Ashworth v. Branford

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ASHWORTH) v. TOWN OF

BRANFORD ET AL. (SC 21175)

Mullins, C. J., and McDonald, D’Auria, Ecker, Alexander, Dannehy and Bright, Js.

Syllabus The plaintiff, administratrix of the estate of the decedent, C, sought to recover damages from the defendant S Co. for the allegedly wrongful death of C, who had been shot and killed by M after M was discharged from a psy- chiatric hospital operated by S Co. M had been in a romantic relationship with C, but C eventually ended their relationship. In response, M went to a hospital, where he reported to medical staff that he was distraught about the end of that relationship, concerned that he would harm C, and was having homicidal ideations. He also reported that he was depressed, having trouble sleeping, using alcohol and drugs, and owned firearms. On the basis of this information, a physician, pursuant to the statute (§ 17a-502 (a)) authorizing the commitment of an individual, for up to fifteen days, when a physician concludes that the individual has psychiatric disabilities and is a danger to himself or others, involuntarily committed M for a fifteen day period. Approximately one day after his involuntary commitment, M was transferred from the hospital at which he was originally committed to S Co.’s psychiatric hospital. Two days later, however, M was discharged. M’s discharge plan did not call for any further supervision, and no one at the psychiatric hospital warned C or law enforcement about M’s discharge. In counts two through six of her complaint, the plaintiff alleged that S Co. knew, should have known, or had reason to know that M had threatened serious harm to C, that S Co. nevertheless failed to exercise reasonable care in its assessment, treatment, monitoring, and discharge of M, and that S Co. also failed to take reason- able measures to control M and to warn C of the danger M posed to her. In count seven, the plaintiff alleged that S Co. had committed gross medical negligence. S Co. filed a motion to strike the counts against it, which the trial court granted and rendered judgment thereon. The court concluded that counts two through six sounded in medical malpractice, insofar as the negligence alleged therein was substantially related to the medical diagnosis or treatment of M and involved the exercise of medical judgment. The court also determined that, because C was not a patient of S Co., those counts were barred as a matter of law in light of this court’s holding in Jarmie v. Tron- cale (306 Conn. 578) that a medical malpractice claim can be asserted only by, or on behalf of, a patient against a health care provider. With respect to count seven, the trial court concluded, inter alia, that Connecticut law does not recognize gross negligence as a separate basis of liability. Thereafter, the plaintiff appealed from the trial court’s judgment in favor of S Co., contending, inter alia, that the trial court had incorrectly concluded that all of the claims in counts two through six sounded in medical malpractice and that the trial court had erred in failing to analyze her claims in those counts under ordinary negligence principles. Held: The trial court incorrectly concluded that all of the claims in counts two through six of the plaintiff’s complaint necessarily implicated the exercise of professional medical judgment and therefore sounded in medical malpractice.

Liberally construed, certain allegations in counts two through six sounded in ordinary negligence rather than in medical malpractice, as those allega- tions challenged S Co.’s reasonable response to a known, substantial risk of imminent physical harm to an identifiable victim.

Specifically, the allegations sounding in ordinary negligence included that S Co. had failed to take reasonably necessary steps to control M so as to prevent him from causing harm to or killing C, failed to use proper and available resources and measures to contact C to warn her of M’s homicidal ideations directed at her, and prematurely discharged M when the fifteen day commitment period contemplated by § 17a-502 (a) had not yet expired.

The trial court correctly determined, however, that certain other allega- tions in counts two through six challenged the adequacy of S Co.’s evalua- tion, diagnosis, or treatment of M, or its administration of medication or discharge planning with respect to M, all of which required the exercise of professional medical judgment arising from the physician-patient relation- ship between S Co. and M.

Specifically, the allegations sounding in medical malpractice included that S Co. had failed to contact other sources to verify information provided by M, discharged M without performing an adequate assessment of risk, failed to properly assess the effects of M’s alcohol and drug use, failed to adequately treat M’s intrusive thoughts, failed to properly titrate M’s medication upon discharge, released M under his own care, and failed to assess how M would act upon discharge if he were to come into contact with C.

This court held, as a matter of first impression, that a mental health care provider who knows that a patient poses a substantial risk of imminent physical harm to an identifiable, nonpatient third party owes a duty to the nonpatient to take reasonable steps to protect him or her from the danger posed by the patient, and such steps may include warning the nonpatient of the risk or controlling the patient.

Although this court had previously expressed a general aversion to extend- ing the duty of health care providers to nonpatient third parties, it also had, under limited circumstances, recognized the potential for liability in cases, such as the present one, involving an identifiable potential victim who will be foreseeably harmed as a result of a health care provider’s negligence.

The extension of a limited, common-law duty to mental health care provid- ers treating psychiatric patients was consistent with the statutory scheme governing emergency involuntary commitment, including § 17a-502, and the statutory scheme ((Supp. 2026) §§ 52-146d through 52-146j) governing the disclosure of communications and records concerning a patient’s psychiatric diagnosis and treatment, as well as the balance the legislature struck in those statutory schemes, which reflected consideration of the patient’s liberty and privacy interests, as well as the need to protect both the patient and the public from physical harm.

Moreover, this court was not persuaded by S Co.’s arguments that the imposi- tion of the duty recognized in the present case would subject the professional judgment of a mental health care provider to hindsight review, encourage defensive medical practices and unnecessary commitments, and expose providers to a broad wave of nonpatient liability arising from patients’ acts of violence, as S Co.’s concerns were substantially mitigated by the limited nature of the duty recognized.

Furthermore, this court’s recognition of the limited duty announced in this case was consistent with the prevailing approach adopted in other jurisdic- tions, with many of those jurisdictions having adopted a duty, such as the one recognized here, that is limited to circumstances in which the physician has actual knowledge of a threat to a readily identifiable victim.

Accordingly, this court reversed the trial court’s judgment with respect to those allegations in counts two through six that could proceed under ordi- nary negligence principles and remanded the case with direction to deny S Co.’s motion to strike as to those allegations and for further proceedings.

This court declined to review the plaintiff’s claim that the trial court had improperly struck count seven of her complaint, in which she alleged gross medical negligence, as that claim was inadequately briefed.

Although the plaintiff relied on and cited certain precedent from this court in support of her claim, she had previously acknowledged before the trial court that that precedent did not directly apply to her claim, and her brief- ing in this court provided little guidance as to how the cited precedent would support recognition of her gross medical negligence claim under the circumstances of this case.

(One justice concurring in part and dissenting in part) Argued January 29—officially released August 4, 2026 Procedural History Action to recover damages for, inter alia, the wrong- ful death of the plaintiff’s decedent as a result of the defendants’ alleged negligence, and for other relief, brought to the Superior Court in the judicial district of Hartford, where the court, Klau, J., granted the motion to strike filed by the defendant SVMC Holdings, Inc.; thereafter, the court, Klau, J., granted the plaintiff’s motion for judgment and rendered partial judgment for the defendant SVMC Holdings, Inc., from which the plaintiff appealed. Reversed in part; further proceedings. Carey B. Reilly, with whom was William M. Bloss, for the appellant (plaintiff).

Eric Del Pozo, with whom was Sarah E. Dlugoszewski, for the appellee (defendant SVMC Holdings, Inc.).

Opinion

BRIGHT, J. Resolution of this appeal requires us to determine whether the administratrix of the estate of an identifiable nonpatient victim, who was murdered by a psychiatric patient following the patient’s involuntary hospitalization and subsequent discharge, may sue the mental health care provider1 that treated and discharged the patient. The plaintiff, Angela Ashworth, administra- trix of the estate of Caroline Anne Ashworth (decedent), appeals2 from the partial judgment of the trial court in favor of the defendant SVMC Holdings, Inc.,3 rendered after the court granted the defendant’s motion to strike counts two through eight of the plaintiff’s third amended complaint (complaint). The trial court, in striking the plaintiff’s claims against the defendant, concluded that those claims sounded in medical malpractice and that, pursuant to Connecticut’s statutory scheme, as explained by this court in Jarmie v. Troncale, 306 Conn. 578, 50 A.3d 802 (2012), only a patient may assert such claims. Given this conclusion, the court did not address whether the defendant owed the decedent a duty of care if the plaintiff’s claims in counts two through six were viewed as ordinary negligence claims, as characterized by the plaintiff. On appeal, the plaintiff claims that the court erred in categorizing her claims in counts two through six4 as sounding in medical malpractice and further argues that this court has previously recognized that a mental health care provider owes a duty of care to an identifiable third party such as the decedent in this case. Additionally, the plaintiff claims that the court erred in striking count seven of her complaint, which purported to assert a claim of gross medical negligence.

We conclude that the trial court incorrectly determined that all of the plaintiff’s allegations against the defen- dant sound in medical malpractice. To the extent that the complaint alleges that the defendant actually knew that the patient posed a substantial risk of imminent physical harm to an identifiable victim and failed to exercise reasonable care to protect that victim, includ- ing, for instance, by failing to warn her or to adequately control the patient, we conclude that the claims sound in ordinary negligence rather than medical malpractice. We further hold, for the first time, that a mental health care provider who actually knows that his or her patient poses a substantial risk of imminent physical harm to an identifiable victim has a duty to exercise reasonable care to protect that victim from that danger. We clarify in this opinion both the narrow circumstances under which this duty arises and the limited scope of the duty.5 Accordingly, we conclude that the trial court improperly granted the defendant’s motion to strike counts two through six of the plaintiff’s complaint and reverse in part the partial judgment of the trial court. We do not address the plaintiff’s claim that she may pursue a claim of gross medical negligence against the defendant because it is inadequately briefed.

We begin by setting forth the facts alleged in the plain- tiff’s complaint, construed in the manner most favorable to sustaining its legal sufficiency, along with the relevant procedural history. See, e.g., Doe v. Cochran, 332 Conn. 325, 328, 210 A.3d 469 (2019). In late 2019 or early 2020, the decedent, then approxi- mately eighteen years old, and Michael Mollow, then approximately fifty-seven years old, began a romantic relationship. During the course of the relationship, Mol- low provided the decedent with financial support and exercised control over her transportation, movements, and communications with others. Mollow initially paid her rent, but, after he stopped making payments, the decedent incurred debt and moved into his residence. In July 2022, Mollow and the decedent purchased a truck together for the decedent’s use, but Mollow retained sole title without the decedent’s knowledge. The truck was equipped with an application that Mollow used to track the decedent’s movements via global positioning system (GPS) technology.6

In August 2022, officers from the Branford Police Department responded to multiple domestic disturbance incidents involving the decedent and Mollow. During these incidents, the decedent informed the responding officers that Mollow previously had threatened to shoot her and had choked her and physically assaulted her. Mol- low admitted to the police that he tracked the decedent’s location using a GPS application, possessed unsecured firearms in his home, and had initiated at least two con- frontations with the decedent that involved violent, physical contact.7 The decedent also informed the police that Mollow had been displaying controlling behavior by disrupting her cell phone service and by preventing her from using the truck and from earning her own income. On or about August 22, 2022, the decedent moved out of Mollow’s residence and drove the truck to Alabama to visit her grandmother. In the early morning hours of August 23, Mollow went to the emergency department at MidState Medical Center (MidState). There, he reported to medical staff that he was “emotionally distraught” because the decedent had ended their three year relation- ship. He told medical staff that he had specific homicidal ideations toward the decedent and feared that he would hurt her if she returned to Connecticut. He also reported that he was “ ‘obsessed’ ” with the decedent, had been suf- fering from sleep disturbances, had been using alcohol and Xanax obtained “ ‘off the street,’ ” and “did not feel able to remain safe outside [of] a hospital environment . . . .” He informed the staff that he possessed a pistol permit and owned firearms located at his residence. Based on this information, a MidState emergency medicine physician executed a fifteen day, involuntary emergency certificate pursuant to General Statutes § 17a-502, opin- ing that Mollow “ ‘ha[d] psychiatric disabilities,’ ” was a danger to himself or others, and needed “immediate care and treatment in a hospital . . . .” In the emergency certificate, the MidState physician certified that Mollow presented with “ ‘positive homicidal ideation [toward his former] girlfriend, depress[ion], insomnia, [and a] poor appetite.’ ”

Further, MidState staff contacted the Branford Police Department and disclosed that Mollow had been admit- ted to the hospital after reporting homicidal thoughts directed toward the decedent, who was in Alabama at the time. MidState staff provided the police with the decedent’s cell phone number and, in subsequent calls, informed officers that Mollow owned firearms and had been hospitalized because of his reaction to his break- up with the decedent. An officer attempted to contact the decedent on her cell phone but did not reach her and could not leave a voicemail. He took no further action and marked the investigation as “ ‘inactive . . . .’ ” The day after his admission to MidState, Mollow was transferred to the defendant’s psychiatric hospital, St. Vincent’s Medical Center (SVMC) in Westport, pursuant to the emergency certificate. Mollow’s medical records from MidState stated that, around the time of the trans- fer, Mollow was “demonstrating ‘anger and nonspecific thoughts of hurting his ex-girlfriend’ and a ‘tendency toward obsessive thinking,’ [and his] status remained as an involuntary admission.” Upon his admission to SVMC, Mollow informed medical personnel that he (1) had been hospitalized because he had thoughts of harming or kill- ing the decedent, (2) was depressed and having trouble sleeping, and was using alcohol and nonprescription Xanax, and (3) was requesting medication “to stop his ‘intrusive thoughts’ ” about harming the decedent and to help him sleep.

Approximately two days later, the attending psychia- trist at SVMC, Nayla Hariz, discharged Mollow from SVMC. SVMC provided Mollow with a discharge plan that involved Mollow’s following up with his primary care physician for medication management and attend- ing an appointment with a social worker five days later. Mollow was released with no additional plan for further supervision.

The following evening, Mollow tracked the GPS loca- tion of the decedent’s truck and followed her to a con- dominium complex in Wethersfield, armed with one of his firearms. The decedent was seated inside the truck in the parking lot of the complex when Mollow confronted her and shot her three times, killing her. Mollow then took his own life.

The plaintiff brought this action against Christopher J. Donlin, administrator of Mollow’s estate, the town of Branford, and the defendant. See footnote 3 of this opinion. On March 20, 2024, the plaintiff filed her third amended complaint, which is the operative pleading.

Counts two through eight of the complaint are directed toward the defendant. In broad terms, those counts assert several related theories of liability arising from the defendant’s alleged conduct in evaluating, treating, and discharging Mollow, and in failing to take reasonable steps to prevent him from harming the decedent. Count two alleges that the defendant breached its duty to con- trol Mollow or to warn the decedent of Mollow’s threats against her. Counts three through five invoke duties arising from special relationships and from §§ 3158 and 3199 of the Restatement (Second) of Torts, and § 4110 of the Restatement (Third) of Torts, Liability for Physical and Emotional Harm. Counts six through eight assert claims for ordinary negligence, gross medical negligence, and common-law medical negligence based on the same underlying conduct. Across these counts, the plaintiff alleges that the defendant knew, should have known, or had reason to know that Mollow had threatened serious harm to the decedent, whom the complaint alleges was his “readily identifiable, foreseeable target,” and neverthe- less failed to exercise reasonable care in its assessment, treatment, monitoring, and discharge of Mollow and to take reasonable measures to control him and to warn the decedent of the danger he posed to her.

On May 15, 2024, the defendant moved to strike counts two through eight of the plaintiff’s complaint “on the [ground] that the counts fail to allege a cognizable duty of care that was owed to the . . . decedent.” The plaintiff objected, and the defendant replied.

On January 10, 2025, the trial court granted the defen- dant’s motion to strike. In its memorandum of decision, the court concluded that, notwithstanding the plaintiff’s characterization of the claims, the counts sounded in medical malpractice because the alleged negligence was of exists between the actor and the other [that] gives to the other a right to protection.” 2 Restatement (Second), Torts § 315, p. 122 (1965). a specialized nature arising out of a medical professional- patient relationship, was substantially related to the medical diagnosis or treatment of Mollow, and involved the exercise of medical judgment. Relying on our inter- pretation of General Statutes § 52-190a in Jarmie v. Troncale, supra, 306 Conn. 578, the court explained that a medical malpractice action must be brought by a patient because the statute limits such claims to negligence occurring “ ‘in the care or treatment of the claimant,’ ” and, therefore, the court concluded that, because the decedent was not a patient of the defendant, the plain- tiff’s claims were barred as a matter of law.

With respect to count seven, in which the plaintiff advances a claim for gross medical negligence, the trial court concluded that Connecticut law does not recog- nize gross negligence as a separate basis of liability and declined to extend the holding of Squeo v. Norwalk Hospital Assn., 316 Conn. 558, 580–81, 113 A.3d 932 (2015), to the plaintiff’s claim.11 The court fur- ther rejected the plaintiff’s contention that count eight of the complaint alleged common-law medical negli- gence outside the purview of § 52-190a.12 In granting the motion to strike, the court emphasized that its rul- ing was limited to the claims as pleaded and expressly declined to decide whether all “ ‘duty to warn’ ” causes of action against mental health care providers neces- sarily sound in medical malpractice. After the plain- tiff elected not to replead, the court rendered partial judgment for the defendant. This appeal followed.

On appeal, the plaintiff argues that the trial court incorrectly determined that all of her claims against the defendant in counts two through six sounded in medical malpractice under § 52-190a and, therefore, could not be maintained by a nonpatient. The plaintiff contends that, in light of Fraser v. United States, 236 Conn. 625, 674 A.2d 811 (1996)—which, she claims, consistent with Tarasoff v. Regents of the University of California, 17 Cal. 3d 425, 431, 439, 551 P.2d 334, 131 Cal. Rptr. 14 (1976), recognized that mental health care providers owe a duty to protect identifiable victims from threats of serious physical harm posed by their patients—the trial court erred in failing to analyze the plaintiff’s claims under ordinary negligence principles. Alternatively, she claims that Connecticut law recognizes a claim for gross medical negligence by nonpatients and that the trial court therefore erred in striking count seven of her amended complaint.

In resolving the plaintiff’s principal claim, we must first determine whether each of the allegations struck by the trial court sounds in medical malpractice or, instead, in ordinary negligence. If any of the allegations sound in ordinary negligence, we must then determine whether, under the circumstances presented, Connecticut law recognizes a duty of care owed by the defendant to the decedent, a nonpatient third party, and, if so, the scope of that duty.

§ 52-190a. It explained that medical malpractice claims are common-law claims that are “ ‘procedurally circumscribed by statute,’ ” and, thus, there is no “statutory cause of action separate and independent from the common-law claim.” On appeal to this court, although the plaintiff acknowledges that the trial court struck count eight of the complaint, she advances no claim of error with respect to that ruling.

I

We first consider whether the trial court correctly determined that counts two through six of the com- plaint sound in medical malpractice and, accordingly, are barred by virtue of § 52-190a and Jarmie because the decedent never was a patient of the defendant.

As a preliminary matter, we set forth the applicable standard of review and relevant legal principles regard- ing medical malpractice actions. “The standard of review in an appeal challenging a trial court’s granting of a motion to strike is well established. A motion to strike challenges the legal sufficiency of a pleading, and, con- sequently, requires no factual findings by the trial court. As a result, our review of the court’s ruling is plenary. . . . We take the facts to be those alleged in the [pleading] that has been stricken and we construe the [pleading] in the manner most favorable to sustaining its legal suf- ficiency.” (Internal quotation marks omitted.) Jarmie v. Troncale, supra, 306 Conn. 583. “[I]f facts provable in the complaint would support a cause of action, the motion to strike must be denied. . . . Moreover, we note that [w]hat is necessarily implied [in an allegation] need not be expressly alleged. . . . It is fundamental that in determining the sufficiency of a complaint challenged by a defendant’s motion to strike, all well-pleaded facts and those facts necessarily implied from the allegations are taken as admitted. . . . “In Connecticut, we long have eschewed the notion that pleadings should be read in a hypertechnical man- ner. Rather, [t]he modern trend, which is followed in Connecticut, is to construe pleadings broadly and real- istically, rather than narrowly and technically. . . . [T]he complaint must be read in its entirety in such a way as to give effect to the pleading with reference to the general theory [on] which it proceeded, and do substantial justice between the parties. . . . Our reading of pleadings in a manner that advances substantial justice means that a pleading must be construed reasonably, to contain all that it fairly means, but carries with it the related proposition that it must not be contorted in such a way so as to strain the bounds of rational comprehension.” (Citation omitted; internal quotation marks omitted.) Doe v. Cochran, supra, 332 Conn. 333–34.

In Jarmie, we interpreted § 52-190a (a)13 to mean that “a cause of action alleging medical malpractice must be brought by a patient against a health care provider because the language of the statute specifically pro- vides that the alleged negligence must have occurred ‘in the care or treatment of the claimant.’ ” (Emphasis in original.) Jarmie v. Troncale, supra, 306 Conn. 587. Consequently, the plaintiff acknowledges that, if her neg- ligence claims sound in medical malpractice, such claims are governed by § 52-190a and cannot proceed because the decedent never was a patient of the defendant.14 Nevertheless, not all claims against health care provid- ers sound exclusively in medical malpractice. See, e.g., Doe v. Cochran, supra, 332 Conn. 336. Indeed, “our courts have long recognized that a health care provider may commit ordinary negligence, as opposed to medical malpractice, in the course of treating a patient or pro- viding medical services.” Id., 334. A claim may sound in ordinary negligence,15 “rather than (or in addition to) medical malpractice,” depending on the circumstances. Id.; see also Jarmie v. Troncale, supra, 306 Conn. 586. Thus, “[t]he classification of a negligence claim as either medical malpractice or ordinary negligence requires a court to review closely the circumstances under which the alleged negligence occurred.” (Internal quotation marks omitted.) Jarmie v. Troncale, supra, 587.

In Jarmie, the plaintiff, who was injured when the defendant physician’s patient blacked out while driv- ing and struck the plaintiff’s vehicle, alleged that the physician had negligently failed to warn the patient that her medical condition impaired her ability to operate a motor vehicle safely. Id., 580–81. In considering the legal sufficiency of the claim, we analyzed the complaint under both medical malpractice and ordinary negligence frameworks. Id., 586. (1997) (“[t]he purpose of the legislation is to inhibit a plaintiff from bringing an inadequately investigated cause of action, whether in tort or in contract, claiming negligence by a health care provider”). Nothing in the statute’s legislative history indicates that the legislature specifically intended to address whether nonpatients may bring negligence claims against health care providers. Nevertheless, in Jarmie, we interpreted § 52-190a to mean that a medical malpractice action may be brought only by a patient. See Jarmie v. Troncale, supra, 306 Conn. 588–89. Although one could reasonably question whether the legislature intended § 52-190a to operate as a bar to medical malpractice claims brought by nonpatients against health care providers, our interpretation in Jarmie of the statutory text, which the plaintiff does not challenge in this appeal, does not permit a different construction.

We first addressed whether the complaint could survive a motion to strike if it sounded in medical malpractice for purposes of § 52-190a. Id. We explained that “[p]rofes- sional negligence or malpractice . . . [is] defined as the failure of one rendering professional services to exercise that degree of skill and learning commonly applied under all the circumstances in the community by the average prudent reputable member of the profession with the result of injury, loss, or damage to the recipient of those services. . . . [M]alpractice presupposes some improper conduct in the treatment or operative skill [or] . . . the failure to exercise requisite medical skill . . . .”(Emphasis omitted; internal quotation marks omitted.) Id., 587–88. We then set forth the relevant considerations for deter- mining whether a claim sounds in medical malpractice: “whether (1) the defendants are sued in their capacities as medical professionals, (2) the alleged negligence is of a specialized medical nature that arises out of the medi- cal professional-patient relationship, and (3) the alleged negligence is substantially related to medical diagnosis or treatment and involved the exercise of medical judg- ment.” (Emphasis in original; internal quotation marks omitted.) Id., 588. Such claims, we emphasized, typi- cally require expert testimony in order to establish the applicable standard of care and the deviation from that standard. Id.

Applying those principles, we determined that the plaintiff’s claim sounded in medical malpractice; see id., 588–89; because the complaint alleged that the plain- tiff’s injuries were caused by the physician’s “[devia- tion from the accepted standard of care applicable to the treatment of the patient] in that [the physician] failed to . . . advise and warn [the patient] not to drive a vehicle.” (Internal quotation marks omitted.) Id., 581. Accordingly, we concluded that, “insofar as the [physi- cian and his employer] characterize[d] the plaintiff’s complaint as sounding in medical malpractice, it [was] legally insufficient because it contain[ed] no allegations that the [parties] had a physician-patient relationship as required under Connecticut’s medical malpractice law.” Id., 588–89.

We then considered whether the physician owed the nonpatient plaintiff a duty of care under ordinary neg- ligence principles. Id., 589. We concluded that he did not, in part because the alleged standard of care turned inherently on the exercise of professional medical judg- ment, as it required a determination of when, in the course of diagnosis and treatment, a patient’s condition warranted a warning. See id., 610. As we observed, most diseases that impair a patient’s ability to drive develop gradually, progress at different rates, and can be dif- ficult to detect in their early stages; depending on the circumstances, the health care provider, in his or her professional judgment, might not deem it necessary to warn the patient regarding the risks of driving. See id., 610–11. Extending such a duty to nonpatients in that context would, “in some cases, allow strangers in their capacity as jurors and medical experts to substitute their judgment for that of physicians and patients . . . .” Id., 609. It could also “interfere significantly with a health care provider’s discretion to treat and counsel patients in accordance with an assessment of the patient’s indi- vidual needs.” Id., 613.

In Doe v. Cochran, supra, 332 Conn. 325, however, we recognized that a negligence claim brought by a non- patient against a health care provider may sound in ordinary negligence, rather than malpractice, when the alleged negligence does not implicate the provider’s professional judgment. See id., 336–38. The defendant physician in Doe negligently misreported to a patient that the patient had tested negative for a sexually trans- mitted disease (STD) when the laboratory results clearly indicated a positive diagnosis. Id., 327–29. The physi- cian was aware that the patient sought testing “for the protection and benefit of” the plaintiff, the patient’s exclusive romantic partner. Id., 328. Under those cir- cumstances, we concluded that the plaintiff’s claims “need not be read to sound in medical malpractice.” Id., 336. Central to our reasoning was that the alleged negli- gence did not involve the exercise of professional medical judgment or skill. See id., 336–37. Rather, it involved a rudimentary failure to convey accurate information. See id. We observed that the determination of whether the defendant was negligent in giving a patient the wrong test results was “well within the ken of a layperson” and would not require expert testimony. Id., 337. Because the alleged negligence consisted of a failure to report accurate test results in light of information already in the physician’s possession, the claim sounded in ordinary negligence rather than medical malpractice. See id., 336–38, 368–69.

What these cases make clear is that there is an impor- tant distinction between allegations that a mental health care provider “knew” of a risk after exercising his pro- fessional judgment and failed to take reasonable steps not involving medical judgment to account for that risk, and allegations that the mental health care pro- vider “should have known” or “had reason to know” of a risk but failed to use reasonable care in exercising that judgment. Determining whether a mental health care provider should have recognized a risk and exercised medical judgment to mitigate that risk requires a retro- spective evaluation of the provider’s clinical assessment and exercise of judgment in diagnosing and treating the patient. Such inquiries ask a fact finder—typically with the help of expert testimony—to determine whether the provider properly exercised the degree of professional skill and learning ordinarily possessed by practitioners in the field. See id., 334–35. As a result, allegations framed in terms of what a provider should have known or had reason to know, or how they should have treated the patient, challenge the adequacy of the provider’s professional evaluation and care of the patient and, therefore, sound in medical malpractice. See, e.g., Gold v. Greenwich Hospital Assn., 262 Conn. 248, 255, 811 A.2d 1266 (2002).

When the complaint alleges that the mental health care provider actually knew that the patient posed a substan- tial risk of imminent physical harm to an identifiable person but failed to exercise reasonable care to protect the victim, however, it does not challenge the adequacy of the provider’s professional judgment in the medical evaluation, diagnosis, or treatment of the patient. In this context, “knew” refers to actual knowledge—that is, the provider already had determined, based on the provider’s professional medical judgment, that the patient posed a substantial risk of imminent physical harm to an identi- fiable victim, even though the provider could not know with certainty that the patient would in fact harm the victim. When such actual knowledge is alleged, the rel- evant inquiry is whether the mental health care provider, having recognized that the patient posed a substantial risk of imminent physical harm to an identifiable victim, exercised reasonable care under the circumstances to protect that victim from the foreseeable harm. In other words, the inquiry concerns whether the provider took reasonable nonmedical steps to protect the identifiable victim once the risk was actually known. Of course, the discharge of this duty of care will necessarily vary with the facts of each case.

To be clear, to state a claim of ordinary negligence similar to what was alleged in Doe, the alleged negligence must be capable of being “judged against the standard of what a reasonable person would have done under the circumstances . . . .” (Internal quotation marks omitted.) Doe v. Cochran, supra, 332 Conn. 335. For example, with respect to an allegation that the defendant negligently failed to control the patient, if a mental health care pro- vider concludes that a patient poses a substantial risk of imminent physical harm to an identifiable third person and intends to control that patient but negligently fails to do so because of an accident, mistake, or other nonmedical error—such as leaving a door unsecured and permitting the patient to escape or incorrectly completing paperwork that results in an improper discharge—the negligent act itself would not implicate the exercise of professional medical judgment. Similarly, if the mental health care provider concludes that the patient poses such a risk but does not take protective measures to control the patient for reasons unrelated to medical judgment—for example, because of financial, insurance, or logistical considerations—the alleged negligence may not concern the provider’s professional judgment.

By contrast, if the mental health care provider con- cludes that a patient poses a substantial risk of imminent physical harm to an identifiable third person but deter- mines, in the exercise of medical judgment, that hospi- talization is unnecessary to control the patient because the risk is adequately managed through medication, out- patient treatment, or follow-up care, or because of some other medical determination, the claim would directly implicate the provider’s professional medical judgment and would sound in medical malpractice under § 52-190a and Jarmie. Thus, once the provider has determined that the patient poses the requisite risk, the claim sounds in ordinary negligence only insofar as the alleged failure to control the patient was not itself based on medical judgment. In such a case, just as the physician’s failure to accurately communicate test results in Doe was judged by the ordinary reasonable person standard, so, too, would the mental health care provider’s conduct taken in response to a known, substantial risk of imminent physical harm to an identifiable third party.

Such line drawing does not come into play when the allegation is that the mental health care provider failed to warn an identifiable third party of a substantial risk of imminent physical harm. In such a case, the provider has already exercised its medical judgment to determine that the risk of harm exists, and the decision whether to warn does not involve treatment of the patient. Instead, the reasonableness of the provider’s conduct can be judged by what an ordinary person would do under such cir- cumstances.

Accordingly, to the extent that the plaintiff’s com- plaint alleges that the defendant should have known or had reason to know that Mollow posed a danger to the decedent, those allegations sound in medical negligence and cannot be maintained on behalf of the decedent, a nonpatient. Allegations that the defendant actually knew of the risk and nevertheless was negligent in the ways that do not involve medical judgment set forth in the remainder of the complaint, however, may support claims sounding in ordinary negligence.

With these principles in mind, we turn to the allega- tions of the complaint.

In counts two through six, the plaintiff alleged that, prior to Mollow’s discharge, the defendant “knew, should have known or had reason to know that Mollow had a history of and/or propensity to cause harm to [the dece- dent],” “that Mollow had expressed specific threats of causing bodily harm to, or possibly the death of, [the decedent],” “that Mollow had the means to cause bodily harm to, or possibly the death of, [the decedent],” and “that Mollow desired to cause bodily harm to, or possibly the death of, [the decedent], who was Mollow’s readily identifiable individual target.” The complaint further alleged that the resulting harm to the decedent was foreseeable and that the defendant’s negligence was the proximate cause of the decedent’s injuries and resulting death. Count two, titled “Violation of Duty To Control and/or Warn To Avoid Injury to Identifiable Third Per- son,” includes eleven specific allegations of negligence, which are repeated in substantially identical form in counts three through six.

As pleaded, several allegations in the complaint chal- lenge the adequacy of the defendant’s psychiatric evalu- ation, diagnosis, treatment, medication, or discharge planning, all of which require professional medical judg- ment arising from the physician-patient relationship between the defendant and Mollow. These include the allegations that the defendant “[failed] to contact col- lateral sources to verify information provided by Mol- low,” “[discharged] Mollow without performing adequate assessment of risk,” “[failed] to properly assess the effects of Mollow’s alcohol use and use of Xanax,” “[failed] to adequately treat Mollow’s intrusive thoughts,” “[failed] to properly titrate [Mollow’s] medications . . . as of the time of discharge,” “[discharged] Mollow under his own care,”and “[failed] to determine how Mollow would act upon discharge if he were to see [the decedent] . . . .” By contrast, the plaintiff sets forth other allegations that do not challenge the adequacy of the defendant’s medical treatment of Mollow. Specifically, the plaintiff alleges that the defendant “[failed] to take reasonably necessary actions to control Mollow to prevent him from causing harm to or killing [the decedent]” and “[failed] to use proper [and] available resources and measures to contact [the decedent] to warn her of Mollow’s homicidal ideations directed specifically at [the decedent].” Further, the plaintiff alleged that the defendant was negligent in “[p]rematurely discharging Mollow . . . when the [emer- gency certificate] had not expired, Mollow was willing to stay in the hospital, and . . . his depression, sleep disorder and homicidal ideations toward [the decedent] had not been adequately treated . . . .”

Although the decision to discharge a patient generally involves the exercise of professional medical judgment; see, e.g., Gold v. Greenwich Hospital Assn., supra, 262 Conn. 255; when read together with the plaintiff’s alle- gations that the defendant actually knew at the time of discharge that Mollow posed a risk of harm to the dece- dent, the allegations regarding Mollow’s discharge and the defendant’s failure to control him may be broadly construed as asserting that the defendant, for reasons unrelated to medical diagnosis or treatment, failed to exercise reasonable care to protect the decedent.16 As previously noted in this opinion, an allegation that the defendant failed to warn after having identified that the patient presents a substantial risk of imminent harm to an identifiable third party does not involve the exercise of medical judgment and may sound in ordinary negligence. Because these allegations concern the failure to take reasonable steps to protect an identifiable third-party victim from a dangerous patient, despite a known, sub- stantial risk of imminent physical harm, they may sound in ordinary negligence rather than medical malpractice. One other allegation requires further parsing because it contains both medical and nonmedical components.

The plaintiff alleged that the defendant “[failed] to ade- quately and properly care for, treat, monitor, supervise and/or control Mollow, so as to protect [the decedent] from [Mollow’s] causing her harm or death . . . .” To the extent that this allegation challenges the manner in which the defendant cared for or treated Mollow, it implicates the exercise of professional medical judgment and therefore sounds in medical malpractice. Insofar as the allegation asserts that the defendant, knowing of the substantial risk of imminent physical harm Mollow posed to the decedent, failed to monitor, supervise, or control him, it may concern the defendant’s alleged failure to exercise reasonable care to protect an identifiable third party, to the extent that such failure was not based on medical judgment.

We disagree with the defendant that our decisions in Gold v. Greenwich Hospital Assn., supra, 262 Conn. 248, and Levin v. State, 329 Conn. 701, 189 A.3d 572 (2018), compel the conclusion that all of the allegations in the plaintiff’s complaint must be construed as sounding in medical malpractice. In Gold, the plaintiff sued a hospi- tal and a physician for negligence after she was injured by a patient who had been treated at the hospital for an that we have in this opinion more clearly defined the test for determin- ing whether a mental health care provider’s failure to control a patient sounds in medical malpractice or ordinary negligence, the plaintiff should be permitted to amend her complaint, if she so chooses, to allege the basis for Hariz’ failure to act. allergic reaction and discharged into the plaintiff’s care. See Gold v. Greenwich Hospital Assn., supra, 250–51.

We concluded that the plaintiff’s claim sounded in medi- cal malpractice because it “implicate[d] the defendants’ medical judgment in discharging [the patient] without ascertaining whether her psychological condition was such that she was a danger to others, e.g., the plaintiff.” (Emphasis added.) Id., 255.

Similarly, in Levin, the plaintiff alleged medical neg- ligence “resulting from the care, treatment, and custody of a patient, and from a failure to warn the decedent of the patient’s dangerous propensities”; Levin v. State, supra, 329 Conn. 703; after a patient on an approved home visit from a state mental health facility killed his mother. See id., 704–705. The plaintiff alleged that the hospital’s “level of care was below that of a reasonably prudent [health care] provider.” Id., 705. We concluded that the action could not proceed because the claim was clearly “presented to, and authorized by, the claims commissioner [as] solely one of medical malpractice”; id., 708–709; and, accordingly, it was “exactly the sort of nonpatient medical malpractice action that Jarmie forbids.” Id., 707. We did not consider in Levin whether the claim could be sustained under ordinary negligence principles because no such claim had been authorized by the claims commissioner. See id., 708–10. Thus, in both Gold and Levin, we concluded that the alleged negligence turned on the provider’s exercise of professional medical judgment and therefore sounded in medical malpractice. Instead, allegations that the defendant failed to take action to mitigate a known risk to the decedent, if not based on the exercise of medical judgment, are more akin to the negligence alleged in Doe. In the present case, the alleged negligence, premised on the claim that the defen- dant knew of the risk Mollow posed to the decedent, may not challenge the mental health care provider’s exercise of professional medical judgment in evaluating, diagnos- ing, and treating the patient. Rather, the alleged negli- gence occurred only after the provider had determined that the patient posed a substantial risk of imminent physical harm to an identifiable individual and may have been based on factors other than the defendant’s exercise of medical judgment. In such a case, as in Doe, the provider’s professional judgment is exercised in mak- ing the underlying medical determination based on the provider’s assessment of the patient; once that determi- nation has been made, however, the remaining question is whether the mental health care provider exercised the reasonable care of an ordinary person in responding to the known risk of harm. Resolving that question does not require the fact finder to evaluate whether the pro- vider should have reached a different medical judgment; rather, like in Doe, it concerns conduct for which “[n]o advanced medical training was necessary . . . .” Doe v. Cochran, supra, 332 Conn. 336–37. Just as the deter- mination of whether delivering the wrong test results “is well within the ken of a layperson”; id., 337; so, too, is the question of whether a mental health care provider was negligent in failing to control a patient the provider knew represented a substantial risk of imminent physical harm to an identifiable person or in failing to warn that person of that known risk.

In sum, we agree with the trial court that several of the plaintiff’s allegations sound in medical malpractice because they challenge the manner in which the defen- dant evaluated and treated Mollow. Those allegations, therefore, are subject to the limitation of § 52-190a (a) and cannot be maintained by a nonpatient. See Jarmie v. Troncale, supra, 306 Conn. 587. We disagree, however, with the trial court’s conclusion that all of the plaintiff’s allegations necessarily implicate the exercise of profes- sional medical judgment. Liberally construed, certain allegations challenge the defendant’s reasonable response to a known, substantial risk of imminent physical harm to an identifiable victim, rather than to the adequacy of the defendant’s medical evaluation or treatment of Mol- low. As such, those allegations may be evaluated under ordinary negligence principles.

II

Having determined that some of the allegations in the plaintiff’s complaint do not sound in medical malpractice, we must decide an issue this court has never squarely addressed: whether a mental health care provider who has actual knowledge that a patient poses a substantial risk of imminent physical harm to a specifically iden- tifiable third person owes a duty of reasonable care to protect that person. We conclude that, in these limited circumstances, such a duty exists.

As a general rule, “absent a special relationship of custody or control, there is no duty to protect a third person from the conduct of another.” (Internal quota- tion marks omitted.) Id., 592. Although it is well settled that physicians owe a duty of care to their patients; see id. (“physicians owe an ordinary duty to their patients not to harm them through negligent conduct and an affirmative duty to help them by providing appropriate care”); there is “no well established common-law rule that a physician owes a duty to warn or advise a patient for the benefit of another person.” (Emphasis added.) Id. In the present case, the alleged duty is owed not to the patient for the benefit of another, but directly to the third-party victim.

The plaintiff contends that this court has repeatedly recognized the existence of a duty owed by a mental health care provider to an identifiable nonpatient victim. See, e.g., Doe v. Cochran, supra, 332 Conn. 338; Gazo v. Stamford, 255 Conn. 245, 252, 765 A.2d 505 (2001); Jacoby v. Brinckerhoff, 250 Conn. 86, 96, 735 A.2d 347 (1999); Fraser v. United States, supra, 236 Conn. 632–35. The defendant disputes this contention and argues that any discussions of a possible duty to such a person in our cases are dicta.

In Fraser, we considered, in response to a certified question from the United States Court of Appeals for the Second Circuit, whether a psychotherapist owed a duty to control a psychiatric outpatient to protect a third party from the patient’s violent conduct. See Fraser v. United States, supra, 236 Conn. 626, 629. The patient, who suffered from paranoid delusions and had long been receiving outpatient psychiatric care at a federal medi- cal center, had stabbed a man to death. Id., 628–29. We acknowledged that, “[i]n its broader form,” the certified question in Fraser addressed whether Connecticut law recognizes a duty arising from the psychotherapist- outpatient relationship that obligates the therapist “to control the behavior of the outpatient to prevent the outpatient from causing bodily harm to third persons”; id., 629–30; a duty recognized in Tarasoff v. Regents of the University of California, supra, 17 Cal. 3d 425.17 However, we expressly declined to decide that broader question and, instead, confined our analysis to “whether a psychotherapist has a duty to exercise control to pre- vent an outpatient, who was not known to have been dangerous, from inflicting bodily harm on a victim who was neither readily identifiable nor within a foreseeable class of victims.” Fraser v. United States, supra, 630. Under those circumstances, we declined to recognize a duty. Id., 632.

We have since discussed Fraser on several occasions. In Jacoby v. Brinckerhoff, supra, 250 Conn. 86, which involved a claim by a former spouse of a psychiatric patient that a psychiatrist’s negligent treatment of the patient caused the deterioration of their marriage; id., 87–88; we explained that, “[i]n Fraser, we delineated the scope of the duty of a psychotherapist to control a psychi- atric outpatient to prevent the patient from committing an imminent act of violence against a third person. . . . To protect the integrity of the therapeutic relationship, we held that a duty to disclose the substantial risk of such an act of violence would arise only if the third person was an identifiable victim or a member of a class of identifiable victims. . . . We declined to jeopardize that relationship except under the most compelling circumstances. Such an exception was warranted, we held, in the event of an imminent risk of serious personal injury to identifiable victims. . . . Third party claimants under Fraser must allege not only identifiability but physical injury.” (Cita- tions omitted.) Id., 96–97. Because the plaintiff had not alleged any physical injuries, her claim failed. Id., 97. In Gazo v. Stamford, supra, 255 Conn. 245, we held that a snow removal contractor owed a direct duty of care to a pedestrian who had slipped on an icy sidewalk because the harm was foreseeable and public policy con- siderations supported the imposition of liability. Id., 250–51. We cited Fraser among several cases in which policy considerations have justified limiting the reach of a duty, describing Fraser as standing for the proposi- tion that “[a] duty to disclose [a] substantial risk of [an] imminent act of violence arises only if [the] third person is [an] identifiable victim or [a] member of [a] class of identifiable victims . . . .” (Citation omitted.) Id., 252. Thus, in both Gazo and Jacoby, we assumed, based on Fraser, that a physician could owe a duty either to con- trol a patient who posed a substantial risk of imminent harm to an identifiable third party or to warn of such risk, but in neither case was the existence of that duty essential to our holding.

Subsequently, in Jarmie v. Troncale, supra, 306 Conn 578, we stated that “[t]he only time that we have even con- templated enlarging the duty of a health care provider to include a person who is not a patient was [in Fraser] when we considered whether a psychotherapist owed a duty to a third party to control an outpatient, who was not known to have been dangerous.” (Emphasis in original.) Id., 593. After determining that the complaint in Jarmie failed to state a cognizable claim for medical malpractice because the plaintiff was not the physician’s patient; id., 588–89; we analyzed the claims under ordinary negligence prin- ciples and concluded that the physician owed no duty to the plaintiff. Id., 590–91. We reasoned, in part, that, because the plaintiff was not an identifiable victim or a member of an identifiable class of victims, “the potential victims of [the physician’s] alleged negligence included any random pedestrian, driver, vehicular passenger or other person who happened to come in close proximity to a motor vehicle operated by [the patient] following her diagnosis.” Id., 597. We explained that the foresee- ability test applied by this court in the context of health care providers has consistently required an identifiable victim; id., 595–98; and, for reasons of public policy, declined to recognize a provider’s duty to unidentifiable third persons. See id., 622. Jarmie, therefore, seemed to leave open the question of whether a health care provider owes a duty of care to an identifiable nonpatient.

In Doe v. Cochran, supra, 332 Conn. 325, we resolved that question, at least in part. We noted that, “although we consistently have expressed a general aversion to extending the duty of health care providers to third parties, we have allowed, under limited circumstances, for the imposition of liability to an identifiable potential victim who will be foreseeably harmed by a physician’s negligence.” Id., 350. We emphasized that “a principal reason that we . . . declined to recognize that the [physi- cian in Jarmie] owed a duty to the plaintiff motorist was because the plaintiff was not an identifiable victim at the time that medical services were provided.” (Emphasis in original.) Id., 347. In Doe, however, because the patient told the defendant physician that he was seeking STD testing for the benefit of his exclusive girlfriend, we concluded that the plaintiff was “an identifiable, if not identified, potential victim of the [physician’s] alleged negligence at the time that treatment was rendered.” Id., 348; see id., 348–49 (“only one woman could have fit the description of [the patient’s] exclusive girlfriend, and [the patient] presumably could have identified her by name if he had been asked to do so”). We explained that “[t]his identifiable victim requirement strikes an equi- table balance between the interests at stake. Although a health care provider’s liability may expand beyond his or her patients, its increased scope would encompass only those third-party victims of whose existence and potential exposure to harm the health care provider had been made aware . . . prior to the negligent act.” Id., 349. This appeal requires us to determine whether the duty we recognized in Doe should be extended to apply to men- tal health care providers treating psychiatric patients. The defendant argues that, even if the harm to the dece- dent was foreseeable because she was an identifiable third party, there are several policy reasons why this duty should not be so extended.18 First, the defendant contends that recognizing a duty would conflict with Connecticut’s statutory schemes governing civil com- mitment and the confidentiality of psychiatric com- munications. Specifically, the defendant contends that the legislature adopted a carefully crafted civil com- mitment framework that places substantial weight on protecting individual liberty by making commitment permissive under § 17a-502 (a) and discharge mandatory under § 17a-502 (b) and (f). According to the defendant, this choice weighs against recognizing any common-law duty that would expose providers to liability for failing to confine a patient or to otherwise protect third parties. The defendant, quoting Jarmie v. Troncale, supra, 306 Conn. 610, also argues that recognition of such a duty would conflict with the confidentiality protections set forth in General Statutes (Supp. 2026) § 52-146e, which generally prohibit disclosure of confidential psychiatric communications and records, and would undermine the physician-patient relationship by “pull[ing] the physi- cian in different directions . . . .” (Internal quotation marks omitted.)

Section 17a-502 governs emergency involuntary hospi- talization through an emergency certificate. The statute permits the involuntary commitment of “[a]ny person who a physician concludes has psychiatric disabilities and is dangerous to himself or others or gravely disabled, and is in need of immediate care and treatment in a hos- pital for psychiatric disabilities . . . .” General Statutes § 17a-502 (a). In such circumstances, the individual “may be confined in such a hospital . . . under an emergency certificate . . . for not more than fifteen days without order of any court . . . .” General Statutes § 17a-502 (a). The statute further requires that the physician issuing the emergency certificate personally examine the patient and state (1) “the findings of the physician relative to the physical and mental condition of the person and the his- tory of the case, if known,” (2) “that it is the opinion of the physician that the person examined has psychiatric disabilities and is dangerous to himself or herself or oth- ers or gravely disabled and is in need of immediate care and treatment in a hospital for psychiatric disabilities,” and (3) “the reasons for [the physician’s] opinion.”19 General Statutes § 17a-502 (a).

Under General Statutes (Supp. 2026) § 52-146e (a), “[e]ach communication and record” relating to a patient’s psychiatric diagnosis or treatment “shall be confiden- tial and subject to the provisions of sections 52-146d to 52-146j, inclusive.” Section 52-146e (a) generally prohibits disclosure of such communications and records without the patient’s consent, and General Statutes (Supp. 2026) § 52-146j (b) provides a civil remedy to per- sons aggrieved by an unauthorized disclosure. General Statutes (Supp. 2026) § 52-146f, however, sets forth sev- eral exceptions to that rule. Most notably, a psychiatric mental health provider may disclose otherwise protected communications and records “when the . . . provider determines that there is substantial risk of imminent physical injury by the . . . patient to himself, herself or others . . . .” General Statutes (Supp. 2026) § 52-146f (2). We are not persuaded that recognition of a limited, common-law duty to protect an identifiable third party from a known, substantial risk of imminent physical harm would conflict with or otherwise undermine these statutory schemes. Both statutory schemes reflect a leg- islative effort to balance a patient’s liberty and privacy interests with the need to protect both the patient and the public from physical harm. The limited duty we recognize in this case is consistent with that legislative judgment. First, by authorizing involuntary commitment pur- suant to § 17a-502 (a) when a physician concludes that a patient with psychiatric disabilities is dangerous to himself or others, the legislature has recognized that the risk of harm to third parties may justify intruding on a patient’s liberty, including the hospital’s commitment emergency certificate must “be examined by a physician specializing in psychiatry not later than forty-eight hours after admission . . . .” General Statutes § 17a-502 (b). If the psychiatrist determines that the patient does not meet the statutory criteria for emergency commit- ment, “such person shall be immediately discharged.” General Statutes § 17a-502 (b); see also General Statutes § 17a-502 (f). Further, unless a written application for commitment has been filed, the patient must be discharged from the hospital after the fifteen day emergency hold has expired. See General Statutes § 17a-502 (a). In addition, patients must be informed of their legal rights, including the right to counsel and the right to a hearing at which they may challenge their commitment. See General Statutes § 17a-502 (c). of, and assumption of control over, the patient to prevent that harm from occurring. Because involuntary commit- ment represents one of the most significant intrusions on personal liberty permitted outside of the criminal con- text, the statute’s authorization of that remedy strongly suggests that preventing violence against others is an important objective of the statutory scheme.

Although we agree that the legislature’s choice to make commitment permissive and discharge manda- tory reflects its effort to protect patient liberty; see State v. Dyous, 307 Conn. 299, 325, 53 A.3d 153 (2012) (civil commitment statutory scheme “effectively places a thumb on the scale in favor of protecting individual liberty”); § 17a-502 does not purport to define the full scope of a mental health care provider’s responsibility to act reasonably when confronted with a known risk of imminent harm to an identifiable third party. Nor does it follow that the legislature intended to preclude any responsibility on the part of a mental health care provider who has actual knowledge that a patient poses a substantial risk of imminent physical harm to an iden- tifiable individual. Indeed, as we discussed, by expressly authorizing commitment when a patient “is dangerous to himself or others,” the legislature has recognized that the risk of harm to third parties may warrant significant intervention by mental health care providers. General Statutes § 17a-502 (a).

Second, by creating the exception in General Statutes (Supp. 2026) § 52-146f (2) allowing the disclosure of confidential communications and records “when the . . . provider determines that there is substantial risk of imminent physical injury by the . . . patient to himself, herself or others,” the legislature has likewise acknowl- edged that, in certain circumstances, the public’s interest in protecting potential victims from physical harm may outweigh the interest in preserving strict confidentiality. In cases in which a mental health care provider knows that a patient poses a substantial risk of imminent physi- cal harm to others, disclosure of otherwise confidential communications is expressly contemplated for the pur- pose of preventing such harm. Furthermore, unlike in Jarmie, in which we expressed concern that extending a physician’s duty to members of the general public would expose confidential patient records to disclosure in litigation brought by third-party victims, thereby undermining the physician-patient relationship; see Jarmie v. Troncale, supra, 306 Conn. 607–609; here, the duty is narrowly confined to circumstances involving a known and specific risk to an identifiable individual and, therefore, does not give rise to the same concerns about widespread litigation or the corresponding invasion of privacy that we acknowledged in Jarmie. See id., 613–14. The defendant further argues that the legislature’s use of permissive statutory language “countervails against superimposing a common-law duty.” In Jarmie, we relied on a statute permitting, but not requiring, physicians to report a patient’s chronic health problems to the Depart- ment of Motor Vehicles as evidence of “the legislature’s judgment that physicians owe no duty to the public to report even serious health problems that could affect a patient’s driving ability.” Jarmie v. Troncale, supra, 306 Conn. 604; see General Statutes § 14-46. Section 17a-502 (a) and General Statutes (Supp. 2026) § 52-146f (2) employ similar permissive language and can be under- stood to reflect the same legislative judgment that, when a patient poses a danger to the public at large, decisions regarding disclosure or intervention should be left to professional discretion. Nevertheless, as we recognized in Fraser, Jacoby, Gazo, and Doe, there is reason to come to a different conclusion when the health care provider is aware of a substantial risk of imminent harm to an identifiable third party. Thus, in the present context, the permissive language in the relevant statutes does not carry the same weight that it did in Jarmie.

Accordingly, our statutory schemes governing civil commitment and patient confidentiality support, rather than undermine, the conclusion that a mental health care provider has a common-law duty to take reasonable steps not involving medical judgment to protect an identifiable third party from the known, substantial risk of immi- nent physical harm that the provider’s patient poses. Recognition of such a limited duty does not (1) require commitment when the statute does not authorize it, (2) prevent discharge once the statutory criteria are no longer satisfied, or (3) expand the circumstances under which confidential communications may be disclosed.

The duty is triggered only when the mental health care provider actually knows of a substantial risk of immi- nent physical harm to an identifiable individual. Thus, it neither disturbs the balance struck by the legislature nor places providers in conflict with their statutory obligations.20

The defendant raises several remaining policy objec- tions, but none defeats recognition of the narrow duty at issue here. Specifically, the defendant contends that imposing a duty would subject mental health care pro- viders’ professional judgments to hindsight review, rest liability on unreliable predictions of future violence, encourage overly restrictive treatment and commit- ment practices, and expose providers to indeterminate liability. These concerns are substantially mitigated by the limited nature of the duty we recognize in this case, which arises only when the provider actually knows that the patient poses a substantial risk of imminent physical harm to an identifiable victim.21 For that reason, liability does not rest on impermissible hindsight review of the mental health care provider’s 3d 451–52 (Mosk, J., concurring and dissenting). He expressed his disagreement with “the majority’s rule that a therapist may be held liable for failing to predict his patient’s tendency to violence if other practitioners, pursuant to the ‘standards of the profession,’ would have done so” because of the “[inherent unreliability of] psychiatric predic- tions of violence . . . .” Id., 451 (Mosk, J., concurring and dissenting). He concurred in the result, “only because the complaints allege[d] that [the] therapists did in fact predict that [the patient] would kill and were therefore negligent in failing to warn of that danger. Thus the issue . . . [was] very narrow: [the court was] not concerned with whether the therapists, pursuant to the standards of their profession, ‘should have’ predicted potential violence; they allegedly did so in actuality. Under these limited circumstances [Justice Mosk] agree[d] that a cause of action [could] be stated.” Id. He concluded that, “[i]f a psychiatrist does in fact predict violence, then a duty to warn arises.” Id., 452 (Mosk, J., concurring and dissenting).

In 1985, the California legislature enacted § 43.92 of the California Civil Code, which both codified the duty articulated by the court in Tarasoff and simultaneously limited the scope of that duty. See Ewing v. Northridge Hospital Medical Center, 120 Cal. App. 4th 1289, 1300– 1301, 16 Cal. Rptr. 3d 591 (2004), review denied, California Supreme Court, Docket No. S127734 (November 10, 2004). The statute currently provides in relevant part: “There shall be no monetary liability on the part of, and no cause of action shall arise against, any person who is a psychotherapist . . . in failing to protect from a patient’s threatened violent behavior or failing to predict and protect from a patient’s violent behavior except if the patient has communicated to the psychotherapist a serious threat of physical violence against a reasonably identifiable victim or victims.” (Emphasis added.) Cal. Civ. Code § 43.92 (a) (Deering Supp. 2026). Under the statute, the psychotherapist’s duty is satisfied “by making reasonable efforts to communicate the threat to the victim or victims and to a law enforcement agency.” Cal. Civ. Code § 43.92 (b) (Deering Supp. 2026).

Section 43.92 of the California Civil Code “was expressly not intended to overrule Tarasoff and its progeny, but rather to limit . . . psycho- therapists’ liability for failure to warn to those circumstances [in which] the patient has communicated an actual threat of violence against an identified victim . . . and to abolish the expansive [ruling] of Tarasoff . . . that a therapist can be held liable for the mere failure to predict and warn of potential violence by his patient.” (Internal quotation marks omitted.) Ewing v. Northridge Hospital Medical Center, supra, 120 Cal. App. 4th 1300. California courts have since explained that “a psycho- therapist may be held liable for failing to warn a third party of a threat of harm only if the plaintiff is able to persuade the trier of fact [that] the psychotherapist actually believed or predicted [that] the patient posed a serious risk of inflicting grave bodily injury [on] a reasonably identifiable victim or victims.” (Emphasis added.) Id., 1301. medical judgment, but on the reasonableness of the pro- vider’s response to a known risk of harm. It therefore does not require a trier of fact to determine whether the provider should have evaluated, diagnosed, or treated the patient differently in the first instance. For the same reason, the duty does not rest on abstract or inherently speculative predictions of future violence. The defendant is correct that psychiatric predictions of dangerous- ness may be uncertain and subject to disagreement. See, e.g., State v. March, 265 Conn. 697, 711, 830 A.2d 212 (2003) (“psychiatric predictions of future dangerousness are tentative at best and are frequently conceded, even within the profession, to be unreliable” (internal quota- tion marks omitted)). The duty we recognize, however, does not arise from a claim that a mental health care provider should have predicted violence in the abstract. The provider is not asked to speculate about the remote possibility of violence but, instead, to respond reason- ably to a risk that the provider already has identified. Nor does the duty compel defensive medical practices or encourage unnecessary commitment, as the defendant suggests. To be sure, in some circumstances, a reasonable response to a known, substantial risk of imminent physi- cal harm may include efforts to control the patient, which could involve continued hospitalization. The limited duty we recognize, however, does not require commitment in circumstances not otherwise permitted by statute and requires only that the provider take reasonable steps not involving medical judgment to protect an identifi- able victim consistent with what the statutes authorize. The discharge of a mental health care provider’s duty of care will necessarily vary with the facts of each case, and it will be up to the fact finder to determine whether the steps taken to protect the identifiable victim were reasonable under the circumstances.

We also are not persuaded by the defendant’s con- tention that recognizing a duty in these circumstances will “open the floodgates” and expose providers to a broad wave of nonpatient liability arising from patients’ subsequent acts of violence. Because the duty to take reasonable steps not involving medical judgment arises only when the mental health care provider has actual knowledge that a patient poses a substantial risk of immi- nent harm to a specific, identifiable victim, it applies in a relatively limited class of cases. See Fraser v. United States, supra, 236 Conn. 630 ( “litigation of this kind does not arise frequently”). Accordingly, recognition of such a duty does not create the kind of expansive exposure to liability that the defendant fears.

Finally, the parties disagree as to the significance of authority from other jurisdictions. The plaintiff con- tends that an overwhelming majority of courts have recognized some form of duty requiring mental health professionals to take reasonable steps to protect third par- ties from a patient’s threatened violence. The defendant responds that such authority is of limited value because jurisdictions vary significantly in how they define and limit any such duty, and, in any event, Connecticut law governs.

We agree with the defendant that decisions from other jurisdictions are not controlling and that the scope of any duty in this context ultimately must be determined as a matter of Connecticut law. We are not persuaded, however, that the variations among jurisdictions render such authority unhelpful. Although courts have adopted differing formulations of the duty first articulated in Tarasoff, those variations largely involve the scope of the duty, not its existence. Indeed, the vast majority of jurisdictions recognize some variation of the Tarasoff duty, whether rooted in the common law or pursuant to statutory enactment.22 See 2 Restatement (Third), Torts, Liability for Physical and Emotional Harm § 41, reporter’s note to comment (g), p. 78 (2012) (“[v]irtually all courts confronting the issue have decided that [mental health] professionals owe some affirmative duty to third parties with regard to patients who are recognized as posing dangers”); see also id., pp. 80–81 (citing cases). The differences among jurisdictions instead reflect differing policy judgments regarding how best to bal- ance competing considerations, and many jurisdictions, consistent with the limitation we first discussed in Fraser and now recognize in this case, restrict the duty to cir- cumstances involving actual knowledge of a threat to a specifically identifiable or readily identifiable victim. See, e.g., Morton v. Prescott, 564 So. 2d 913, 916 (Ala. 1990) (psychiatrist has duty of care in connection with release of mental patient only when patient has made specific threats against identifiable third persons or members of identifiable group); Emerich v. Philadelphia Center for Human Development, Inc., 554 Pa. 209, 224–26, 720 A.2d 1032 (1998) (mental health professional has duty to warn third party of potential harm by patient when patient conveys “a specific and immediate threat of serious bodily injury” against “a specifically identi- fied or readily identifiable victim”); Peck v. Counseling Service of Addison County, Inc., 146 Vt. 61, 68, 499 A.2d 422 (1985) (“a mental health professional who knows or, based [on] the standards of the mental health profession, Ann. § 202A.400 (2) (LexisNexis 2020); La. Stat. Ann. § 9:2800.2 (A) (2018); Me. Rev. Stat. Ann. tit. 32, § 7007 (1) (Cum. Supp. 2026); Md. Code Ann., Cts. & Jud. Proc. § 5-609 (b) (LexisNexis 2013); Mass. Ann. Laws c. 123, § 36B (1) (LexisNexis 2017); Mich. Comp. Laws Serv. § 330.1946 (1) (LexisNexis 2017); Minn. Stat. Ann. § 148.975 (2) (West 2025); Mont. Code Ann. § 27-1-1102 (2023); Neb. Rev. Stat. § 38-3132 (2016); Nev. Rev. Stat. § 629.550 (1) (2025); N.H. Rev. Stat. Ann. § 329-B:29 (2025); N.J. Stat. Ann. § 2A:62A-16 (b) (West Cum. Supp. 2026); N.Y. Mental Hyg. Law § 9.46 (b) (McKinney Cum. Supp. 2026); Ohio Rev. Code Ann. § 2305.51 (B) (West Cum. Supp. 2026); Tenn. Code Ann. §§ 33-3-206 through 33-3-209 (2015 and Supp. 2025); Utah Code Ann. § 78B-3-502 (1) (LexisNexis 2012); Vt. Stat. Ann. tit. 18, § 1882 (b) (2023); Va. Code Ann. § 54.1-2400.1 (B) (2019); Wn. Rev. Code Ann. § 71.05.120 (3) (West Cum. Supp. 2026); Wis. Stat. Ann. § 51.17 (3) (West 2024). should know that his or her patient poses a serious risk of danger to an identifiable victim has a duty to exercise reasonable care to protect him or her from that danger”). Some jurisdictions have adopted broader formulations, while a small minority have declined to recognize such a duty altogether.23 These differences do not undermine the relevance of the broader consensus but, instead, underscore that the duty, when recognized, is carefully circumscribed.

Accordingly, we find it significant that our recogni- tion of a limited duty is consistent with the prevailing approach in other jurisdictions, even though those juris- dictions differ in how they define the precise contours of that duty.24

When these considerations are viewed together, the statutory framework and relevant case law reflect a consistent policy balance between patient confidentiality, professional judgment, and the protection of the public from serious physical harm. Recognition of a limited duty requiring mental health care providers to exercise reasonable care under the circumstances to protect an identifiable victim when they have determined that a patient poses a substantial risk of imminent physical harm to that identifiable victim is consistent with that balance and does not undermine the statutory scheme governing civil commitment or the policy considerations we discussed in Jarmie. Accordingly, we conclude that, in these circumstances, public policy supports the rec- ognition of such a limited duty.

To the extent there was any question after Fraser and its progeny, we hold that a mental health care provider that knows that a patient poses a substantial risk of imminent physical harm to an identifiable third party owes a duty to that party to take reasonable steps to protect the party from the danger posed by the patient, which could include warning the party of the risk or controlling the patient.25 designed to deter frivolous claims, rather than as substantive limitations on who may bring a negligence action against a health care provider. Thus, other jurisdictions that have recognized duties to control or warn are not similarly constrained by statutory enactments analogous to § 52-190a, as interpreted by this court, and, therefore, generally need not determine whether such claims sound in ordinary negligence or professional negligence. Even in North Carolina, where “[i]t is well settled that the relationship of physician to patient must be established as a prerequisite to an actionable claim for medical malpractice”; Easter v. Lexington Memorial Hospital, Inc., 303 N.C. 303, 305–306, 278 S.E.2d 253 (1981); when “a mental patient is wrongfully discharged and injures a third party outside the physician-patient relationship, general tort principles of negligence apply.” Gregory v. Kilbride, 150 N.C. App. 601, 606, 565 S.E.2d 685 (2002), review denied, 357 N.C. 164, 580 S.E.2d 365 (2003); see also Pangburn v. Saad, 73 N.C. App. 336, 338, 326 S.E.2d 365 (1985).

III

Finally, the plaintiff, relying on this court’s decision in Squeo v. Norwalk Hospital Assn., supra, 316 Conn. 558, contends that the trial court improperly struck count seven of the complaint, which purported to assert a claim for gross medical negligence. The plaintiff’s briefing on this issue, however, is limited. Aside from a brief assertion that the trial court erred in concluding that the claim was not cognizable as a matter of law under the circumstances of this case, the plaintiff does not provide any analysis explaining the legal basis for the claim or identifying the specific respect in which the trial court’s reasoning is incorrect.

Although the plaintiff references Squeo,26 she does not explain how that decision applies to the claim asserted we held that parents did not breach a duty to warn a police officer about their adult schizophrenic son’s dangerous propensities; see id., 30–31; in part because they had described their son’s symptoms and his possession of axes to members of the responding crisis team, their son’s condition was the precipitating factor for the officer’s visit to the home, and the officer made no claim that the crisis team withheld the information from him. See id., 37–38. The circumstances in the present case are materially different. In Kaminski, the officer already possessed the same information that a warning would have conveyed, rendering any additional warning superfluous. See id. We are unwilling to conclude that the decedent’s general awareness of Mollow’s past threats, made while they were in a relationship and living together, established that she knew the danger he posed at the time of his hospitalization and sub- sequent release. Based on the allegations in the complaint, the defendant possessed different or more particularized information about the nature and severity of the risk of harm than previously known to the decedent, including whether and to what extent the former couple’s separation and Mollow’s involuntary hospitalization may have escalated that risk. here. In particular, the plaintiff does not identify how the claim in count seven resembles the derivative bystander emotional distress claim recognized in Squeo or why the reasoning of that decision should extend to the nonder- ivative claim asserted in this case. Nor does the plaintiff offer any analysis as to why the conduct alleged in this case would rise to the level of gross professional negli- gence contemplated in Squeo.27 Indeed, before the trial court, the plaintiff acknowledged that this action seeks damages for wrongful death on behalf of the decedent’s estate rather than damages for emotional distress, “so the holding in Squeo does not directly apply.” In light of that position, the plaintiff’s argument on appeal provides little guidance as to how Squeo would support recogni- tion of the claim asserted here.

It is well established that appellate review ordinarily requires that claims be supported by adequate briefing and analysis. See, e.g., Connecticut Coalition Against Millstone v. Connecticut Siting Council, 286 Conn. 57, 87, 942 A.2d 345 (2008) (“We are not obligated to consider issues that are not adequately briefed. . . . Whe[n] an issue is merely mentioned, but not briefed beyond a bare asser- tion of the claim, it is deemed to have been waived. . . . In addition, mere conclusory assertions regarding a claim, with no mention of relevant authority and mini- mal or no citations from the record, will not suffice.” (Citations omitted; internal quotation marks omitted.)). Because the plaintiff’s argument regarding the legal sufficiency of her gross medical negligence count is not sufficiently developed to permit meaningful review, we decline to address it further. in so doing, when the patient then proceeded to take his own life shortly after discharge.” Id. We nevertheless upheld the trial court’s decision granting the hospital’s motion for summary judgment; id., 600; because the evidence submitted by the plaintiffs was insufficient “to create a genuine issue of material fact as to whether the plaintiffs suffered severe and debilitating mental distress such that they were unable to cope with the challenges of daily life.” (Emphasis omitted.) Id., 599.

The judgment is reversed only as to those claims in counts two through six of the third amended complaint that may proceed under ordinary negligence principles consistent with this opinion and the case is remanded with direction to deny the defendant’s motion to strike as to those claims; the judgment is affirmed in all other respects.

In this opinion MULLINS, C. J., and McDONALD, D’AURIA, ALEXANDER and DANNEHY, Js., con- curred.

************************************************ The “officially released” date that appears near the beginning of an opinion is the date the opinion will be published in the Connecticut Law Journal or the date it is released as a slip opinion. The operative date for the beginning of all time periods for the filing of postopinion motions and petitions for certification is the “officially released” date appearing in the opinion.

All opinions are subject to modification and technical correction prior to official publication in the Connecti- cut Law Journal and subsequently in the Connecticut Reports or Connecticut Appellate Reports. In the event of discrepancies between the advance release version of an opinion and the version appearing in the Connecticut Law Journal and subsequently in the Connecticut Reports or Connecticut Appellate Reports, the latest version is to be considered authoritative.

The syllabus and procedural history accompanying an opinion that appear in the Connecticut Law Journal and subsequently in the Connecticut Reports or Connecticut Appellate Reports are copyrighted by the Secretary of the State, State of Connecticut, and may not be reproduced or distributed without the express written permission of the Commission on Official Legal Publications, Judicial Branch, State of Connecticut. ************************************************ ECKER, J., concurring in part and dissenting in part. One sign that something has gone wrong in our case law is that a legal precedent produces nonsensical results over time. The present case illustrates the dangers of following ill-conceived precedent off the proverbial cliff. A man who cannot stop thinking about an ex-girlfriend is admitted to a hospital. He reveals to the hospital staff that he is totally obsessed with her, he owns guns, and he is thinking about killing her, a pathological condition antiseptically known in psychiatric parlance as homicidal ideation. The patient is transferred to an affiliated psy- chiatric hospital, which then releases him within a mat- ter of days, with no warning to the girlfriend. Obsession fast becomes reality when, the very next day, the man murders the girlfriend and then kills himself. We hold today that our case law allows the killer’s estate to sue the psychiatric hospital for medical negligence but bars the victim’s estate from doing so—unless, perhaps, the victim happens to have been married to her killer at the time of the murder, in which case the statutory prohibi- tion somehow disappears.

We are trapped in this thicket of unreason only because we must follow the court’s decision in Jarmie v. Troncale, 306 Conn. 578, 50 A.3d 802 (2012), which construes General Statutes § 52-190a to bar claims brought by a nonpatient for injuries or death caused by a health care provider’s professional negligence. See id., 587–89. In my view, Jarmie is a deeply flawed decision that has created an untenable doctrinal framework, leading to unjust results, based on a construction of § 52-190a that was never intended by the legislature. The problem is not only that Jarmie was wrongly decided at the time. Its long shadow has since forced this court to work around its erroneous holding in a string of subsequent deci- sions—including the present one—that sows further doctrinal confusion and inconsistencies.

In the absence of a request to overrule Jarmie,1 the majority follows that precedent where it leads and, con- sequently, holds that § 52-190a bars the medical negli- gence2 claims brought by the plaintiff, Angela Ashworth, administratrix of the estate of her daughter, Caroline Anne Ashworth (decedent), against the defendant SVMC Holdings, Inc.3 I agree with the majority that the statute, as it was construed by a majority of this court in Jarmie, precludes the plaintiff, as a nonpatient, from bringing most of her claims against the defendant arising from the defendant’s alleged failure to comply with the profes- sional standard of care governing its duty to warn and to otherwise protect the decedent, an identifiable victim, from the foreseeable homicidal acts of Michael Mollow.4 I therefore concur in the result reached by the majority, which concludes that the plaintiff’s claims are barred to the extent that they are based on allegations of medical negligence. I write separately to explain why Jarmie any Connecticut authority contrary to the recognition of the cause of action sought by the plaintiff under the circumstances of this case.” Parties often make litigation decisions on the basis of existing law and, understandably, do not lightly assume that the overruling of precedent is in the cards, but a request to overrule precedent ordinarily must be fully briefed to be entertained by this court. gravely misconstrued § 52-190a and should be overruled when the opportunity arises. In addition, I dissent from that aspect of the majority opinion holding that count seven of the plaintiff’s complaint fails to state a claim of gross negligence. See part III of this opinion; see also part III of the majority opinion.

I

Before conducting the statutory construction that the majority in Jarmie neglected to undertake, I offer two introductory observations regarding the dubious prec- edential value of that case. These remarks are pertinent because the doctrine of stare decisis always deserves serious attention when precedent is challenged on the ground that it was wrongly decided. To overcome the force of stare decisis in the present case, I rely primar- ily on what I consider to be the overwhelming merits of the legal analysis pursued in this opinion. The following two preliminary considerations further diminish any concern about adhering to the holding in Jarmie based on § 52-190a.

The first and most prominent of these points focuses on this court’s recent decision in Carpenter v. Daar, 346 Conn. 80, 287 A.3d 1027 (2023). Carpenter also involved the proper construction of § 52-190a and, of critical significance for present purposes, overruled this court’s decision in Morgan v. Hartford Hospital, 301 Conn. 388, 21 A.3d 451 (2011). See Carpenter v. Daar, supra, 84–87. Morgan had construed § 52-190a to impose a jurisdictional requirement, such that failure to timely submit a fully compliant expert opinion letter5 is fatal to a medical negligence action, however meritorious. See id., 100–103. It reached that conclusion even though § 52-190a does not speak in jurisdictional language; see id., 105–107; and, by all accounts, the legislature’s inten- tion in imposing the requirement was merely to ensure an adequate, good faith investigation so as to eliminate frivolous cases. See, e.g., id., 124; see also Lynch v. State, 348 Conn. 478, 504 n.18, 308 A.3d 1 (2024); footnote of the majority opinion. In overruling Morgan, the court in Carpenter unanimously concluded that the legis- lature never intended § 52-190a to transform “what the legislature intended to be a simple prelitigation docu- mentation of the plaintiff’s good faith inquiry into, in essence, a trap under which even meritorious suits are subject to dismissal.” Carpenter v. Daar, supra, 124. As I will discuss in part II of this opinion, Carpenter is only the most recent in a line of decisions holding that overly literalistic interpretations of § 52-190a must be eschewed in favor of more reasonable, commonsense constructions that comport with the purpose of the statute. See, e.g., Shortell v. Cavanagh, 300 Conn. 383, 388–90, 15 A.3d 1042 (2011); Dias v. Grady, 292 Conn. 350, 359–61, 972 A.2d 715 (2009).

Carpenter is important because Jarmie is another Morgan era decision, and the majority in Jarmie was similarly and equally misguided in its construction of § 52-190a to impose more than prelitigation procedural requirements designed to prevent frivolous medical malpractice claims. After Carpenter, no viable argument remains that § 52-190a imposes any substantive limita- tions on such claims. Simply put, Jarmie erroneously read into a purely procedural statute a substantive bar prohibiting actions by nonpatients involving allegations of medical negligence.

The second set of preliminary observations focuses on the fact that Jarmie adjudicated the statutory issue in an unusually casual manner, and its irregular methodology undoubtedly contributed to the flawed result. To begin with, the trial court in Jarmie did not purport to rely on § 52-190a when it struck the plaintiff’s complaint; nor did it conclude that the legislature has barred actions by nonpatients involving allegations of medical negligence. See Jarmie v. Troncale, Superior Court, judicial district of New Haven, Docket No. CV-XX-XXXXXXX (December 31, 2008) (46 Conn. L. Rptr. 874, 875–76), aff’d, 306 Conn. 578, 50 A.3d 802 (2012). In their brief to this court, the defendants in Jarmie argued only in passing that § 52-190a barred the plaintiff’s medical negligence claims because of his status as a nonpatient. See Jarmie v. Troncale, Conn. Supreme Court Records & Briefs, March Term, 2012, Defendants’ Brief pp. 3–7. Their statutory argument covered one and one-half pages of their brief and consisted largely of quoting out of context a portion of Plainville v. Wheeler Clinic, Inc., Supe- rior Court, judicial district of New Britain, Docket No. HHB-CV-XX-XXXXXXX (December 11, 2008) (46 Conn. L.

Rptr. 812, 813–14), in which the trial court construed § 52-190a to mean the very opposite of the result reached by this court in Jarmie. See Jarmie v. Troncale, Conn. Supreme Court Records & Briefs, supra, Defendants’ Brief pp. 5–6; see also part II A of this opinion.

Of still greater concern is that the Jarmie majority adopted the defendants’ statutory argument by way of a truncated analysis incommensurate with the far- reaching implications of its conclusion that § 52-190a established a statutory prohibition against all actions by nonpatients involving allegations of medical negligence. The entire discussion in Jarmie spans a total of three paragraphs, and the court’s actual analysis of the statute is confined to a single conclusory sentence, followed by citations to three cases having nothing to do with the issue at hand. See Jarmie v. Troncale, supra, 306 Conn. 587–88. It is fair to say that the Jarmie majority did not engage in the usual methodology applied in Connecticut to construe a statute.

More specifically, the decision does not mention Gen- eral Statutes § 1-2z or its common-law antecedents, and it neglects to apply the highly developed and entrenched principles of statutory construction that guide our analy- sis in virtually every case in which we are called on to determine the meaning of a statute. See generally id. In Jarmie, that methodology would have required the court to consider as a threshold matter whether the statutory text and its context rendered § 52-190a ambiguous with respect to the question being addressed, namely, whether the statute prohibits a nonpatient from bringing a per- sonal injury or wrongful death action against a health care provider on the basis of allegations of negligence in the care or treatment of the provider’s patient. As I will discuss in greater detail hereinafter, Jarmie failed even to mention, let alone analyze, such key considerations as (1) whether a plausible alternative construction of the statute rendered its meaning ambiguous, (2) whether, applying established principles of statutory construction, that alternative construction was preferable, and (3) whether, in light of the ambiguity, the intended mean- ing of the statute can be ascertained by examining the legislative history of the statute, including the manner in which Florida’s appellate courts have construed the Florida statute on which § 52-190a was modeled.

These methodological shortcomings extend beyond the internal mechanics of Jarmie’s statutory construction. Viewing the opinion from start to finish reveals that the court need not have reached the statutory issue at all. This is so because the majority in Jarmie concluded, as a matter of Connecticut common law, that the defendants owed no duty of care to the plaintiff; as a “random pedes- trian,” the plaintiff was not an identifiable victim of the alleged negligence. Id., 597. All of the plaintiff’s claims were consequently barred as a matter of law, regardless of any statutory considerations. Seen in this light, the entire discussion of § 52-190a in Jarmie is dictum. See, e.g., Honulik v. Greenwich, 293 Conn. 641, 645 n.5, 980 A.2d 845 (2009). I will not treat it as such in this opinion because this court has not done so, either in Jarmie or in subsequent decisions, including the present one, but the point remains that Jarmie’s precedential value is doubt- ful from the beginning because its statutory analysis was unnecessary to the outcome.6 To summarize these preliminary considerations, the Jarmie majority reached out unnecessarily to construe a statute that had not formed the basis of the trial court’s decision and was not necessary for resolution of the appeal, which, unlike the present case, involved an unidentifiable victim. The Jarmie majority nonetheless took the occasion to construe § 52-190a to foreclose, as a matter of law, a broad range of potentially meritori- ous third-party medical negligence claims.7 The Jarmie majority offered only the scantest analysis in support of its construction, the implications of which extended well beyond the narrow factual confines of that case. As I will further elaborate in part II A of this opinion, the Jarmie majority did so without acknowledging or addressing the plausibility of contrary constructions adopted by a court in Connecticut and one other jurisdiction (Florida) construing a statute identical to § 52-190a in all relevant respects. The flawed methodology inevitably led to flawed results.

II

A

A careful review of § 52-190a reveals the inadequate nature of Jarmie’s construction of the statute. The whom no duty was owed under Connecticut common law, whereas the decedent in this case was an identifiable victim. Jarmie also arose out- side of the singular context of duties owed to third parties by mental health care professionals. language at issue is contained in the initial sentence of § 52-190a (a): “No civil action or apportionment com- plaint shall be filed to recover damages resulting from personal injury or wrongful death . . . whether in tort or in contract, in which it is alleged that such injury or death resulted from the negligence of a health care pro- vider, unless the attorney or party filing the action or apportionment complaint has made a reasonable inquiry as permitted by the circumstances to determine that there are grounds for a good faith belief that there has been negligence in the care or treatment of the claimant.” This language has remained substantially unchanged since the legislature enacted the original law in 1986, as part of what is known as Tort Reform I. See Public Acts 1986, No. 86-338, § 12 (P.A. 86-338); see, e.g., Daley v. Kashmanian, 344 Conn. 464, 482, 280 A.3d 68 (2022).

The first thing to notice, even before analyzing the semantics and syntax of this provision, is that the statute imposes procedural requirements (the need to conduct a good faith inquiry and to obtain a presuit opinion letter from a qualified health care professional) on a certain category of professional negligence cases. See part I of this opinion (discussing Carpenter v. Daar, supra, 346 Conn. 80). It is now well established that § 52-190a, like the other components of the tort reform legislation relating to medical negligence claims, does not purport to effectuate any substantive or jurisdictional changes in the common law governing such claims. Our post-Jarmie case law explains that the statute “regulates pleading and service of process . . . [but] has been expressly construed . . . as having no effect on the standard for substan- tive liability . . . .” (Internal quotation marks omitted.) Carpenter v. Daar, supra, 115; accord Corley v. United States, 11 F.4th 79, 87 (2d Cir. 2021); see also Dias v. Grady, supra, 292 Conn. 359. The Jarmie majority did not have the full benefit of these later insights regard- ing the procedural nature of the statutory scheme, but the precedential and persuasive value of the decision nonetheless is diminished by reason of these subsequent developments.

Turning to the statutory text, I note that there are at least three plausible ways to construe the relevant language. As we shall see, two of these alternatives were never considered by the Jarmie majority, and the third was insufficiently vetted.

The first plausible reading, which I consider the best of the three, is the commonsense construction that Judge Patty Jenkins Pittman adopted in Plainville v. Wheeler Clinic, Inc., supra, 46 Conn. L. Rptr. 812, several years before Jarmie was decided.8 The issue in Plainville, which the trial court described as one of first impression in Con- necticut, arose in connection with a medical negligence claim brought by a police officer against a health clinic after the officer was injured while attempting to subdue a patient at the clinic. Id., 812–13. The plaintiff town alleged that the officer’s injuries were proximately caused by the defendant clinic’s medical negligence relating to its staffing and procedures, as well as its care or treat- ment of the patient. Id. The court reviewed the text and legislative history of § 52-190a (a), as well as the manner in which sister states such as Florida have construed similar statutes.9 Id., 813–14. Based on this analysis, the court concluded that § 52-190a governs only those medical malpractice actions that are initiated by patients; it simply does not speak, one way or the other, to actions brought by nonpatients. Id., 814.

The second plausible construction resides at the other end of the spectrum. If one were to read the first sentence of § 52-190a (a) strictly, literally, and in isolation, the result would be to prohibit not only third-party medical malpractice actions but also a wide range of what we call “ordinary” negligence actions against health care providers. This construction would emphasize that the statutory language, by its terms, does not speak of, and is not limited to, medical malpractice actions. Rather, the statute applies to any personal injury or wrongful death action alleging that the injury or death “resulted from the negligence of a health care provider,” a broad phrase that, on its face, sweeps in ordinary as well as professional negligence. General Statutes § 52-190a (a). The text purports to bar all such actions, unless they are supported by a letter from “a similar health care provider” opining “that there appears to be evidence of medical negligence . . . .” General Statutes § 52-190a (a). If we read the statutory language verbatim, and conclude, as Jarmie did, that the literal language of the statute permits only those claims filed by patients, then we must acknowledge that the same text also bars, at the very least, all manner of ordinary negligence claims brought by hospital visitors and other nonpatients; the first sentence would preclude everything from the type of claim that we allowed to proceed in Doe v. Cochran, 332 Conn. 325, 327–28, 336–38, 210 A.3d 469 (2019), to routine slip and falls. Indeed, reading the statute literally would preclude even those ordinary negligence claims brought by patients themselves, insofar as the first sentence of § 52-190a (a) bars any action alleging the negligence of a health care provider unless there is evidence of medical negligence.

Although these two constructions provide the most natural readings of the statutory language, Jarmie failed even to mention, let alone adopt, either one. Instead, without any evident effort to consider other construc- tions that would make sense of the statutory scheme, Jarmie adopted a third, alternative construction of the statute, as if it were the only choice available. This con- struction reads certain selected portions of the stat- ute strictly and literally, while altogether ignoring any semantic or syntactic indications of a different meaning. Specifically, Jarmie’s interpretation of § 52-190a focused entirely on a single word appearing at the very end of the statute’s first sentence: “ ‘claimant.’ ” (Emphasis omitted.) Jarmie v. Troncale, supra, 306 Conn. 587.

The Jarmie majority observed that the statute requires, before the filing of an action seeking damages for personal injury or death resulting from the negligence of a health care provider, “ ‘a good faith belief that there has been negligence in the care or treatment of the claimant’ ”; (emphasis in original) id.; and concluded, without test- ing the proposition against common sense or considering any other standard tools of construction, that the word “claimant” must mean the plaintiff bringing the negli- gence action. See id., 587–89. Thus, because the statute stipulates that claimants are patients receiving care or treatment from health care providers, it follows that nonpatients cannot be plaintiffs in any action alleging medical negligence against health care providers. Quod erat demonstratum.

As a cursory reading of the statute’s literal language, construed in a vacuum, this construction is plausible. However, it is by no means the only plausible reading of the statute, and its entire weight rests on the sudden and wholly unexpected appearance of a solitary word at the end of the first sentence. Nothing else in the statutory scheme gives any indication that the legislature intended to bar all nonpatient claims involving allegations of medi- cal malpractice against health care providers, and, if the court in Jarmie had consulted the standard principles of statutory construction, it would have realized that an alternative reading of § 52-190a was far more plausible. First, and most broadly, the court would be well- advised in this case to take heed of the admonition that “[the legislature] does not hide elephants in mouseholes.” (Internal quotation marks omitted.) Cyan, Inc. v. Bea- ver County Employees Retirement Fund, 583 U.S. 416, 431, 138 S. Ct. 1061, 200 L. Ed. 2d 332 (2018); see also, e.g., NEMS, PLLC v. Harvard Pilgrim Health Care of Connecticut, Inc., 350 Conn. 525, 547, 325 A.3d 196 (2024) (“it is unlikely that the legislature would have enacted a sea change in [a statutory scheme] . . . without acknowledging that change”); New Haven v. Board of Education, 228 Conn. 699, 719, 638 A.2d 589 (1994) (“[w]e will not infer that the legislature intended to enact a significant change in existing law without an unequivocally expressed manifestation of legislative intent” (internal quotation marks omitted)). If the leg- islature had intended to use the procedural vehicle of the good faith inquiry requirement to impose a substantive prohibition on all third-party actions against health care providers, surely, there were clearer, more direct ways to do so. Other Connecticut statutes make it abundantly clear when the legislature has intended to foreclose third- party liability for a category of plaintiffs, claims, or defendants.10

Of course, there is no requirement that the legislature use the clearest and most direct language possible when drafting a statute. But Jarmie reads a major, substan- tive limitation into a statute that, in all other respects, contains no provisions purporting to define or delimit the substantive components of a lawsuit seeking damages caused by medical negligence. Indeed, this same misstep was one of the primary reasons why we overruled Morgan in Carpenter. We explained that “the absence of jurisdic- tional language puts § 52-190a in stark contrast to other statutes governing personal jurisdiction and the service of process in a wide variety of contexts”: Carpenter v. Daar, supra, 346 Conn. 105; and that “[t]he legislature’s failure to use the terms ‘personal jurisdiction’ or ‘service of process’ in § 52-190a, when it so readily uses those terms in other statutes in the same title governing civil actions, provides strong textual evidence that the leg- islature did not intend the opinion letter and good faith certificate to implicate the court’s personal jurisdiction.” Id., 107. In my view, it is not reasonable to believe that our legislature intended to wade silently into the waters inhabited by the well-known and controversial Tarasoff11 doctrine, to depart from the prevailing approach by categorically foreclosing such claims, and then to bury that policy choice in the connotative shadows of the final word of a procedural statute designed only to prescribe the contents of the good faith opinion letter that must accompany a claim for medical negligence.

Second, we repeatedly have emphasized that “[s]trict construction does not mean that a statute must be read in isolation.” (Internal quotation marks omitted.) State v. John F.M., 285 Conn. 528, 547, 940 A.2d 755 (2008). “[C]ontext matters in statutory construction, as do prac- tical consequences . . . .” Blondeau v. Baltierra, 337 Conn. 127, 137, 252 A.3d 317 (2020). Jarmie concluded that the statute established a substantive limitation, precluding actions by nonpatients involving allegations of medical negligence, on the basis of one single, iso- lated word. See Jarmie v. Troncale, supra, 306 Conn. 587–89. But a contextualized reading tells a different story. Section 52-190a is codified in chapter 900 of the General Statutes, which governs “[c]ourt [p]ractice and [p]rocedure.” The remainder of the statute is addressed to various purely procedural concerns, including the intricacies of the good faith certificate requirement; see General Statutes § 52-190a (a); and the availability of a ninety day extension to allow for a reasonable inquiry. See General Statutes § 52-190a (b). Neighboring statutes govern things like the proper form of bonds and recog- nizance for prosecution; General Statutes §§ 52-185 and 52-189; the routing of actions to the complex litigation docket; General Statutes § 52-190b; mandatory media- tion procedures; General Statutes § 52-190c; and the precedence of certain civil actions over others. General Statutes §§ 52-191 through 52-192. Not surprisingly, given the subject area, the word “claimant” is used in various contexts throughout chapter 900. The word “patient” is not. Similarly, “claimant” is used more than forty times in P.A. 86-338, the tort reform statute, with respect to various categories of torts, whereas “patient” does not appear a single time in the act. These observa- tions strongly support the notion that § 52-190a, like the statutes surrounding it, sets forth purely procedural rights, and the legislature simply did not consider that its use of the same word (“claimant”) throughout like statutes could, in this particular instance, be misunder- stood to have the unforeseen and unintended effect of foreclosing common-law actions in which the claimant is not the direct victim of negligence.

A third, corollary principle is that statutory words are confined to the subject matter that the legislature had in view, and, therefore, we must be wary lest gen- eralized words such as “any” or “no” be given an overly broad, literal sweep that extends beyond the types of core cases that the statute was written to address. This is a canon of statutory construction with historical roots that reach back to the earliest days of the republic; see, e.g., United States v. Palmer, 16 U.S. (3 Wheat.) 610, 631, 4 L. Ed. 471 (1818); see also Holy Trinity Church v. United States, 143 U.S. 457, 458–59, 12 S. Ct. 511, 36 L. Ed. 226 (1892); and it retains vitality today. See, e.g., Yates v. United States, 574 U.S. 528, 546, 135 S. Ct. 1074, 191 L. Ed. 2d 64 (2015); American Civil Liberties Union v. Dept. of Defense, 543 F.3d 59, 68–69 (2d Cir. 2008), vacated on other grounds, 558 U.S. 1042, 130 S. Ct. 777, 175 L. Ed. 2d 508 (2009). The principle has been invoked by this state’s appellate courts as well. See, e.g., State v. Salamon, 287 Conn. 509, 524, 540, 949 A.2d 1092 (2008); Fairchild Heights, Inc. v. Dickal, 118 Conn. App. 163, 177, 983 A.2d 35 (2009), aff’d, 305 Conn. 488, 45 A.3d 627 (2012). Its application to § 52-190a helps us see that one way to understand the error in Jarmie’s reasoning is that the case construed the statute’s opening phrase, “[n]o civil action or apportionment complaint,” in the broadest possible sense, whereas the context indi- cates that the good faith certificate requirement was never intended to apply to actions involving allegations of medical negligence brought by nonpatients. But see part II C of this opinion.

Fourth, statutes in derogation of the common law are to be strictly construed and should not be interpreted to limit or impair a common-law interest, unless “the language of the legislature plainly and unambiguously reflects such an intent . . . .” (Internal quotation marks omitted.) Kumah v. Brown, 307 Conn. 620, 630, 58 A.3d 247 (2013). In Lostritto v. Community Action Agency of New Haven, Inc., 269 Conn. 10, 848 A.2d 418 (2004), this court explained that § 52-190a is “in derogation of the common law” and, for that reason, should be nar- rowly construed. Id., 37; see also Dias v. Grady, supra, Conn. 359–60.

Indeed, Jarmie itself acknowledged that our common law has been open to recognizing third-party medical negligence claims when the claimant is an identifiable victim of the negligent act or omission. See Jarmie v. Troncale, supra, 306 Conn. 594 (referring to “past cases in which this court has limited foreseeable victims of a health care provider’s negligence to identifiable per- sons”); id., 586 (“there [is] nothing in . . . the case law of this state that precludes the plaintiff from bringing an action against the defendants on negligence grounds”); see also id., 595–97 (discussing Connecticut common-law precedent involving identifiable victims). This principle of construction also counsels in favor of a meaning that does not produce a result in tension with the common law. With respect to professional negligence actions against health care providers in particular, common-law causes of action by nonpatients had been recognized in many of our sister states prior to the adoption of § 52-190a. See generally F. Buckner & M. Firestone, “ ‘Where the Public Peril Begins’: 25 Years After Tarasoff,” 21 J. Legal Med. 187 (2000). Significantly, even after the enactment of § 52-190a, this court analyzed a Tarasoff type case with- out any indication whatsoever that the statute would stand as an impediment. See Fraser v. United States, 236 Conn. 625, 632, 674 A.2d 811 (1996) (rejecting claim by estate of nonpatient because decedent was not identifiable victim, “our decisions defining negligence do not impose a duty to those who are not identifiable victims,” and, “in related areas of our common law, we have concluded that there is no duty except to identifiable persons”); see also Jacoby v. Brinckerhoff, 250 Conn. 86, 96, 735 A.2d 347 (1999) (“To protect the integrity of the therapeutic relationship, we held [in Fraser] that a duty to disclose the substantial risk of . . . an act of violence would arise only if the third person was an identifiable victim or a member of a class of identifiable victims. . . . Such an exception was warranted, we held, in the event of an imminent risk of serious personal injury to iden- tifiable victims.” (Citations omitted.)).12 Prior to the enactment of tort reform in 1986, moreover, Connecticut also had recognized third-party professional negligence claims in other contexts. See, e.g., Licata v. Spector, 26 Conn. Supp. 378, 378–79, 383–84, 225 A.2d 28 (1966) (allowing third-party negligence claim against attor- ney and observing, with respect to rejection of privity requirement, that “Connecticut was one of the states at the vanguard of this legalistic revolution”). Far from conducting an analysis in accordance with a clear state- ment requirement, the majority in Jarmie failed even to consider whether it was sensible to conclude that the legislature would foreclose a myriad of common-law claims without clearly signaling its intent to do so.13 Fifth, Jarmie is predicated on the assumption that a strict, literal reading of § 52-190a is to be favored over a reasonable, commonsense construction. That is not the approach we usually take. See, e.g., Casey v. Lamont, 338 Conn. 479, 493, 258 A.3d 647 (2021) (“[i]n constru- ing a statute, common sense must be used and courts must assume that a reasonable and rational result was intended” (internal quotation marks omitted)). And, in this case, the literalist approach is demonstrably misguided. As I have discussed, a literal reading of the language of the statute would require us to conclude that it bars even “ordinary” negligence claims brought by patients themselves because the text applies to any action seeking damages for injury or death resulting from “the negligence of a health care provider . . . .”

General Statutes § 52-190a (a). I trust that no one seri- ously believes that the legislature intended the good faith certificate requirement to preclude recovery in such cases, as Jarmie itself recognized. See Jarmie v. Troncale, supra, 306 Conn. 586 (“nothing in the relevant statutory authority . . . of this state . . . precludes the plaintiff from bringing an action against the defendants on [ordinary] negligence grounds”). But that is where the logic of Jarmie’s literal and all-encompassing construc- tion of the statute’s first sentence leads.14 This court has twice rejected as implausible interpre- tations of § 52-190a that were, if anything, less bizarre than results like this that follow from Jarmie’s literal reading of the statute. In Dias v. Grady, supra, 292 Conn. 350, this court rejected the argument that the statute requires an expert opinion letter as to causation. See id., 359–61. Because a similar health care provider is not required to give such an opinion at trial, we reasoned, it would be bizarre for the legislature to have required it at the pleading stage. Id., 361. Subsequently, in Shortell v. Cavanagh, supra, 300 Conn. 383, this court concluded that it would be absurd to interpret § 52-190a to require an opinion letter from a similar health care provider in an informed consent case, when no such testimony is neces- sary at trial. See id., 388–90. We reached this conclusion even though informed consent is a species of negligence; see, e.g., Sherwood v. Danbury Hospital, 278 Conn. 163, 181, 896 A.2d 777 (2006); and, therefore, would seem to be encompassed within a literal reading of the statute.15 In the same way that a blindered reading of one por- tion of § 52-190a does not justify the conclusion that the statute bars ordinary negligence or informed consent claims against health care providers, the same approach to construing a single word of the text cannot easily lead to the conclusion that the legislature intended silently to erect a bar to actions by nonpatients involving alle- gations of medical negligence. Dias and Shortell teach that the broad terms of the first sentence of the statute are qualified by its setting, which, in the present case, demonstrates that the statute is only addressed to claims of medical negligence brought by patients; it doesn’t prohibit nonpatient claims any more than it prohibits ordinary negligence claims or informed consent claims.16 The bizarre results of a strict, literalist construction of § 52-190a are seen in other ways as well. Under Jarmie, a killer can bring a claim against his negligent health care provider, but his victim cannot, despite the fact that both deaths were proximately caused by the very same medical negligence and the additional fact that the homi- cide victim would, in the view of many, have a stronger case in principle for tort compensation. Likewise, under Jarmie, the homicide victim may have a Tarasoff type claim if she were the estranged wife of the killer such that her wrongful death claim could be brought in the would be absurd to subject parties seeking damages for loss of consortium arising from medical malpractice to statutory requirements), review denied, 790 So. 2d 1102 (Fla. 2001); see also part II B of this opinion (discussing close connection between Florida and Connecticut statutes). same action as the killer’s wrongful death claim, but an estranged girlfriend is without recourse. See footnote 16 of this opinion. One can imagine reasons why a legislature might opt to foreclose all nonpatient medical negligence claims or some meaningful subset of such claims. But it is inconceivable to me that the legislature intended to allow some Tarasoff claims, and to foreclose others, on the basis of arbitrary distinctions that bear no relation to the statutory purpose.

To summarize, Jarmie embodies many of the same vices that compelled us to overrule Morgan. The deci- sion construed a purely procedural statute as curtailing, sub silentio, litigants’ substantive rights. It did so in the face of, and without considering, plausible alternative constructions more consistent with a holistic reading of the statutory scheme. It ignored numerous principles of statutory construction: the importance of context and common sense, the perils of overgeneralization, the idea that the legislature typically conveys its intent expressly (especially when it has done so in like circumstances) and does not hide elephants in mouseholes, and the rule that statutes in derogation of the common law are strictly construed. Jarmie instead adopted a novel, forced con- struction that, taken to its logical conclusion, would lead to results bordering on the absurd. Even without recourse to the legislative history, then, I would conclude that Jarmie’s construction of the statute must be repudi- ated. At the very least, these various factors render the statute ambiguous with respect to the issue at hand.17 B

The foregoing analysis leads me to examine the legis- lative history of § 52-190a for additional guidance. See General Statutes § 1-2z. The parties and the majority agree that the lengthy legislative debates regarding Tort Reform I make no reference to nonpatient claims. See footnote 14 of the majority opinion. This omission in itself adds force to my concern about elephants hidden in mouseholes. Just as one would reasonably expect a plain statement in the statutory text that the legislature intended to foreclose an entire category of claims to an entire class of plaintiffs, it is virtually unthinkable that such a bold, substantive innovation would have passed without any comment in the lengthy legislative his- tory of tort reform. See, e.g., Chisom v. Roemer, 501 U.S. 380, 396 n.23, 111 S. Ct. 2354, 115 L. Ed. 2d 348 (1991) (articulating “the dog that did not bark” canon of statutory construction); see also Bennett v. New Milford Hospital, Inc., 300 Conn. 1, 26–28, 12 A.3d 865 (2011) (applying principle in context of § 52-190a); King v. Sultar, 253 Conn. 429, 451, 754 A.2d 782 (2000) (same). The drafting history of the statute provides strong evi- dence for the conclusion that no such meaning should be attributed to it. Two aspects of that history in particular support my conclusion that Plainville got it right and that the legislature, in imposing a good faith certifi- cate requirement, did not intend to foreclose Tarasoff type claims involving allegations of medical negligence brought by nonpatients.

First, and most tellingly, § 52-190a was modeled on a Florida statute that had been enacted the year before § 52-190a was enacted. See Fla. Stat. Ann. § 766.104 (West 2024). The Florida statute uses almost identi- cal language,18 and a report contained in the bill file to circumstances of a nonpatient who has only limited presuit access to such records.

P.A. 86-338 confirms that the Law Review Commit- tee of the Governor’s Task Force on Insurance Costs and Availability was inspired by Florida law in rec- ommending that our legislature consider “allowing attorneys to obtain a so-called ‘certificate of merit’ . . . to satisfy the ‘reasonable inquiry’ and ‘good faith’ responsibilities.”19 For this reason, our construction of § 52-190a, to the extent it relates to language drawn from the Florida model, should give serious consider- ation to the construction accorded to that language by Florida courts. See, e.g., State v. Carter, 350 Conn. 43, 58, 323 A.3d 297 (2024) (“when [a] Connecticut statute has been modeled on that of another jurisdiction, the judicial interpretation . . . accorded [to that other juris- diction’s] act is of great assistance and persuasive force in the interpretation of our own act” (internal quotation marks omitted)).

It was understood from the outset in Florida that Fla. Stat. Ann. § 766.104 was purely procedural in nature.20 Accordingly, and notwithstanding that § 766.104 (1) contains language identical to § 52-190a (a) requiring “a good faith belief that there has been negligence in the care or treatment of the claimant,” the Florida statute has never been interpreted to bar actions by nonpatients alleging medical negligence. See, e.g., Pate v. Threlkel, 661 So. 2d 278, 281–82 (Fla. 1995) (noting that “the plaintiffs have pled [good faith] com- pliance with [§] 766.104,” allowing third-party action to proceed, and holding that, “when the prevailing standard of care creates a duty that is obviously for the benefit of certain identified third parties and the physician knows of the existence of those third parties, then the physi- cian’s duty runs to those third parties”); see also J.B. v. Sacred Heart Hospital of Pensacola, 635 So. 2d 945, 946–47, 949 (Fla. 1994) (allowing Cochran type claim to proceed). But cf. Boynton v. Burglass, 590 So. 2d 446, 447 (Fla. App. 1991) (declining to adopt Tarasoff duty under state common law).

The Florida District Court of Appeals explained why the Florida statute does not bar third-party medical negligence claims: “[T]o be a claimant under the [Florida Medical Malpractice] Act, the person presenting the claim must have received negligent medical care and treatment from a medical care provider that resulted in the person’s injury or death. . . . If the person mak- ing the claim did not receive negligent medical care or treatment, the person does not qualify as a claimant under the [a]ct by definition and hence cannot be required to comply with the [presuit] notice and investigation requirements of the [a]ct.” (Citation omitted; emphasis added.) Pavolini v. Bird, 769 So. 2d 410, 413 (Fla. App. 2000), review denied, 790 So. 2d 1102 (Fla. 2001).21 In other words, Florida courts construe the same statu- tory text—the very language on which § 52-190a was modeled—to draw a distinction between plaintiffs and claimants (i.e., patients) and to hold that the statute applies only to those cases in which personal injury or wrongful death of a claimant is alleged.

Also instructive is the history of our legislature’s efforts to address the perceived problem of frivolous medical negligence claims. Prior to the enactment of Tort Reform I in 1986, Connecticut law provided a mechanism by which the parties to a medical negligence action could, at their option, convene a malpractice screening panel comprised of doctors and lawyers to opine as to the merits of the plaintiff’s claims. See General Statutes (Rev. to 1985) §§ 38-19b through 38-19f. However, parties rarely if ever availed themselves of that option. See Report of the Law Review Committee of the Governor’s Task Force on Insurance Costs and Availability (1986) p. 22.

As initially drafted, the bill that ultimately became P.A. 86-338 would have retained the screening panel mechanism but made its use mandatory in all medical malpractice actions. See Raised Bill No. 6134, 1986 Sess., § 13; Substitute House Bill No. 6134, 1986 Sess., § 10. The initial draft provided in relevant part that “[n]o civil action for medical malpractice shall be commenced . . . until a written notice of the intention to commence such action has been filed” with the screening panel and the panel has made a finding as to liability. Substitute House Bill No. 6134, supra, § 10. For present purposes, the important point is that nothing in the language of the draft legislation would even arguably have precluded actions by nonpatients involving allegations of medical negligence.

Substitute House Bill No. 6134 was referred back to the Judiciary Committee on March 31, 1986. The com- mittee held hearings on the bill, and, in late April, it recommended an amended version (subsequently adopted as House Amendment A) that omitted the mandatory screening panel provision.22 Instead, that amendment contained the good faith certificate requirement, bor- rowed from Florida, that was subsequently codified at § 52-190a (a). Both the House and the Senate adopted the amendment the following week, without any debate or discussion regarding the new good faith certificate requirement.

It is undisputed that “the purpose of the original version of § 52-190a was to prevent frivolous medical malpractice actions.” Dias v. Grady, supra, 292 Conn. 357; see also Carpenter v. Daar, supra, 346 Conn. 124 (“Morgan has created roadblocks for otherwise meritori- ous cases that are squarely at odds with the legislature’s limited goal of ensuring an adequate, good faith investi- gation and eliminating only frivolous cases” (emphasis added)). It is clear from the legislative history that the Judiciary Committee inserted the relevant language into the bill at the eleventh hour, and it was approved with little apparent scrutiny. In my view, there is sim- ply no reasonable possibility that, when the legislature abandoned the idea of the mandatory screening panel and found a ready replacement in Florida’s good faith certificate requirement, it meant to incorporate thereby hidden restrictions on plaintiffs’ substantive rights that Florida itself has never found in the source statute.23 C

A word is needed regarding the proper application of the statutory construction adopted in Plainville, which I believe is the correct one. Because there is no indication that the legislature, in enacting § 52-190a, contemplated or considered the class of cases involving allegations of medical negligence brought against health care provid- ers by nonpatients, a court seeking to apply the statute to such cases under the Plainville construction has two options.

The first option is the one that Judge Pittman adopted in Plainville; see Plainville v. Wheeler Clinic, Inc., supra, Conn. L. Rptr. 813–14; and that Florida courts have embraced. See, e.g., Pavolini v. Bird, supra, 769 So. 2d 413. These courts concluded that, because the statute was intended to encompass only those claims brought by patients, nonpatient plaintiffs asserting claims involv- ing allegations of medical negligence are not required to comply with the good faith certificate and opinion letter requirements. This approach makes sense to the extent that one views the statute as part of a larger compro- mise, pursuant to which legislators agreed in this part of the tort reform package to address the chief cause of the perceived problem relating to medical malpractice, which was frivolous medical malpractice actions brought by patients. Claims by nonpatients are relatively rare, and nonpatients in any event typically will not have access to the confidential patient medical records that would be the focus of a good faith inquiry, at least not at the initial, prefiling stage of the litigation process. Accordingly, requiring a good faith inquiry in those cases, which account for a tiny fraction of all medical negligence claims, could place an undue burden on plain- tiffs while doing little to advance the statutory purpose No. 6134, as amended by House Amendments A, C, and G, and Senate Amendments B and E, An Act Concerning Tort Reform (1986) p. 12. A third, unidentified summary of the amendment stated that the bill “provides that an attorney or party filing a medical malpractice action may satisfy the reasonable inquiry standard . . . by obtaining a certificate from a physician evidencing malpractice.” (Emphasis added.) Although such summaries are hardly dispositive of the intent of the drafters, let alone the question of the statute’s meaning, they do reinforce the impression that no one at the time appeared to be focused on what the Jarmie majority considered to be a key consequence of the statute. of winnowing the meritorious claims from the frivolous ones. See, e.g., Pavolini v. Bird, supra, 413–14. This approach would construe the statute to exclude alto- gether the special case of nonpatient suits and leave it to the legislature to amend the statute if it wishes to fill in the gap.

The second option is to adopt, as a common-law rule applicable to nonpatients who bring claims alleging medical negligence against health care providers, the same procedural requirements that § 52-190a imposes on patients who bring such claims. The procedural require- ment would not be imposed as a matter of statutory construction, but as a judge made, common-law rule designed to implement a procedure in medical negligence cases that serves current social interests at the same time it creates a uniform and harmonious system consistent with the procedures imposed by § 52-190a on patients bringing such claims.

Either approach is reasonable, and I see no need to express my preference at this point. We need not choose between them for present purposes, insofar as the plain- tiff complied with § 52-190a by attaching a good faith certificate and opinion letter to her complaint. If nothing else, this concurring and dissenting opinion highlights the need for further legislative attention to the statute. III

I dissent from part III of the majority opinion, in which the majority holds that the plaintiff has inadequately briefed her claim on appeal that the trial court had erro- neously struck count seven of the operative complaint, alleging a claim of gross negligence against the defen- dant. I agree that the argument is not presented in the robust fashion that is optimal, and sometimes necessary, for proper determination of an issue on appeal.24 I believe, however, that we should exercise our discretion sparingly to deem a claim forfeited due to inadequate briefing, and should do so only when the particular legal grounds supporting the argument cannot reasonably and read- ily be discerned, or when the court determines that the party’s failure to more fully elaborate the argument is the result of a lack of concern or substance rather than word limitations. “[T]he rules of practice are to be construed liberally, rather than narrowly and technically, in order to facilitate judicial business and to advance justice. . . . Courts usually favor a party’s right of appeal and con- strue statutes and rules to protect that prerogative . . . . The essential policy animating this broad judicial approach is . . . that courts should consider cases on their merits and in terms of a party’s substantive rights and not defeat them on mere technicalities.” (Citations omitted; internal quotation marks omitted.) In re Taijha H.-B., 333 Conn. 297, 310–11, 216 A.3d 601 (2019).

The plaintiff’s argument is simple and straightfor- ward: her claim of gross negligence is cognizable, not- withstanding the holding in Jarmie, for the same reasons that this court concluded that the plaintiffs’ personal injury claims were cognizable in Squeo v. Norwalk Hospital Assn., 316 Conn. 558, 113 A.3d 932 (2015), a unanimous decision issued three years after Jarmie. The majority deems this argument inadequately briefed because the plaintiff fails to explain why Squeo cannot be distinguished, inasmuch as Squeo involved a “deriva- tive” personal injury claim by nonpatients for bystander emotional distress, whereas the present case involves a nonpatient’s wrongful death claim. Part III of the majority opinion.

No doubt it would be preferable to know the plaintiff’s response to possible points of distinction. But there is a difference between an argument that is directionless or indecipherable on its own terms, on the one hand, and an argument that may prove unpersuasive on the merits Practice Book § 67-3A (setting forth procedures to request permission to exceed word limitations). because it fails to anticipate or rebut countervailing arguments, on the other. In my view, the plaintiff’s gross negligence claim is sufficiently clear and legally grounded to warrant review on the merits.

It does not take a great feat of imagination to appre- hend the plaintiff’s argument. Squeo expressed its hold- ing as follows: “We are unable to conclude, as a matter of law, that a hospital that discharges a potentially suicidal patient under the circumstances alleged could not have demonstrated gross negligence in so doing, when the patient then proceeded to take his own life shortly after discharge.” Squeo v. Norwalk Hospital Assn., supra, 316 Conn. 581. Changing two inessential words of this holding illuminates the plaintiff’s argument that the reasoning of Squeo permits her claim of gross negligence to go forward in the present case: “We are unable to con- clude, as a matter of law, that a hospital that discharges a potentially [homicidal] patient under the circumstances alleged could not have demonstrated gross negligence in so doing, when the patient then proceeded to take his [ex-girlfriend’s] life shortly after discharge.” Id. This court is perfectly capable of taking the argu- ment presented by the plaintiff and determining for itself whether the holding in Squeo is, and should be, distinguishable in the present circumstances. Indeed, the majority’s treatment of the plaintiff’s Squeo based argument indicates that it fully apprehends the issues, because the majority identifies and even adverts to the merits of the potentially distinguishing features that the majority considers inadequately briefed, i.e., the fact that a bystander emotional distress claim is a “derivative” claim whereas a wrongful death claim is not, and the legal sufficiency of the allegations on which the plaintiff bases her gross negligence claim. Part III of the majority opinion. I believe that the plaintiff’s gross negligence argument, read in the light of her entire brief, warrants adjudication on the merits. I would reach the merits and, for the following reasons, reverse the trial court’s decision striking the gross negligence count.

First, I consider it highly significant that the court in Squeo did not see Jarmie or § 52-190a as foreclosing, as a matter of law, the court’s conclusion that Connecti- cut recognizes a claim of bystander emotional distress grounded in the defendant health care providers’ medi- cal negligence in the care or treatment of someone other than the nonpatient plaintiffs. See Squeo v. Norwalk Hospital Assn., supra, 316 Conn. 568, 574. Squeo was decided three short years after Jarmie and was authored in plain view of § 52-190a by a member of the panel that decided Jarmie. The decision mentions Jarmie only in passing; see id., 574; and does not so much as mention the statute, which, if applicable, would have required the court to reject the plaintiffs’ claim without further analysis. In the language of the statute, as construed in Jarmie, the parents’ claim in Squeo would be barred by § 52-190a because the parents (1) sought to recover dam- ages in tort for “personal injur[ies]” sustained by them (2) as a result of the alleged “negligence of a health care provider” (3) whose “care or treatment” was provided, not to the parents (“the claimant[s]”) themselves, but to their son.

I see no good response to this point. It is true that the defendants in Squeo evidently did not raise Jarmie or § 52-190a as a bar to the parents’ claim, but I consider it well-nigh impossible to imagine that this court would spend pages upon pages analyzing and adjudicating a common-law issue of first impression—whether Con- necticut common law recognizes a bystander emotional distress claim based on allegations of medical negli- gence—when that very claim is barred by statute under the unequivocal holding of a case decided by the court just three years earlier. See Squeo v. Norwalk Hospi- tal Assn., supra, 316 Conn. 568–81. Viewing Squeo in such a manner would render its elaborately reasoned, novel holding a dead letter of little or no precedential value because any defendant citing Jarmie in response to a Squeo type claim would prevail as a matter of law regardless.

It is also unavailing to suggest that Squeo is distin- guishable because a claim for bystander emotional dis- tress is “derivative” in nature and therefore somehow avoids the Jarmie prohibition of nonpatient claims. Part III of the majority opinion. First, nothing in the court’s analysis in Squeo states or suggests that its outcome depends in the slightest on the derivative nature of the nonpatients’ claim. The opinion contains a single ref- erence to that term, which appears in the background discussion prior to the analysis of the plaintiffs’ legal claims. See Squeo v. Norwalk Hospital Assn., supra, 316 Conn. 564. The legal analysis itself, which spans more than ten pages, never mentions that the claim is a derivative one, and its reasoning does not rely on that fact. See id., 568–81. Second, nothing in the court’s analysis in Jarmie states or suggests that its construction of § 52-190a as barring all actions by nonpatients would not extend to bystander emotional distress and other claims that are derivative of a patient’s primary injury. As construed in Jarmie, the text of § 52-190a bars any claim in which the plaintiff (i.e., “the claimant”) is not the patient but nevertheless seeks “to recover damages resulting from personal injury . . . [and] in which it is alleged that such injury or death resulted from the neg- ligence of a health care provider . . . .” General Statutes § 52-190a (a). A claim of bystander emotional distress in this context does not seek recovery for injuries or harm sustained by the patient; it seeks damages for personal injuries sustained by the nonpatient plaintiff and, as such, falls squarely within the statutory prohibition, as construed in Jarmie, regardless of whether the claim is “derivative” in nature.

Finally, glancing up for a moment from the doctrinal technicalities to view the legal landscape being regulated, it is counterintuitive, to say the least, to believe that the legislature intended § 52-190a to permit a claim by nonpatients (the parents in Squeo) for the emotional harm they suffered as a result of witnessing the con- sequences of medical malpractice, but to bar a claim by a nonpatient (the decedent in the present case) for the mortal, physical harm she suffered as a result of being a direct victim of the consequences of medical negligence. To illustrate the point, consider how today’s holding would adjudicate a case in which the parents in Squeo sought damages for emotional distress after witnessing their son kill his girlfriend (instead of himself) upon release from a hospital for having homicidal (instead of suicidal) thoughts. I am unwilling to accept the notion that a well pleaded “derivative” claim of emotional dis- tress is permitted but that the nonderivative wrongful death claim of the decedent’s executor is barred. I trust that this court would not allow our self-created doctrinal jumble to require it to impute such a bizarre and unjust intention to our legislature.

Two questions remain. First, does Connecticut law recognize a claim in tort for gross negligence? And, second, if so, does § 52-190a, as construed in Jarmie, bar a claim by a nonpatient for damages sustained as a result of the gross negligence of a health care provider? In my view, the answer to both questions is found by necessary implication in Squeo, which held that the nonpatient plaintiffs could maintain a personal injury claim arising from the gross negligence of a health care provider. Squeo v. Norwalk Hospital Assn., supra, 316 Conn. 581. Gross negligence in the care or treatment of the patient was the specific standard of liability identified by the court.25 Gross negligence is not the same as negli- gence, as Squeo makes clear. Id., 579–80. Connecticut law more generally defines gross negligence “to mean no care at all, or the omission of such care [that] even the most inattentive and thoughtless seldom fail to make their concern, evincing a reckless temperament and lack of care, practically [wilful] in its nature.” (Inter- nal quotation marks omitted.) Hanks v. Powder Ridge Restaurant Corp., 276 Conn. 314, 352, 885 A.2d 734 (2005) (Norcott, J., dissenting); see also C & H Electric, Inc. v. Bethel, 312 Conn. 843, 869, 96 A.3d 477 (2014) (“[g]ross negligence requires conduct that ‘betokens a reckless indifference to the rights of others’ ”); 57A Am. Jur. 2d 296–97, Negligence § 227 (2004) (“ ‘Gross neg- ligence’ means more than momentary thoughtlessness, inadvertence or error of judgment; hence, it requires proof of something more than the lack of ordinary care. It implies an extreme departure from the ordinary standard of care, aggravated disregard for the rights and safety of others, or negligence substantially and appreciably greater than ordinary negligence.” (Footnotes omit- ted.)). Considered in the proper light under the standard applicable at this stage, the allegations contained in count seven of the plaintiff’s complaint plainly state a claim of gross negligence.

IV

In the relatively short time since Jarmie has been on the books, it has already done significant damage to the development of our common law relating to the liability of health care professionals for harm caused to others resulting from medical negligence in the care or treat- ment of a patient. This distorting effect is attributable to the simple fact that Jarmie construed § 52-190a to bar any third-party medical negligence claim requiring establishing a bystander emotional distress claim; it altered the legal standard of medical negligence necessary for a nonpatient to recover damages for bystander emotional distress arising from the care or treat- ment provided by a health care provider to a patient. I cannot think of a reason why the same reasoning would not, at the very least, permit a nonpatient’s wrongful death claim to proceed based on allegations of gross negligence by the patient’s medical care providers. expert testimony to establish the standard of care. This holding has cast a long shadow over the development of related common-law doctrine over the past fourteen years, including the decision in the present case, because of the perceived need to evade the apparent strictures of § 52-190a that have required the court to formulate theories of liability that can be established without expert medical testimony. I agree with the majority that, if Jarmie were to be overruled, this court would be required to decide anew what common-law path to follow, unfet- tered by the constraints imposed by Jarmie. In the con- text of a Tarasoff type claim in particular, the question will be what affirmative duty of care mental health care providers owe to identifiable victims at risk of harm from a patient. See, e.g., 2 Restatement (Third), Torts, Liability for Physical and Emotional Harm § 41 (b) (4), p. 65 (2012); see also Fraser v. United States, supra, Conn. 633–34 (discussing common-law identifiable victim doctrine in this context).

Because Jarmie still controls, I concur in the result reached in parts I and II of the majority opinion. I respect- fully dissent from part III of that opinion.