1

TABLEOFCONTENTS I.Descriptionofincident....................................................................................2 II.Summaryofargument......................................................................................9Tableof Authorities.................................................................................9 III.Addendum................................................................................................15 IV.Definitions................................................................................................16 V.Documents.......................................................................................(attached)

DETAILEDACCOUNTOFTHEINCIDENT 1.AtapproximatelynoononSaturday,December1,2007,IwasinthemiddleoftakingtheDecember 2007versionoftheLSATs.iThetestingcenterwaslocatedattheUniversityofNorthCarolinaat GreensborowhereIalsowasattendingcollege.Midwaythroughthetest,Icancelledmyscores,left, andhadafrienddropmeoffattheemergencyroom(ER)atWesleyLongHospital,inGreensboro, NC. WesleyLongHospitalERii2.Duringmyinitialassessment,Itoldthe(triage)nursethat: a.Ihadasevererashthatwasinfected.Iexplainedthattheskinconditions*Iwasalreadydiagnosed withdidnotexplaintheseverityoftherashIwasexperiencing,whichhadbeengoingonforabout67 monthsatthatpoint.Ialsotoldherthattheskinsymptomswerecontinuingtopersistdespitemy treatmentwiththeprescriptioncreamsand/orointments.b.Ihadnotsleptfortheprevioustwo nightsinspiteoftakingthesleepingmedicationIwasprescribed(Ambien).IexplainedhowIthought thedegreeofinsomniaIwasexperiencingseemedtocorrelatewiththelevelofseverityofmyskin symptoms,sincetheinsomniabeganaroundthesametimemyskinsymptomsstartedworsening(67 monthsbefore).
*BriefDermatologicalBackground Asachild,Iwasdiagnosedwitheczemaandatopicdermatitistwochronic(yetcommon)skindiseasesthatare characterizedbydry,rough,red,anditchypatchesofskin.Myskinisextremelysensitiveanythingthatusually irritatesmyskinwilltypicallymanifestinsomesortofrash.Mostofthetime,itscompletelymanageablethroughthe useofspecificlotions,soaps,certaintypesofmakeup,etc.Prettymuchanypersonalorhouseholdnecessitythat yieldsthewordsfragrancefreeand/ordermatologistrecommendedissomethingthatIown. Occasionallyhoweverallergenswillinitiatesymptomsofeczemaoratopicdermatitisthatleadtobacterial infections.Inthepast,dermatologistshaveprescribedmetopicalcorticosteroids,suchasTriamcinoloneor Betamethasone,forsituationslikethese.

3.ItoldthenurseIhadbeendiagnosedwithScabiestwiceabout2monthspriortomyvisit.Ialso emphasizedthatIhadtoundergotworoundsoftreatment(Permethrin)whichisunusualinattempts togetridofthescabiesmites.IinformedherthatinthemonthsprecedingIhadbeentothe dermatologist,aswellasdoctorsattheStudentHealthCenteriii(UNCG).Bothassumedthatthe increasedseveritywasntanythingmorethanacombinationofenvironmentalinfluencesandmy aggravationoftheirritatedareas.Similartothefirstapplication,thesecondroundofPermethrin(forthe scabiesmites)alsofailedtoproduceresults. IthenexplainedthatwithmyabilitytosleepandtheconditionofmyskinessentiallyunpredictableI hadstarteddoingasubstantialamountofresearch.Aspastdiagnoseshaddictated,myskinsymptoms resembledthoseofsomeonewithScabies.Additionally,thetopicalcorticosteroidtreatment(s)Ihad beenusingovertheyearswerenthelpingwithwhateverwaswrongnow.Typically,scabiesmitesare theonlyparasitethatisspreadthroughhumancontact...andmanifestswithdermatological symptoms...andarefoundthroughouttheUnited

States.1Takingeverythingintoaccountpossiblechangesinenvironment,lifestressors,etc.theonly considerablethingthathadchangedaroundthesametimemyskinstartedtakingaturnfortheworse wasthefactthatIhadtakeninastraycat.So,Ithoughtthatthecathadtobeapartoftheproblem.I alsoexplainedhowthecatwassick,mainlybecausethereseemedtobelittleorangecoloredballsat randomspotsonthecarpet. IthenattemptedtoexplainwhatIthoughtwasresponsibleforallofmyskinsymptoms.Ialreadyhad therelevantdermatologicaljournalarticlesandadditionalimagessavedonmylaptop.Ibegantoexplain thesimilaritiesbetweenmyskinandhookwormfolliculitis,2aconditionthathas...anunusualpresence oftheparasiteinthedermis.Themostessentialconnectionresidedinthefactthattheparasitic dermatosisresultsfromzoonotictransmission,meaningitwastransmittedfromanimals(i.e.cats)to humans. Additionalsimilarities:1.thephysicalsimilaritiesoftheskinlesions 2.thesimilarityinlocationofthesymptoms3.howthesymptomswould...persistforweeksto months...thenresolvespontaneously 4.howtheunderlyingmechanismscanalsoresemblethe behaviorof...demodexfolliculorummites. 4.AftermyattemptatexplainingwhatIthoughtwasgoingon,thenurseproceededwithapsychiatric lineofquestioning:ifIwascurrentlytakingallofmyprescribedmedicationsandwhatIwastakingthem for.Next,shebeganaskingquestionsbasedonhowsheinterpretedmyuseofthewordparasite: WheredidIseethem?HowoftendidIseethem?Howexactlydidthecatgivethemtomeorvice versa? Shortlyafter,around1:30PM3,theRNtoldmethattheyneededaurinesample.Iaskedhowaurine samplecould(atall)aidindiagnosingmyskinissues.Sheresponded(literally),Wellifyouhavea parasite,thenitshouldshowupinyourtests.Whileintheroom,Istartedtoworkonapaperthatwas dueonthatcomingMondayforapsychologyclass(PSY515).Accordingtothesequenceofevents dictatedinthelog,justbefore3:00PM,ZachSmith(PA)enteredtheroombriefly(nomorethanfive minutes).Irememberhimaskingacoupleofquestionsconcerningmylackofsleepandaboutthe parasiteIwasapparentlyvisualizing.4Still,noonehadexaminedtheskinlesions. 5.JustafterthePAhadleft,Iwasmovedtoastretcherinthehallway...whereIcontinuedtodomy homework.Shortlyafter,someonecamebytodrawblood.Iaskedherifsheknewanykindoftime frameregardingwhenIwasgoingtoseeadoctorshedidnt. At3:44PM5,BeckyBerman(RN),walkeduptothestretcherIwassittingonwithasyringe.She casuallybegantomovemysleeveuptowardsmyshoulderinpreparationforadministering
1http://www.cdc.gov/scabies/2RiveraRoig,V.,Sanchez,J.L.,andHillyer,G.V.(2008).HookwormFolliculitis. InternationalJournalofDermatology,47,24648.3seechronologydepictedinPatientAssessmentSheetin attacheddocuments4accordingtodoctor(s)statementoncommitmentform5Id.,at3

ashot.Imovedmyarmandaskedherwhatshewasdoing.Shecalmlysaid,Iamgoingtogiveyou somethingthatwillcalmyouandyourrashdown.Isaid,Imprettysurethatcanthappeninone medication.Whatisit?SheinformedmethatitwasGeodone6(anantipsychotic).Ithenexplainedto herthatshewasnotgoingtoadministeranantipsychotictohelpmewithmyrash.Atthispoint,itis approximately4:00PM.IhadbeenattheERinWesleyLongHospitalforover3hours.NooneIhad comeincontactwithhaddoneanything(outsideofobtainingaurinespecimenandorderingmybloodto bedrawN)thatwasdiagnosticallyinformativeorsignificant.Iwasstillsittingonthestretcher,working onmylaptop.Istartedpackingupmystuffandsaid,Okay...Iamjustgoingtogosomewhereelse. Thisisridiculous.Inlessthanaminute,therewere4securityguardsatmybedsidethatwereputin placetostopmefromleaving.Following,theymovedmeintoaroomacrossthehall.Twopolice officerswereplacedoutsidemydoor. 6.Shortlyfollowing,ZachSmith(PA)cameintheroom.Iaskedtoseethepaperworkthatwaslegally allowinghim/themtokeepmehere.Heshowedmeoneoftheforms(Idontrememberwhich)andtold meIwasbeinginvoluntarilycommittedforbeingadangertomyselfonthebasisthatmyskinlesions wereallselfinflicted.StillhowevermyskinhadYETTOBEEXAMINED,inanyrespect.I remindedhimthatI(infurtheranceofpersonalcare)cametothem(WesleyLongHospital),after leavingtheLSATs,becauseIwantedtwo(nonmutuallyexclusive)things:1.formyskinconditionto improveinsomeway:thebestcase,obtainingadiagnosistheworstcase:thatthesituationwould remainunchanged2.tominimizethelevelofinsomniaIhadbeenexperiencing. IalsotoldMr.SmiththatIhaveneverbeeninvoluntarilycommittedand/orhospitalizedbefore. ItoldhimthatIhaveIneverbeenadangertomyself,7thathecouldattempttoverifythisbycallingmy psychiatrist(Dr.Kaur).ItoldhimthatIhadacatthatneededcare...whowaslocatedatthehouseI livedinalone,ownedbymylandlord(BulentBediz),whomIpaidrenttoeachmonth. I then told him that I was scheduled to workthenextmorningat11:00AM(Sunday,12/02/07).Iwas employed fulltime at Bravo, an Italian restaurant. Since I knew that it was unlikely that I would be release from MCBH in time to get to work, I called a friend/coworker whoexplainedtomy manager whatwasgoingon. Finally,IexplainedthatsinceIwasalsoafulltimestudent,itwasimportantformetobeatschoolthat comingMonday. They(thedoctors)thenbroughtupmydisheveledappearanceandmytangentialspeechpatterns.I feltasthoughtheresponsetomyappearancewasessentiallyrhetorical:Ihadntsleptinover 48hoursontopofhavingacontinuallydeterioratingskinconditionthosewerethereasonsIwentto thehospitalinthefirstplace.Inresponsetomyspeechpatterns,Itoldhim
6orziprasidonemeslyate(intramuscularinjection),indicatedforacute...psychomotoragitationinthetreatmentof acutemanicormixedepisodesassociatedwithbipolardisorder,withorwithoutpsychoticfeatures (https://www.pfizerpro.com/product_info/geodon_pi_indications_and_usage.aspx)7seeregistrationhistoryin attacheddocuments

thatwordsliketangentialandhyperverbalcoulddescribethewayItalkalmostallthetime.My mindtendstomovefasterthanmymouth. 7.MydecisiontogototheERthatdaywasbasedinpartonknowingthatthehospitalhadboththe equipmentandresourcestoperformaskinscrape,8whichwouldhavebeenthemostdiagnostically comprehensiveandbeneficialproceduretodate.Ibroughtuptheskinscrapeprocedureto[them],and proposedthattakingasampleofskinlesion(s)couldservethepurposeofobjectivelydetermining whetherthelesionswereinfactselfinflicted.[They]werentinterested. OnatleastoneoccasionduringmycourseofstayintheER(between12:54PMand8:30PM),andby atleastofthefollowingindividuals,BeckyBerman(RN),ZachSmith(PA),IvaKnapp(MD),orJonR. Knapp(MD,PSA),Iwasdescribedasoneormoreofthefollowing:agitated,anxious,argumentative, delusional,disheveled,disoriented,hallucinating,hostile,manic,psychotic,disoriented,orsuicidal. 8.JustbeforeIwastransferredtoMosesConeBehavioralHealth(MCBH),anothernursecameinto theroomwitha1mgsyringeofAtivan(tobeadministeredviaintermuscularinjection)whensaidthatit wasunnecessary,sheexplainedthatIdidnthaveachoiceinthematter.Shethenadministeredthe drug. 9.Atapproximately8:45PM,Iwashandcuffed,putinthebackofapolicecar,anddrivenacrossthe streettoMCBH. MosesConeBehavioralHealth10.IarrivedatMCBHshortlybefore9:00PM(12/1/07)asaresultof theinvoluntarycommitmentorderimposedbycertainERphysiciansandstaffmembers.Iwas committedonthebasisthatIwas: (1)mentallyillanddangeroustomyselfAND(2)requiredimmediatehospitalizationtopreventharm IvaKnapp(MD),wasthepetitioneronthefirstassessment/examination,claimingthatImetthecriteria forcommitmentbecauseIwas(accordingtoDMH57201) (1)mentallyill(296.80=ManicDepressiveNOS)and(2)dangeroustomyself(Imadeastatementto physicianthatIcouldnttakeitanymore)(3)descriptionoffindingsstated:
Respondentmadestatementtophysicianthatshecouldnttakeitanymoresheappearsdelusionalandneeds hospitalizationforfurthertreatment.

JonR.Knapp(MD,PSA),wasthephysician/eligiblepsychologistonthesecond(andfinal) examination,whoprovidedaswornstatementstatingthat(accordingtoDMH57201A)I... (1)wasmentallyillanddangeroustomyselfand(2)requiredimmediatehospitalizationtopreventharm, basedonhisstatementthat:

8Skinscrapingisa...techniqueindermatologythatisappliedinahighproportionofcases...[and]...enables...thefull thicknessoftheepidermis...tobesampled.(http://www.rvc.ac.uk/review/Dermatology/Tests/Scraping.htm)

Pt. is currently delusional. Is concerned w/ visualization of parasites in her skin. Pt. has flight of ideas, [is] disheveled, [has] tangential speech. ReportsIcanttakeitanymore.Iwantthesethingsout ofme.Concernpt.may bedangertoherself.

11.Uponarrival,IaskedtheadmittingnursewhenIwouldbeabletotalktosomeonewhohadto authoritytodischargeme.ThenursetoldmethatIwouldmostlikelyseethepsychiatrist(BarbaraSmith (MD)around1:00PMthenextday(12/2/07).Afteradmissionpaperworkwasfilledout,Iwasgiven Ambien(2)tohelpmefallasleep.Thiswasaround10:30PM. December2,2007(Thenextday)12.Iwokeupatapproximately10:00AM.Iaskedanursewhat timeIcouldseethepsychiatristshetoldmeitwouldntbelong.At10:45AM:Imetwiththe psychiatrist,BarbaraSmith(MD),andexplainedtoherasconciselyaspossiblewhathappenedin myvisittotheERatWesleyLongthepreviousday.Aftertalkingwithherforabout45minutes,she immediatelyinitiatedthedischargepaperwork. 13.OnmyDischargeSummary,Dr.Smithstatedthat(inreferencetome):...shewenttotheED whothoughtthatshewasdeliberatelyharmingherself,becausetherewereopenlesions.Inboththe historyofpresentillnesssectionandthehospitalcoursesectionofthesummary,statedthatmy thoughtcontentwasgrosslywithinnormallimits.Inthedischargediagnoses,theresultsarelistedas follows:
AxisI:1.BipolardisorderNOS 2.TrichotillomaniaAxisII:None AxisIII:Rash(scabies)AxisIV:Severe(psychosocialstressors,etc.)AxisV:GAFupon admission=55GAFupondischarge=65

14.IdidntandstilldontunderstandhowIcouldbeinvoluntarilycommittedfromtheERonthe basisofaselfinflictedskincondition,yetbedischargedthenextdaywithadiagnosisofanactualskin diseasethatdoesnotariseduetoanymeasuresofselfinfliction. MyActualDiagnosisivFinally,inFebruaryofthisyear,Ifoundoutwhatwaswrong.Aftermultiple referralsandstillnoanswers,IwenttoseeDr.JosephJorizzoatWakeForestUniveristysDepartment ofDermatology.Dr.JorizzowaspreviouslyvicepresidentfortheAmericanAcademyofDermatology. Hefrequentlyleavesthecountrytogivelecturesontheareaofdermatologyhespecializesin.Inshort, heishighlyregardedinhisfield.Hediagnosedmewiththefollowing: 1.Eczema2.AtopicDermatitis3.IchthyosisVulgarisv

iLSATCandidateCancellationCard(inattacheddocuments)iiPatientAssessmentSheet(PAS)(inattached documents)iiiOutpatientClinicRecord(UNCG)(inattacheddocuments)ivseemedicalrecordsvseedescriptionof disorder(inattacheddocuments)

TABLEOFAUTHORITIES
CasesAddingtonv.Texas,441U.S.418(1979) ...........................................................................................8,10DeMarcov.Sadiker,897F.Supp. 693(1995)...............................................................................9,10,11Glassv.Mayas,984F.2d 55(1993)......................................................................................................11Grahamv.Connor, 490U.S.386(1989)...............................................................................................11Harlowv. Fitzgerald,457U.S.800(1982)............................................................................................11 Humphreyv.Cady,405U.S.504(1972) .................................................................................................8InreHernandez,46N.C.App. 265(1980)..............................................................................................8OConnorv.Donaldson, 422U.S.563(1975)...................................................................................9,10ProjectRelease v.Prevost,722F.2d960(1983)....................................................................................10 Rodriguezv.CityofNewYork,861F.Supp.1173(1994) .......................................................................10Vitekv.Jones,445U.S.480(1980) .........................................................................................................9Wetherhornv.Alaska PsychiatricInstitute,156P.3d371(2007)......................................................8,10 Statutes42U.S.C.1983 ...................................................................................................................................11N.C.G.S. 122C2..................................................................................................................................9 N.C.G.S.122C210.1 ..........................................................................................................................11N.C.G.S. 122C262...............................................................................................................................8 N.C.G.S.122C268(j) ...........................................................................................................................8N.C.G.S. 122C3(11)(a)...........................................................................................................................7 N.C.G.S.122C3(11)(b) ..........................................................................................................................8

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SUMMARYOFARGUMENT Thestatespowertoinvoluntarilycommitanindividualresideswithintwolegitimateinterests:first,its parenspatriaepowertoprovidecareforanindividualwhoisunabletocareforthemselvesand second,itspolicepowertoprotect(inthiscase)societyfromtheindividualbylimitingtheircontactwith thepublic.Atthesametime,however,involuntarilycommittinganindividual...constitutesasignificant deprivationoflibertythatrequiresdueprocessprotection.Addingtonv.Texas,441U.S.418,425 (1979).TheSupremeCourthasrepeatedlyacknowledgedthatsucha...massivecurtailmentof liberty,Humphreyv.Cady,405U.S.504,512(1972),requiresthatthestatebeartheburdenof justifyingthenecessityforcommitment,as...theinfringementoftherespondentslibertyrights...begins [at]themomenttherespondentisdetainedinvoluntarily.Wetherhornv.AlaskaPsychiatricInstitute, 156P.3d371,381(2007).Thatburdencanonlybemetwhenthecriteriaforinvoluntarycommitment aremetandsufficientfindingsexisttosupportthecommitmentorder. Inmysituation,thestatesburdenrestedontheactionsofpetitioningphysicians(asstateactors),who wererequiredtoprovethat...clear,cogent,andconvincingevidenceexisted,demonstratingthatI was...mentallyilland(emphasismine)adangertoself1ordangeroustoothers,2asspecifically requiredbyN.C.G.S.122C268(j)(2007).Sincethedoctorswereconvinced3that...anydelay causedbyutilizingthenormalprocedurewouldcreateadangerofharmto[myself]andthatI ...requiredimmediatehospitalizationtoprevent[this]harm,Iwascommittedunderaspecial emergencyprocedure,asdefinedinN.C.G.S.122C262.Thisemergencyprocedurerequiredthe doctor(s)tosubmitaswornaffidavitthatestablishedthe...factsuponwhich[their]opinion[was] based,andthatthe...factsmustbesufficienttoestablish...that[I]wasimminentlydangerousto [myself[atthetimeofthecommitment.InreHernandez,46N.C.App.265(1980). Thestatefailedtomeetitsburden. Duetothefactthatthestatesfindingswereinsufficienttosupportacommitmentorder,theinvoluntary commitmentthatfollowedwasunconstitutionalandproducedsignificantlibertyviolations.Consequently, themannerinwhichmylibertieswereviolatedwasdirectlyrelatedtothebehavior/actionsofthestaff physicianstheirconductsubstantiallydeviatesfromprofessionalstandards,whichatthevery leastplacestheirimmunityfromliability4and/orpotentialentitlement(s)toqualifiedimmunity5in seriousjeopardy. ATheinvoluntarycommitmentofanindividualisa deprivationoflibertythatrequiresdueprocessprotection.Thelossoflibertyproducedbyan involuntarycommitmentismore(emphasismine)thanalossoffreedomfromconfinement.Vitekv. Jones,445U.S.480,492(1980).Thestatespowertoinvoluntarilycommitapersonexistswithinthe confinesofproceduraland
1 N.C.G.S.122C3(11)(a)2 N.C.G.S.122C3(11)(b)3

basedontheirfindingslistedinthestatutorilyrequiredcommitmentdocuments4N.C.Gen.Stat.122C210.1542U.S.C. 1983

11

substantivedueprocess.Proceduraldueprocessessentiallyrequiresthatthesamestandardis adheredtointheassessmentofcommitmentcriteriathatonehasbeen...giventhebenefitof proceduralsafeguardstoreducethechanceoferroneouscommitment.DeMarcov.Sadiker,897 F.Supp.693,699(1995). Themedicalstaffsainitialassessmentandfollowingreassessmentsfailedtodetermineandmuchless evaluatethatIwasadangertomyselforothers.Thestatesincorporationofthedangerousness standardintotheirownstatutorylanguagesonlyaddstoblurredlineofdistinctionthatattemptsto designatethepoint(s)atwhichanindividualslibertyinterestisunreachablebytheallencompassing interestsofthestate.Moreoveratnopointdidthedoctorseventrytomeettheconstitutional minimum,wherethe...lossoflibertycallsforashowingthattheindividualsuffersfromsomethingmore seriousthanisdemonstratedbyidiosyncraticbehavior.InreAddington,supra. Additionally,thedoctorsdeterminationofmentalillnesswasbasedlargelyonmyselfreportedpatient history.bIn2004,IwasdiagnosedwithBipolarIIDisorderandAttentionDeficitHyperactivity Disorder(ADHD)byDr.AndrewProffer.cIalsosufferfromTrichotillomania.Themedicalstaff concludedthatmyinitialcomplaintofasevereskinrashuponarrivaltotheERcoupledwithmy statementthatIhadntsleptfortwodayswasbestexplainedbydelusionsand/orpsychoses associatedwithamanicepisode.6Thefollowingadditionalfacts7wereknown,butnotconsidered:
1.ManicEpisodesoccuronlyinthecontextofBipolarIDisorder.ThepresenceofaManicorMixedEpisode precludesthediagnosisofBipolarIIDisorder.DSMIVTR,296.89(c).2.IhavehadnopreviousonsetsofaManic EpisodewithPsychoticFeatures.83.IwasmisdiagnosedwithScabies(133.0,ICD9CM,underthecategoryof InfectiousandParasiticDiseases)twice,approximatelytwomonthsprior.4.IlivedbymyselfinahousethatIpaid rentforeverymonth.5.Iworkedfulltime.96.IwenttoschoolfulltimeattheUniversityofNorthCarolinaat Greensboro.d7.Ihavenopriorhistoryofinpatientpsychiatrichospitalization.8.IcametotheERatWesleyLong Hospitalonmyown(bychoice).

TherequiredexistenceofdangerousnesssetforthinOConnorv.Donaldson,422U.S.563,575 (1975),outlinestheconstitutionalminimumrequisiteforsatisfyingproceduraldueprocess:that...a findingofmentalillnessalonecannotjustify...custodialconfinement.Thedoctorsfailuretoconduct anexaminationand/orassessmentofmydangeroustoselfinaccordancewiththestatute*constituted aviolationofmyproceduraldueprocessrights.Withregardtoinvoluntarycommitmentstatutes,the needforstateactorstotakethetimetotediouslyfollowthestatutorylanguageistantamountto preventinganyarbitrarydeprivationofliberty.Thementallyill10areindangerofbeingconfined ...merelybecausethey...exhibitsomeabnormalbehavior

6seedefinitionspage7relevantcriteriatothelegallyrequiredassessmentinFormNo.DMH572018InBipolarIIDisorder, onlyaMajorDepressiveEpisodecanmanifestinpsychoticfeatures9asaserveratBravo!CucinaItaliana,locatedatthe FriendlyShoppingCenterinGreensboro,NC10anyonewithaDSMIVTRdiagnosisadditionally,thetermisveryeasily stretchedtoencompassawiderangeofindividuals

12

whichmightbeperceivedbysomeassymptomaticofamentaloremotionaldisorder,butwhichisin factwithinarangeofconductthatisgenerallyacceptable.Wetherhornv.AlaskaPsychiatricInstitute, supra,at378(citingAddington,441U.S.at426427). Inaddition,thedoctorsfailuretoconductanexaminationand/orassessmentinaccordancewiththe statuteviolatesproceduraldueprocessonthegroundsthattheydidnotconsider...alternativeformsof careandtreatmentbesidesinvoluntaryhospitalization.ProjectReleasev.Prevost,722F.2d960 (1983).Additionally,thedoctorsactionsgoesagainstNorthCarolinasmentalhealthpolicy,asdefined inN.C.G.S.122C2,whichstatesthat...thepolicyofthestateistoassistindividualswithneedsfor mentalhealth...throughasystemdesignedtomeetthe[ir]needs...intheleastrestrictive,therapeutically mostappropriatesettingavailable.
*OnFormNo.DMH57201,itstatesthat:Includedintheexaminationwasanassessmentoftherespondents:(1) currentandpreviousmentalillness...including,ifavailable,previoustreatmenthistory(2)dangerousnesstoselfor othersasdefinedinG.S.122C3(11)(3)abilitytosurvivesafelywithoutinpatientcommitment,includingthe availabilityofsupervisionfromfamily,friends,orothersand(4)thecapacitytomakeaninformeddecision concerningtreatment.

BSubstantivedueprocessanalysisrequiresthe balancingofstateinterestsagainstthelibertyinterestsoftheindividual.Appliedtoinvoluntary commitmentlaws,thestatemaintainstheburdenof...constitutionallyjustify[ing]thedeprivationofa personsphysicalliberty.OConnorv.Donaldson,supra,at563.Thedoctorsfailuretogivemethe ...benefitofproceduralsafeguardssignificantlyincreasedthelikelihoodoferroneouscommitment. DeMarcov.Sadiker,supra,at699.Attributedheavilytotheviolationofproceduraldueprocess,the doctorsdecisiontoinvoluntarilycommitmewithoutrequisitefindingsofORrequisiteattemptsto determinedangerousnessconstitutesaviolationofmysubstantivedueprocess. Thus,theviolationofsubstantivedueprocessasappliedtomysituationbecameinevitablepursuant totheproceduralviolations.However,ifthedoctorshadfollowedthestatutorilymandatedprocessin determiningthedangerousnessstandard,asubstantiveelementwouldstillexist.Thequestionthenturns totheissueofwhetherornotmybehaviorwiththerelevantpast11rendersmeadangertomyself. Consequently,animpartialfactfinder,guidedbymedicaldocumentation,shouldbe[able]todetermine thatmentalillness[was]presentanddangerlikelywithout[having]towaitfor[my]conducttomake seriousharmallbutinevitable.Rodriguezv.CityofNewYork,861F.Supp.1173(1994).Ifsucha factfinderwasappliedtothiscase,theywouldalsofindmyconduct12wasnotconducivetoafinding ofdangerousnesstoself.The...courtstask...istoexaminetheundisputedfactsofaplaintiffsbehavior andthedefendantsresponsesanddecidewhethertherecordpermitsadeterminationasamatterof lawthatthedefendantsfindingofdangerousnesswasobjectivelyreasonable.DeMarcov.Sadiker, supra,at707. C
11Id.at1.12Id.at8.