable and whether the conduct of the defendants was reasonable under the circumstances. Winger, 299 Ill. App. 3d at 375. Plaintiff appears to be arguing that the appellate court in Winger established that the question of whether a defendant\u2019s conduct was reasonable under the circumstances, and not only the question of foreseeability, must be determined by the jury and so defendants\u2019 special interrogatory on foreseeability would not have disposed of all material issues. Plaintiff relies on this from the Winger opinion:\n\u201cIt is well settled that a hospital and its staff must exercise reasonable care to protect suicidal patients from self-harm. ***\n% * Hs\n*** Rather than absolve the physician of liability when self-destructive conduct is reasonably foreseeable, the better approach is to require reasonable precautions in light of the special relationship between the physician and his patient. We find that the proper standard is most ably stated in Cowan v. Doering, 215 N.J. Super. 484, 494-95, 522 A.2d 444, 449-50 (1987), aff\u2019d, 111 N.J. 451, 545 A.2d 159 (1988):\n\u2018Where it is reasonably foreseeable that a patient by reason of his mental or emotional illness may attempt to injure himself, those in charge of his care owe a duty to safeguard him from his self-damaging potential. This duty contemplates the reasonably foreseeable occurrence of self-inflicted injury regardless of whether it is the product of the patient\u2019s volitional or negligent act.\u2019 \u201d Winger, 299 Ill. App. 3d at 372-74.\nWe disagree with plaintiffs conclusion that this section of Winger changes the proximate cause analysis in medical negligence cases that involve suicide. The Winger analysis pertains to the \u201cduty\u201d analysis in a negligence claim, not to a \u201cproximate cause\u201d or \u201clegal cause\u201d analysis. See City of Chicago v. Beretta U.S.A. Corp., 213 Ill. 2d 351, 395, 821 N.E.2d 1099 (2004) (the question of foreseeability plays a pivotal role not only in the question of the existence of a duty but also in the determination of legal cause). The court in Winger addresses foreseeablity in the context of duty, not proximate cause. This is supported by the fact that the Winger court repeatedly mentions a caregiver\u2019s duty to a patient, but not causation. Where a patient\u2019s self-destructive conduct is reasonably foreseeable, the physician must take reasonable precautions in light of his special relationship with his patient. Winger, 299 Ill. App. 3d at 374. Caregivers have a duty to safeguard a self-destructive patient because there is a reasonably foreseeable occurrence of self-inflicted injury. Winger, 299 Ill. App. 3d at 374, quoting Cowan v. Doering, 215 N.J. Super. 484, 494-95, 522 A.2d 444, 449-50 (1987).\nThe conclusion that Winger addresses duty is supported further by the procedural posture of Winger, a summary judgment, which differs from the situation here. In reviewing an appeal from a summary judgment, the appellate court typically tests the trial court\u2019s legal conclusions on the duty aspect of a negligence claim. See Sandoval v. City of Chicago, 357 Ill. App. 3d 1023, 1027, 830 N.E.2d 722 (2005) (\u201c[wjhether a duty of care exists is a question of law, appropriately determined by the trial court on a motion for summary judgment\u201d). Here, factual questions of causation, not legal questions of duty, are the subject of this appeal. See First Springfield Bank & Trust v. Galman, 188 Ill. 2d 252, 257, 720 N.E.2d 1068 (1999) (proximate cause is generally an issue for the trier of fact); Tennant v. Clark Equipment Co., 143 Ill. App. 3d 28, 34, 492 N.E.2d 632 (1986) (summary judgment is improper where an issue of material fact exists about causation and foreseeability). Since Winger dealt with the duty element of negligence in a summary judgment context, its discussion of foreseeability as it pertains to duty does not control here.\nWe conclude that defendants\u2019 special interrogatory was in the proper form and should not have been refused by the trial court. Defendants were prejudiced because a negative answer to their interrogatory would have been inconsistent with the general verdict against them. A negative answer \u2014 that is, that Hooper\u2019s self-destructive behavior was not foreseeable \u2014 would have controlled and required the court to enter a judgment in defendants\u2019 favor.\nIn a petition for rehearing filed by plaintiff after our disposition of this cause in an unpublished order under Supreme Court Rule 23 (166 Ill. 2d R. 23), plaintiff insisted that, based on the testimony of Dr. Kapoor, Dr. Spadoni and Betty Shamley, \u201cthere was no question of fact regarding the issue of foreseeability.\u201d We have withdrawn that order and now address plaintiff\u2019s arguments.\nPlaintiff cited seven instances of undisputed pertinent facts that he claims establish that Hooper\u2019s suicide was foreseeable: (1) Shamley was concerned that Hooper would act impulsively or unpredictably; (2) Shamley testified it was unclear whether Hooper was suicidal because she could not finish her examination of Hooper; (3) Kapoor ordered a test to determine whether Hooper had suicidal tendencies; (4) one-to-one nursing care was ordered for Hooper to protect her from any type of injury; (5) Spadoni testified that patients like Hooper who suffer from ICU psychosis can be at risk for suicide; (6) Spadoni testified that the reason one-to-one nursing care was ordered was to protect Hooper from injury; and (7) Dr. Kapoor and other experts at trial testified that unpredictable behavior in patients with psychosis includes suicidal behavior. Plaintiff then argued that these facts establish conclusively that Hooper\u2019s suicide was reasonably foreseeable by an attending physician.\nWhat is omitted for plaintiffs argument to prevail is that these undisputed, pertinent facts establish as a matter of law that Hooper\u2019s suicide was foreseeable. While stressing the undisputed facts, plaintiff never argues that such an assembly of factual matter is so conclusive that the question is decided as a matter of law. \u201cWhat constitutes the proximate cause of an injury in a particular case is ordinarily a question of fact to be determined from all the attending circumstances, and it can only be a question of law when the facts are not only undisputed but are also such that there can be no difference in the judgment of reasonable men as to the inferences to be drawn from them.\u201d Merlo v. Public Service Co. of Northern Illinois, 381 Ill. 300, 318, 45 N.E.2d 665 (1942). Plaintiff does not argue, and we do not believe, that these seven facts could never cause differing inferences in the minds of reasonable people.\nFor these reasons, we reverse the judgment of the circuit court and remand for a new trial.\nReversed and remanded.\nBURKE and McBRIDE, JJ., concur.", "type": "majority", "author": "PRESIDING JUSTICE CAHILL" } ], "attorneys": [ "Richard A. Devine, State\u2019s Attorney, of Chicago (Patrick T. Driscoll, Jr., and Patrick M. Blanchard, Assistant State\u2019s Attorneys, and Marcie Thorp, Special Assistant State\u2019s Attorney, of counsel), for appellants.", "Powers, Rogers & Smith, PC., of Chicago (Larry R. Rogers and Devon C. Bruce, of counsel), for appellee." ], "corrections": "", "head_matter": "KENNETH HOOPER, Special Adm\u2019r of the Estate of Louise Hooper, Deceased, Plaintiff-Appellee, v. THE COUNTY OF COOK et al., Defendants-Appellants (Glenda Edmond-Nolla, Defendant).\nFirst District (1st Division)\nNo. 1-03-1842\nOpinion filed May 15, 2006.\nRehearing denied April 26, 2006.\nRichard A. Devine, State\u2019s Attorney, of Chicago (Patrick T. Driscoll, Jr., and Patrick M. Blanchard, Assistant State\u2019s Attorneys, and Marcie Thorp, Special Assistant State\u2019s Attorney, of counsel), for appellants.\nPowers, Rogers & Smith, PC., of Chicago (Larry R. Rogers and Devon C. Bruce, of counsel), for appellee." }, "file_name": "0001-01", "first_page_order": 19, "last_page_order": 29 }