ORDER FOR THE CARE IN AN ESTABLISHMENT

 

CANADA                (A translation of an original at my best knowledge)

PROVINCE OF QUEBEC COURT OF QUEBEC

DISTRICT OF ST-FRANÇOIS

450-40-000016-959

PAUL MONTAMBAULT, director doctor of the professional service who practicing his function at Centre hospitalier universitaire de Sherbrooke, 3001 12 e avenue nord, Fleurimont (Quebec) J1H 5N4, district of St- François, represent by ANDRE SIMARD, M.D., President of CMDP

Applicant

 -and-

 

Mister Serge Bourassa- Lacombe

880 Jogues, app101

Sherbrooke (Quebec) J1H 2X9

 Respondent

 -and-

(Confidential)

 Call-into

ORDER FOR THE CARE IN AN ESTABLISHMENT

OF HEALTH OR SOCIALS SERVICES.

(Art. 30 C.c.Q., art. 13 L.P.M., et art.778 et ss. C.p.C.)

IN VIEW of the petition for the care of the respondent party in establishment;

IN VIEW of the absence of consent;

IN VIEW of the psychiatric report given to the tribunal concluded to the necessity to keep the respondent party in establishment;

IN VIEW of that the signification of the petition to the respondent party could be harmful health or to the security or the last mentioned or to others;

IN VIEW of the proof who have been submitted to us;

IN VIEW of that it is manifestly useless to interrogate the respondent party in reason of his state of health;

BY THOSE MOTIVES, THE COURT:

WELCOME the request;

GRANT the applicant for the dispensation to serve notice to the respondent party the petition

ORDER the care of the respondent party for a period of no more than twenty one days in the following establishment: Centre hospitalier de Sherbrooke;

AUTHORIZE all agent peace to take the respondent party to the aforesaid establishment;

THE ALL without charges

FLEURIMONT (CHUS/CUSE), this April 19^th 1995    [top]

Judge of the Court of Quebec

LOUIS-DENIS BOUCHARD 

CANADA

PROVINCE OF QUEBEC COURT OF QUEBEC

DISTRICT OF ST-FRANÇOIS

450-40-000016-959

PAUL MONTAMBAULT, director doctor of the professional service who practicing his function at Centre hospitalier universitaire de Sherbrooke, 3001 12 e avenue nord, Fleurimont (Quebec) J1H 5N4, district of St- François, represent by ANDRE SIMARD, M.D., President of CMDP

Applicant

 -and-

Mister Serge Bourassa- Lacombe

880 Jogues, app101

Sherbrooke (Quebec) J1H 2X9

   Respondent

 -and-

'Receipt copy for to be worth'

(Confidential)

Link of relatives : Confidential

Date of signature: April 2^nd 1995

Call-into 

REQUEST FOR THE CARE IN AN

ESTABLISHMENT OF HEALTH OR THE SOCIAL SERVICES 

(Art. 13 of the law on the protection of mental illness, Art.30 C.P.Q. Arts 763, 773, et ss. C.P.c.)

TO ONE OF THE HONORABLE JUDGE OF THE QUEBEC COURT, CIVIL CHAMBER, IN AND FOR THE DISTRICT OF ST-FRANCOIS, THE APPLICANT PARTY RESPECTFULLY EXPOSE:

1. The respondent party had been submitted to a psychiatric examination conclusive to the necessity of the care in establishment like it appears in the medical reports of the attendant physicians Jean-Philippe Boulanger and Lynn Gaudreault, psychiatric, produce to support the present under the mark R-1 for to make part like if recited all long;

2. The respondent party refuse to be kept in an establishment;

3. The mental state of the respondent party is sensitive to put his health or his security or these of others;

4. In view of the emergency of the situation and taking into account that it will be harmful to the health and to the security of the respondent party or of others to signified him the present petition, it is necessary that the applicant party been dispensed to signified him this present petition;

5. It is manifestly useless to require the testimony of the respondent party;

FOR THOSE MOTIVES, PLEASE TO THE TRIBUNAL;

EXEMPT the applicant party to signify the present petition to the respondent party;

EXEMPT the cross-questioning of the respondent party;

ORDER the care of the respondent party in the establishment centre hospitalier universitaire de Sherbrooke for a duration of not more than 21 days;

AUTHORIZE all peace agent to take the respondent party to the aforesaid establishment.

This March 24 ^Th 1995, 

Andre Simard, M.D., president du CMDP pour: Paul Montambault 

A F F I D A V I T

I, undersigned, Andre Simard, physician, president of the executive of counsel of physicians, dentists, and pharmacists at centre hospitalier universitaire de Sherbrooke, practicing my profession and, been duly on oath, declare and said:

1. I am the applicant;

2. The facts put forward to this present petition are in accordance with the notes of the medical file.

 IN FAITH OF WHAT I SIGNED

 Andre Simard, M.D., President of CMDP

ON OATH IN FRONT OF ME

At Fleurimont (CHUS/CUSE)

This March 24 ^Th 1995

Denise Lareau #120545

Commissioner of the oath

District of Saint-François

ADVICE OF PRESENTATION

TO : (Confidential)

TAKE ADVICE that the present request will be presented by tender in front of one of the honorable judges of the court of Quebec (Civil chamber) at court house of Sherbrooke in chamber, the March 31^st 1995, at 09 h 00

PLEASE ACT IN CONSEQUENCE

This, March 24 ^Th 1995

Andre Simard,

M.D., President du CNMP

PIECE R-1

CLINICAL PSYCHIATRIC TEST REPORT

(A translation of an original at my best knowledge)

LEGEND for only piece R-1 :

TRUE = black

FALSE = red

IN PARENTHESIS = NON VERIFIABLE UNTIL NOW

identification of the examinate person

Lacombe Serge male 880 Jogues app #101 Sherbrooke J1H 2X9 (#4664-1)

Information obtained on the actual condition of the person examinate

(Patient, Parents + roommate, nursing staff)

Patient admitted the 95-02-11, brought by the police after having presented violent action against object in front his roommate + his parents in a context of attitude changing since Dec 94 : augmentation of energy, augmentation of sociability, sleeplessness, augmentation of libido than apparition of delirium of grandeur + religious with irritability development + inadequate comportment ; insistence to evangelize either his class + roommate, very irritable etc.

observation and provisional physician diagnosis

Initially hospitalization and  voluntary intake of medication with relative amelioration, since 95/03/13 refusal to take the medication and this gay patient who desire a refusal treatment to be called all right. And who still affected with an augmentation of psychometric activity + much mist contain irritability ; patient need to stand up to keep the control and leave the meeting room).  Aggressive action made towards the medical team like point a finger, threatening look, clap one's hands, indirect menacing etc. Also patient who present a delirium of grandeur and religious very invading whom make him act; lay hands on the patients to heal them etc. none self-criticism and lack of judgment ++. Important: bipolarity affective illness, maniac psychosis + psychotic element, evident to be dangerous at the present time.

I certify that the close cure it necessary

Date 95/03/17   physician signature : Lynn Gaudreault, CHUS No of the physician license : 88-442

CLINICAL PSYCHIATRIC TEST REPORT

(A translation of an original at my best knowledge)

LEGEND for only piece R-1 :

TRUE = black

FALSE = red

IN PARENTHESIS = NON VERIFIABLE UNTIL NOW

identification of the examinate person

Lacombe Serge CHUS # 398 068 950213 M 579620

 

880 Jogues app #101 Sherbrooke J1H -1X9

Information obtained on the actual condition of the person examinate

(Parents + personal of 4e B, patients)

Patient of 38 years without previous psychiatric problems having brusquely change his mood since 1994 with specially violent behavior which cause his hospitalization in February. Refuse all treatment since a few days, ask for his leaving and present some strange behaviors like lay hands on others patients ; hold some mystic-religious purpose, talk of energy transfer, heal by his energy the patients of the department.

observation and provisional physician diagnosis

Patient cooperative but affected ; good orientation but important reserve to evoke his problems.  Stay evasive with circumtantial discourses, not much coherent, loose association and incomprehensible allusion to some relation that only him understand between certain facts. For all the effort from the patient to seem in control appear a delirious activity of mystic topic and of grandeur opposite of which exist none autocritical. Suspicious and interpretative, the patient think that certain persons are inspired by the demon more particularly ; his roommate, that his parents don't understand him and that we had film him at the emergency.  Beside the troubles of judgment bringing his state dangerous for himself existing therefore some persecute elements which bring him potentially dangerous for others and justified his keeping at the hospital.

I certify that the close cure it necessary

Date the March 19 1995     Physician signature : J. Philippe Boulanger CHUS No of the physician license : 91-006