Nguyen v. Massachusetts Institute of Technology , 479 Mass. 436 ( 2018 )


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    SJC-12329
    DZUNG DUY NGUYEN, administrator,1 vs. MASSACHUSETTS INSTITUTE
    OF TECHNOLOGY & others.2
    Middlesex.     November 7, 2017. - May 7, 2018.
    Present:   Gants, C.J., Gaziano, Lowy, Cypher, & Kafker, JJ.
    Wrongful Death. Negligence, Wrongful death, College. Damages,
    Wrongful death, Conscious pain and suffering, Breach of
    contract. Practice, Civil, Amendment of complaint.
    Workers' Compensation Act, Exclusivity provision.
    Civil action commenced in the Superior Court Department on
    September 6, 2011.
    The case was heard by Bruce R. Henry, J., on motions for
    summary judgment.
    The Supreme Judicial Court granted an application for
    direct appellate review.
    Jeffrey S. Beeler for the plaintiff.
    Kevin P. Martin (Yvonne W. Chan also present) for the
    defendants.
    Alan D. Rose, B. Aidan Flanagan, & Antonio Moriello, for
    Amherst College & others, amici curiae, submitted a brief.
    1   Of the estate of Han Duy Nguyen.
    2   Birger Wernerfelt, Drazen Prelec, and David W. Randall.
    2
    Jonathan A. Karon, Thomas R. Murphy, Mark F. Itzkowitz, &
    Lisa DeBrosse Johnson, for Massachusetts Academy of Trial
    Attorneys, amicus curiae, submitted a brief.
    KAFKER, J.    The plaintiff, Dzung Duy Nguyen, commenced a
    wrongful death action against the defendants, Massachusetts
    Institute of Technology (MIT), MIT Professors Birger Wernerfelt
    and Drazen Prelec, and MIT assistant dean David W. Randall,
    arising out of the suicide of his son, Han Duy Nguyen (Nguyen).
    The defendants are alleged to have been negligent in not
    preventing Nguyen's suicide.    The motion judge allowed summary
    judgment for MIT and the individual defendants, finding no duty
    to prevent Nguyen's suicide.    Although we conclude that, in
    certain circumstances not present here, a special relationship
    and a corresponding duty to take reasonable measures to prevent
    suicide may be created between a university and its student, we
    affirm the decision of the motion judge that the defendants are
    entitled to judgment as a matter of law.3
    Background.    We summarize the facts in the record in the
    light most favorable to the plaintiff.    Godfrey v. Globe
    3 We acknowledge the amicus brief filed by the Massachusetts
    Academy of Trial Attorneys; and the amicus brief filed in
    support of defendants by Amherst College, Bentley University,
    Berklee College of Music, Boston College, Boston University,
    Brandeis University, College of the Holy Cross, Emerson College,
    Endicott College, Harvard University, Northeastern University,
    Simmons College, Smith College, Stonehill College, Suffolk
    University, Tufts University, Williams College, and Worcester
    Polytechnic Institute.
    3
    Newspaper Co., 
    457 Mass. 113
    , 114 (2010).    We reserve additional
    facts for our discussion of the legal issues.
    1.   The parties.    At the time of his death on June 2, 2009,
    Nguyen was a twenty-five year old graduate student in the
    marketing program at MIT's Sloan School of Management (Sloan)
    and lived off-campus.    Prelec was a Sloan faculty member and
    served as Nguyen's graduate research advisor.   Wernerfelt was a
    Sloan faculty member and head of the Marketing Group Ph.D.
    program whose responsibility included advising graduate students
    concerning their coursework and research.    Randall was an
    assistant dean in MIT's student support services (student
    support) office.
    2.   MIT support resources.    In May, 2007, after his first
    academic year at MIT and two years before his death, Nguyen
    contacted Sloan's Ph.D. program coordinator, Sharon Cayley, for
    assistance with test-taking problems.    Nguyen explained to
    Cayley that he was "failing all of my classes because I don't
    know how to take [examinations (exams)].    I know the course
    material, but it just won't happen for me on exams."   Cayley
    then referred Nguyen to an MIT student disability services
    office coordinator, who described some of MIT's accommodations
    for individuals with disabilities.   Nguyen declined such
    accommodations.    In her notes from her meeting with Nguyen, the
    coordinator wrote that Nguyen "does not want to connect with MIT
    4
    Medical.   (I recommended that he do so.)   Says it won't be
    helpful; no reason to do so" (emphasis in original).    After two
    meetings with the coordinator, Nguyen reported to Cayley that
    the meetings were of "absolutely no use . . . [the coordinator]
    seemed to think that because I was referred to her, that meant
    that I was disabled, and therefore had only disability
    accommodations to offer me."
    On June 25, 2007, Cayley referred Nguyen to MIT's mental
    health and counselling service (MIT Mental Health) and informed
    Wernerfelt that this referral was Cayley's "response to
    [Nguyen's] expressed need for remedial study skills."     On July
    9, 2007, Nguyen met with Dr. Celene Barnes, a psychologist at
    MIT Mental Health.    On meeting Barnes, Nguyen stated that he did
    not know why he "was referred here.    My issues have nothing to
    do with [mental health]."    During the intake meeting, Nguyen
    denied suicidal ideation.    Barnes "provided [a] brief overview
    of [information] on test anxiety and gave him handouts used in
    the test anxiety workshop [and] [o]ffered to work with him on
    this issue."   Nguyen "declined, stating again that he did not
    want to seek[] services at [MIT Mental Health] due to the stigma
    associated with it."
    On July 25, 2007, Nguyen had a second appointment with
    Barnes.    She conducted a general intake, which irritated Nguyen
    because "he didn't know what other [mental health] issues had to
    5
    do with his test taking problem."   During this meeting, Nguyen
    disclosed to Barnes that he had had a long history of depression
    with two prior suicide attempts during college but denied any
    present suicidal ideation.   Nguyen also disclosed that he had
    been in treatment prior to coming to MIT and that he had resumed
    treatment with a psychiatrist in the area.   Although Nguyen had
    hoped that his test anxiety issue would be resolved in one
    appointment, he agreed to follow up with Barnes at the start of
    the school year.
    On July 29, 2007, Nguyen told Cayley that he found MIT
    Mental Health to be "useless," that Barnes "proceeded to turn me
    into a mental patient, and I was forced to discuss things that I
    really didn't want to," and that he doubted that MIT Mental
    Health was the "correct agency to solve my problem."   Further,
    Nguyen questioned why Wernerfelt had to be informed of the
    referral to Barnes because Nguyen was "hoping to keep the circle
    as small as possible, since I'm very ashamed and embarrassed
    about [my test-taking problems]."
    On August 9, 2007, Nguyen reported to Barnes that he was
    receiving treatment from Dr. John J. Worthington, a psychiatrist
    at Massachusetts General Hospital (MGH), not MIT Mental Health.
    Barnes offered to consult about treatment planning, but Nguyen
    declined.   Subsequently, Nguyen informed Barnes that he had
    "been able to make other arrangements for treatment, so there
    6
    will be no need to search any further, but I really appreciate
    all of your effort thus far."
    On September 6, 2007, Nguyen met with Randall, the
    assistant dean in the student support office.4   Before meeting
    with Randall, Nguyen had sent an electronic mail (e-mail)
    message to another student support dean, inquiring whether the
    student support office could help him with his problem, which
    was that he had "difficulty with taking exams, to the extent
    that [he was] failing classes" and asked if the student support
    office offered "any kind of counseling service that teaches
    study skills."   In their first meeting, Randall reported that
    Nguyen was "very committed to this not being seen as a 'problem'
    and [was] looking for a quick fix."   Toward the end of the
    meeting, Nguyen acknowledged that he had a long history of
    mental health issues and depression and that he was seeing a
    psychiatrist, Dr. Worthington, off campus.
    On September 24, 2007, Nguyen returned to see Randall.
    Nguyen described a "long history of depression dating back to
    high school," and treatment by "several . . . therapists during
    college."   He also "acknowledged two suicide attempts in the
    4 At the time, Randall was a licensed clinical psychologist.
    Both parties are in agreement, however, that Randall did not
    have a clinician-patient relationship with Nguyen in his
    nonclinical capacity as assistant dean in the Massachusetts
    Institute of Technology (MIT) student support services office.
    7
    past and frequent suicidal thoughts."   Nguyen, however, stated
    that he "did not identify a specific plan [to commit suicide]
    . . . and [was] not imminently suicidal."   Although perceiving
    that Nguyen was not an imminent threat, Randall "strongly
    encouraged" Nguyen to visit MIT Mental Health.   But after his
    recent MIT Mental Health meeting with Barnes, Nguyen was
    resistant and stated that his current psychiatrist was already
    aware of his prior suicidal ideation and that Nguyen also had
    plans to see another therapist, Dr. Stephen Bishop, in Rhode
    Island.
    By the end of the September 24 meeting, Nguyen gave Randall
    permission to contact Worthington, Bishop, and Barnes.     Later
    that day, Randall left a voice message for Worthington.
    Subsequently, Nguyen revoked Randall's permission to contact
    Worthington and stated in an e-mail message that he would "like
    to keep the fact of my depression separate from my academic
    problems.   I'd prefer that we not any further discuss the
    depression, that my academic problems can be framed in terms of
    a deficit in study skills instead.   If you can offer any such
    aid, I'd be happy to further employ your services."   On
    September 25, Randall acknowledged Nguyen's decision and replied
    that he "would still like to meet with you and think that I can
    be helpful."   Randall also stated in the e-mail message that
    Nguyen was permitted "to schedule another [appointment]."
    8
    Nguyen did not respond to Randall's e-mail message and did not
    have any further meetings or contact with Randall after
    September, 2007.
    Worthington followed up with Randall on September 27, 2007.
    Worthington was unable to share any information or confirm that
    Nguyen was his patient, but said that he could listen to
    Randall's concerns, especially regarding Nguyen's safety.
    Randall informed Worthington that Nguyen appeared "agitated, a
    little suspicious, and anxious, both at [the student support
    office] and MIT [Mental Health]," and of Nguyen's "suicidal
    thoughts and previous attempts."   Worthington did not discuss
    the case further, but agreed the information should be taken
    seriously.   On September 28, 2007, Randall told Barnes that he
    had spoken with Worthington about Nguyen, and wrote, "Let's keep
    in touch about this student."   Barnes responded, "I agree, let's
    definitely keep in touch about [Nguyen]."   Nguyen did not return
    to see Barnes or any other mental health provider at MIT Mental
    Health.
    3.    Nguyen's mental health history.   Although Nguyen
    briefly sought out the student disability services office, MIT
    Mental Health, and the student support office between May and
    September, 2007, he extensively consulted with clinicians not
    affiliated with MIT.   Between July, 2006, when Nguyen moved to
    Massachusetts, and May, 2009, Nguyen saw at least nine private
    9
    mental health professionals who collectively recorded over
    ninety in-person visits during this period.   There was no
    indication from any of these mental health professionals that
    Nguyen was at an imminent risk of committing suicide.
    From July, 2006, two months before enrolling at MIT, to
    November, 2008, Nguyen was treated by Worthington, a
    psychiatrist at MGH.   Over the course of their forty-three in-
    person appointments, Worthington discerned nothing indicating
    that Nguyen was at an imminent risk of suicide.   Nguyen
    requested electroconvulsive therapy to treat his depression, and
    received six rounds of it at MGH in August and September, 2006.
    Starting in September, 2006, Nguyen began therapy with a
    social worker at MGH and was scheduled for sixteen sessions.
    Nguyen disclosed to the social worker that he had occasional
    suicidal thoughts, but no suicidal intent or plan.   After their
    twelfth visit, Nguyen canceled his remaining appointments
    stating that his "time together [with the social worker had] not
    resulted in an inch of progress."
    Nguyen's next therapist was Bishop, whom he saw for several
    months in Rhode Island beginning in October, 2007.   Bishop
    diagnosed Nguyen with dysthymic disorder, a chronic depressive
    condition.   Nguyen saw Bishop six times between October, 2007,
    and March, 2008, but stopped seeing him because of the distance
    and because Bishop did not accept his health insurance plan.
    10
    From April, 2008, to March, 2009, Nguyen sought treatment
    from a doctor at a private practice group who specialized in
    sleep disorders.   This doctor did not think that Nguyen was at
    risk of suicide during the time she was treating him.      Starting
    in August, 2009, Nguyen saw a psychologist affiliated with the
    same private practice group.   In February, 2009, Nguyen canceled
    his future appointments with the psychologist because he
    believed his "sleep patterns [were] beginning to converge on
    nonpathology."
    Next, in November, 2008, Nguyen met twice with another
    doctor to complete a psychological test.   During the interview,
    Nguyen told that doctor that he was "not imminently suicidal."
    That same month, Nguyen stopped seeing Worthington because
    Nguyen believed him to be "too autocratic and didn't consider
    [Nguyen's] input."5   Nguyen then began seeing yet another doctor
    and continued to see him through May, 2009.   At Nguyen's initial
    appointment, that doctor noted that Nguyen "made two 'half-
    assed' suicide attempts.   He denies suicidal ideation."    At each
    appointment, the doctor and Nguyen discussed whether Nguyen had
    "any self-destructive thoughts . . . [or felt like] giving up."
    5 Nguyen had made a similar point in June, 2008, when he
    sent an electronic mail (e-mail) message to Worthington stating,
    "I need you to consider me as part of the team when it comes to
    my own treatment. . . . After all I am a PhD student at one of
    the world's top universities. Please give me a little credit
    here."
    11
    Nguyen denied any such thoughts or feelings.
    In March, 2009, Nguyen began seeing a different doctor,
    with whom he had six visits.    Nguyen told the doctor about his
    two prior suicide attempts but denied any current suicidal
    ideation.   Throughout this time, the doctor did not believe that
    Nguyen was at an imminent threat of self-harm.
    Nguyen's last appointment with this doctor was on May 28,
    2009, five days before Nguyen's death.    The doctor noted that
    Nguyen "did not say anything that sounded imminently suicidal or
    hopeless, and we discussed more things that he would do toward
    exploring thesis and career options, and we made a next
    [appointment] for [June 18]."
    4.   Nguyen's academic challenges.    At times during his
    studies at Sloan, Nguyen struggled academically and performed
    "well below average" in some of his courses.   During Nguyen's
    time at MIT, neither Wernerfelt nor Prelec was aware of Nguyen's
    history of severe depression or prior suicide attempts.
    Wernerfelt knew only that Nguyen had insomnia and test taking
    anxiety, and that he was consulting off-campus mental health
    professionals.
    On May 9, 2008, Prelec was informed by one of his MIT
    colleagues that Nguyen was reportedly "out of it" and
    "despondent," potentially because Nguyen was "having trouble
    sleeping as of late."   On May 12, Prelec met with Nguyen and
    12
    reported to Wernerfelt that Nguyen is "sleep deprived . . . and
    is taking something on prescription to help him sleep.    He is
    seeing a psychiatrist regularly, at Mass General (not MIT).
    Same person he has been seeing since he got here."   Wernerfelt
    replied that Nguyen "has had some serious issues with exam
    anxiety, so I worry about the general[] [exams].   Perhaps we can
    give them in a less concentrated form . . . [t]hat way he can
    get a good grade under his belt . . .   I think that it would be
    good to give him some confidence."6
    On May 26, 2008, Wernerfelt was informed that Nguyen had
    performed poorly in a course that an MIT colleague taught.
    Nguyen had told that colleague that he had "medical problems
    that have prevented him from focusing on classes . . . [and]
    asked [the colleague] to consider his weakened health when he
    [took] the final."   Wernerfelt responded to his colleague that
    Nguyen was "having serious problems.    Some of his issues seem to
    peak at exam time, but there is much more to it than that.     He
    has been seeing a psychiatrist at MGH (not MIT) as long as he
    has been here.   I thus have no official information, but I do
    6 Wernerfelt testified that "general exams" were required
    for all MIT Sloan School of Management Ph.D. students. Students
    typically take these examinations at the end of their second
    year, over a period of several days.
    13
    believe that he is at risk."7   Wernerfelt suggested that his
    colleague be lenient and "grade him based on the problem sets"
    rather than his final examination.
    On June 2, 2008, Wernerfelt sent an e-mail message to seven
    of Nguyen's professors, informing them that Prelec and he had
    "decided to reduce the pressure on [Nguyen] by spreading out his
    general[] [exams] over several weeks."   On June 4, Wernerfelt,
    "[i]n an attempt to reduce the pressure on [Nguyen] as much as
    possible," further modified Nguyen's examination schedule
    allowing Nguyen to take the examinations when he was ready.
    In a June, 2008 self-evaluation form, Nguyen stated that
    his academic performance was "[b]elow average, due to my medical
    condition."   Nguyen indicated that the "primary nature of this
    illness [was] insomnia" and that he had "been seeing a team of
    doctors at [MGH] and elsewhere who have been trying to help me."
    Nguyen described how "horrendously bad" his medical condition
    was, stating that "[t]here were days during which I was so
    completely debilitated for the entire day that I was unable to
    get out of bed at all, much less function properly" and that at
    one point he "had to be hospitalized because I was so delirious
    7 Wernerfelt testified that he meant "risk" to refer to
    "some adverse reaction if [Nguyen] were to get a really low
    grade" in Nguyen's economics course. Wernerfelt stated that a
    low grade was "not a big deal" because if Nguyen got "a bad
    grade . . . he [could] take a makeup exam or . . . take another
    course instead" to satisfy the graduate school requirement.
    14
    and incoherent after not being able to sleep for over [seventy-
    two] hours."   Nguyen further stated that he "would not be
    surprised if I have to be hospitalized again in the near
    future."   Nguyen also stated that he was on his ninth different
    sleeping pill prescription and that he was still not functioning
    well.    Nguyen did not disclose any history of depression,
    suicidal ideation, or his prior suicide attempts in his self-
    evaluation.    After receiving Nguyen's self-evaluation,
    Wernerfelt offered to help Nguyen obtain a "leave from the
    program . . . such that [he] could return to a good situation
    once the [doctors] lick [his] sleeping problems."
    On October 30, 2008, Nguyen sent an e-mail message to
    Wernerfelt and requested an examination schedule that would take
    place between January 12 and January 26, 2009, with his oral
    examination during the week of January 26 through January 30,
    2009.8   Prelec testified that Nguyen's performance "varied some,
    but overall it was not a good performance."
    After Nguyen had completed his general examinations, the
    faculty in his department met in January, 2009, to discuss
    Nguyen's performance and whether he had passed.    Wernerfelt
    advocated that "Nguyen should be passed and that the faculty
    should counsel him to pursue a master's degree."    Wernerfelt
    8 Nguyen's general examinations originally had been
    scheduled for the summer of 2008.
    15
    also stated that "they might end up with 'blood on their hands'"
    if the faculty were to fail Nguyen.9   One of Wernerfelt's
    colleagues testified that the phrase, "blood on our hands," was
    repeated several times.    After the faculty passed Nguyen,
    Wernerfelt met with Nguyen to inform him that he had passed,
    although he was required to take certain additional courses to
    remain in the Ph.D. program.   Further, Wernerfelt "laid out the
    path to a [Master's degree] . . . [and] [s]aid that all members
    of the faculty felt that he would be unhappy in a professorial
    job."    In March, 2009, Nguyen sent an e-mail message to Prelec,
    telling him that "to be a professor" is what Nguyen "want[ed]
    more than anything. . . . [and he was not] convinced that anyone
    has really taken [his] health issues into consideration."
    Nguyen remained insistent that he would "still do everything in
    [his] power to ensure that [he] will finish the PhD."
    Prelec met with Nguyen weekly during the spring of 2009 and
    noticed that Nguyen "seemed better" and was having fewer sleep
    problems.   That semester, Nguyen served as a teaching assistant
    and, at the end of the semester, was offered another teaching
    assistant position for the fall of 2009, which he accepted.     In
    9 In contrast to failing a course, failing general
    examinations could lead to dismissal from the graduate program.
    Wernerfelt testified that if Nguyen were to fail his general
    examinations, there was a "very small chance that . . .
    something bad could happen . . . such as [Nguyen] hurting
    himself or others."
    16
    May, 2009, Prelec recommended Nguyen for a summer research
    assistant position in an MIT laboratory.   On May 27, 2009,
    Nguyen sent an e-mail message to the project investigator that
    he was "very excited about [the] project . . . [and] would be
    eager to begin very soon."   Nguyen also requested an update
    about funding logistics, as he was under the impression that the
    MIT laboratory's "coffers were bottomless."   Prelec was copied
    on this message and forwarded it to Wernerfelt, stating that he
    was "mildly nervous" about recommending Nguyen because "[w]ith
    this talk of bottomless coffers . . . [Nguyen] will rapidly
    offend . . . folks."   In response, Wernerfelt suggested that
    "someone should talk to [Nguyen] about sending more respectful
    e-mails" and that "[p]erhaps we should offer to prescreen his e-
    mails . . . after two or three [Nguyen] might get the idea."
    Wernerfelt offered to take the lead on speaking with Nguyen
    about e-mail etiquette.
    5.   Nguyen's suicide.   At approximately 7 A.M. on June 2,
    2009, Nguyen sent the project investigator an e-mail message, on
    which he blind-copied Prelec:
    "I forgot to mention that this upcoming Monday I have
    a doctor's appointment that I had scheduled a long time
    ago, so I won't be able to come into the office until about
    11:30 that day. I hope that that won't be a problem.
    "If we can quickly follow up on the conversation that
    we had yesterday, if you'll forgive me, I'd like to be
    honest with you about something. [Prelec] recommended me
    for this position . . . [a]nd I'm not an undergrad
    17
    anymore; I'm a grad[uate] student now. For those reasons,
    it was disturbing, as well as a little insulting, to me
    that yesterday you took pains to express your expectations
    of me in a manner that presumed that I would give you
    anything less than this project deserved, that you would
    'give me a signal' if you didn't think that my contribution
    amounted to something deserving of authorship credit, that
    'there would be a problem' if it turned out that '[you]
    could do [the work] faster [your]self,' that you threatened
    me that you could tell by visual inspection whether my work
    was up to par. I like to feel like I've earned the right
    not to have my effectiveness or my integrity questioned
    anymore, and to hear you do that yesterday was kind of
    hurtful. I'm not sure that if you continue to do this that
    I'll be able to work as effectively as I'd like to be able
    to. Although I keep asking about it, I'm not just doing
    this for the money. I want to learn something and make a
    meaningful contribution . . . . Would it be possible that
    we could move forward with an understanding of good faith
    on my part?"
    After receiving Nguyen's e-mail message, Prelec and the project
    investigator spoke about it.   The project investigator told
    Prelec that Nguyen had taken his comments out of context and
    that Nguyen misinterpreted his intentions and the tone of the
    meeting.
    Prelec forwarded the e-mail message to Wernerfelt, asking
    if Wernerfelt could "talk to [Nguyen] as a somewhat neutral
    party . . . [Nguyen] is misreading things.   Even so, the tone of
    reply is totally out of line."   Wernerfelt responded, "I am so
    sorry.   I will talk to [Nguyen] and let you know what he says."
    At approximately 9 A.M. on June 2, Nguyen arrived at a
    laboratory in a building on MIT's campus.    The laboratory
    coordinator noted that Nguyen's demeanor appeared "pretty
    18
    normal" and that Nguyen was preparing for a research project.
    After a number of missed calls between Nguyen and Wernerfelt, at
    10:51 A.M., Nguyen reached Wernerfelt by telephone.   Nguyen left
    the laboratory to take the call.10   After the telephone call
    ended at approximately 10:59 A.M., Nguyen went to the roof of
    the building and jumped off the building to his death.   A first
    responder administered first aid to Nguyen "a few seconds" after
    he landed and did not identify any signs of breathing, eye
    movement, pulse, or consciousness.   It was determined that the
    immediate cause of Nguyen's death was "blunt trauma with head,
    skull, torso and extremity injuries" and that it occurred within
    "seconds."
    Meanwhile, after Wernerfelt finished speaking with Nguyen,
    at 11:04 A.M., Wernerfelt sent an e-mail message to Prelec:
    "I read [Nguyen] the riot act
    "Explained what is wrong about the e-mail
    "Told him that you or I would look over future e-mails he
    10Wernerfelt testified that he contacted Nguyen because he
    had been forwarded Nguyen's e-mail message to the project
    investigator and that he wanted to help with Nguyen's "social
    skills." Wernerfelt testified that he "went through point for
    point" giving "advice and explanations" on what was improper
    with Nguyen's e-mail. Wernerfelt recommended that Nguyen, in
    the future, let him or Prelec review Nguyen's e-mail drafts.
    Wernerfelt reiterated that Nguyen "would be happier outside the
    academe" and "should think about getting a [M]aster's degree and
    pursuing a nonacademic job." At the conclusion of the telephone
    call, Wernerfelt told Nguyen that "some patching up would have
    to be done after this e-mail, and [Wernerfelt] thought [Nguyen]
    should . . . contact [Prelec] and the two of them could together
    figure out what the next steps would be."
    19
    send[s] . . .
    "I said that we know that he is not out to offend anyone
    but that he seems poor at navigating the academe
    "Said that this is an example of why we all recommended
    that he take a [Master's Degree] and go out to get a job
    "I talked about some papers he could turn into [a Master's]
    thesis and volunteered to supervise it
    "Said that he made you look bad vs [the laboratory] and
    that some patching up was necessary
    "He will call you about what to do"
    Later in the afternoon on June 2, 2009, one of Wernerfelt's
    colleagues sent an e-mail message to Wernerfelt that "I know you
    were worried about suicide, but you can feel positive that we
    tried very hard to help [Nguyen] (and especially you did so much
    to help him)."11
    In 2011, the plaintiff commenced an action in Superior
    Court, alleging that the defendants' negligence caused Nguyen's
    death.    In March, 2016, the defendants moved for summary
    judgment and the plaintiff filed a cross motion for summary
    judgment.   In October, 2016, the defendants' motion for summary
    judgment was allowed and the plaintiff's cross motion for
    summary judgment was denied.    The plaintiff appealed from the
    denial of his motion, and we granted his motion for direct
    appellate review.
    Discussion.    The plaintiff contends that the defendants
    owed Nguyen a duty of reasonable care and committed a breach of
    11The colleague testified that Wernerfelt "didn't actually
    say suicide. He said serious consequences, which I interpreted
    . . . as a risk for suicide."
    20
    this duty.   Additionally, the plaintiff argues that the record
    supports claims for punitive damages, conscious pain and
    suffering, and breach of contract.     The plaintiff also asserts
    that the Superior Court judge improperly denied the plaintiff's
    motion to amend the complaint to assert claims against former
    MIT chancellor Phillip Clay.    Lastly, the plaintiff contends
    that summary judgment should be entered in his favor that Nguyen
    was not an MIT employee at the time of his death for workers'
    compensation purposes.
    1.   Standard of review.    Where the parties have cross-moved
    for summary judgment, we review a grant of summary judgment de
    novo to determine whether, viewing the evidence in the light
    most favorable to the unsuccessful opposing party and drawing
    all permissible inferences and resolving any evidentiary
    conflicts in that party's favor, the successful opposing party
    is entitled to judgment as a matter of law.     Epstein v. Board of
    Appeal of Boston, 
    77 Mass. App. Ct. 752
    , 756 (2010).     See Cabot
    Corp. v. AVX Corp., 
    448 Mass. 629
    , 636–637 (2007), citing Augat,
    Inc. v. Liberty Mut. Ins. Co., 
    410 Mass. 117
    , 120 (1991).
    2.   Negligence claim.     a.   General negligence principles.
    "To prevail on a negligence claim, a plaintiff must prove that
    the defendant owed the plaintiff a duty of reasonable care, that
    the defendant [committed a breach of] this duty, that damage
    resulted, and that there was a causal relation between the
    21
    breach of the duty and the damage."   Jupin v. Kask, 
    447 Mass. 141
    , 146 (2006).   Generally, there is no duty to prevent another
    from committing suicide.   Under our case law, "we do not owe
    others a duty to take action to rescue or protect them from
    conditions we have not created."   Cremins v. Clancy, 
    415 Mass. 289
    , 296 (1993) (O'Connor, J., concurring).   "[T]he law has
    persistently refused to impose on a stranger the moral
    obligation of common humanity to go to the aid of another human
    being who is in danger, even if the other is in danger of losing
    his life."   W.L. Prosser & W.P. Keeton, Torts § 56, at 375 (5th
    ed. 1984).
    b.   Special relationships and the duty to prevent suicide.
    We have, however, recognized that special relationships may
    arise in certain circumstances imposing affirmative duties of
    reasonable care in regard to the duty to rescue, including the
    duty to prevent suicide.   The classic case is the custodial
    relationship, particularly jails or hospitals.12   In Slaven v.
    12In noncustodial cases, a defendant is also "liable for
    another's death by suicide when, as a consequence of a physical
    impact, death results from an 'uncontrollable impulse, or is
    accomplished in delirium or frenzy.'" Slaven v. Salem, 
    386 Mass. 885
    , 886–887 (1982), quoting Daniels v. New York, N.H. &
    H.R.R., 
    183 Mass. 393
    , 399-400 (1903). The plaintiff asserts
    that the second scenario applies, that Wernerfelt triggered
    Nguyen's uncontrollable suicidal impulse by the "riot act"
    telephone call. In this case, the "uncontrollable impulse"
    scenario does not apply, as there has been no prior physical
    22
    Salem, 386 Mass 885, 888 (1982), we addressed the duty and
    accompanying responsibilities of a jailor for the suicide of a
    prisoner in his custody.
    "One who is required by law to take or voluntarily
    takes the custody of another under circumstances such as to
    deprive the other of his normal opportunities for
    protection is under a duty (1) to protect them against
    unreasonable risk of physical harm, and (2) to give them
    first aid after it knows or has reason to know that they
    are ill or injured, and to care for them until they can be
    cared for by others."
    Id. at 887, citing Restatement (Second) of Torts § 314A (1965).
    We further explained that "[t]he comments to § 314A state that a
    'defendant is not liable where he neither knows nor should know
    of the unreasonable risk, or of the illness or injury.'"
    Slaven, 
    supra,
     citing Restatement (Second) of Torts, supra at §
    314A comment e.   Finally, we noted that in cases in other
    jurisdictions "that have addressed the issue of the liability of
    a jailor for the suicide of one in his custody, most have
    required that there be evidence that the defendant knew, or had
    reason to know, of the plaintiff's suicidal tendency."     Slaven,
    supra at 888.
    We likewise conclude that there are other special
    relationships, outside the custodial context, that may impose
    affirmative, albeit limited, duties in regard to suicide
    injury causing the uncontrollable impulse.   Slaven, 
    supra at 887
    .
    23
    prevention.    We therefore turn to the scope of the university-
    student relationship, and the duties, if any, it imposes
    regarding suicide prevention.13
    c.     The modern university-student relationship.   We begin
    with the Restatement (Third) of Torts, which states that "[a]n
    actor in a special relationship with another owes the other a
    duty of reasonable care with regard to risks that arise within
    the scope of the relationship."     Restatement (Third) of Torts:
    Liability for Physical and Emotional Harm § 40(a) (2012).
    Included in the list of special relationships giving rise to
    such duty is "a school with its students."     Id. at § 40(b)(5).
    This, of course, is the beginning and not the end of the
    analysis.    There is a wide range of schools -- from elementary
    to graduate school -- and great differences in the scopes of
    student-school relationships.     Additionally, the Restatement
    (Third) of Tort's formulation of special relationship is not
    focused on the specific question of student suicide.
    The particularities of the university-student relationship
    are of paramount importance in defining any duty.     Universities
    are clearly not bystanders or strangers in regards to their
    students.    See Mullins v. Pine Manor College, 
    389 Mass. 47
    , 51-
    13Our use of the term "university" encompasses other
    institutions of higher education, including but not limited to
    colleges and universities.
    24
    52 (1983).    The primary mission of universities is academic in
    nature.14    Universities also sponsor and have special
    relationships with their students regarding athletics and other
    potentially dangerous activities.    See, e.g., Kleinknecht v.
    Gettysburg College, 
    989 F.2d 1360
    , 1370 (3d Cir. 1993) (duty of
    care to lacrosse player during practice); Davidson v. University
    of N. Carolina at Chapel Hill, 
    142 N.C. App. 544
    , 555-556 (2001)
    (duty of care to cheerleader during practice).     See also Massie,
    Suicide on Campus:     The Appropriate Legal Responsibility of
    College Personnel, 
    91 Marq. L. Rev. 625
    , 641 (2008) (Suicide on
    Campus).    Cf. Kavanagh v. Trustees of Boston Univ., 
    440 Mass. 195
    , 202 (2003) (special relationship does not extend to
    athletes from other schools).    They are also property owners and
    landlords responsible for their students' physical safety on
    campus.     See Mullins, 
    389 Mass. at 51-52
    ; Massie, Suicide on
    Campus, supra at 642.     Furthermore, university involvement
    extends widely into other aspects of student life.     See Dall,
    Determining Duty in Collegiate Tort Litigation:     Shifting
    Paradigms of the College-Student Relationship, 
    29 J.C. & U.L. 485
    , 519 (2003) (universities "do not conceive of their
    14For example, "[t]he mission of MIT is to advance
    knowledge and educate students in science, technology, and other
    areas of scholarship that will best serve the nation and the
    world in the 21st century]." http://web.mit.edu/facts
    /mission.html [https://perma.cc/KF4R-PQ3W].
    25
    educational role narrowly . . . and foster many aspects of
    student life and community involvement such as residential life,
    multicultural programs, student organizations, student
    government, student media, community service, internships and
    externships, technology, health and fitness, and spirituality").
    Accord Regents of the Univ. of Cal. vs. Superior Court of Los
    Angeles, Supreme Court of California, No. S230658, slip op. at
    27 (Mar. 22, 2018) (Regents) ("Along with educational services,
    colleges provide students social, athletic, and cultural
    opportunities. Regardless of the campus layout, colleges provide
    a discrete community for their students.").
    But universities are not responsible for monitoring and
    controlling all aspects of their students' lives.   "There is
    universal recognition that the age of in loco parentis has
    passed, and that the duty, if any is not one of a general duty
    of care to all students in all aspects of their collegiate
    life."   Massie, Suicide on Campus, 91 Marq. L. Rev. at 640.    See
    Mullins, 
    389 Mass. at 52
     (describing major "changes in college
    life," and "the general decline of the theory that a college
    stands in loco parentis to its students"); Schieszler v. Ferrum
    College, 
    236 F. Supp. 2d 602
    , 610 (W.D. Va. 2002) ("colleges are
    not insurers of the safety of their students").   See also
    Bradshaw v. Rawlings, 
    612 F.2d 135
    , 139 (3d Cir. 1979)
    (describing end of loco parentis relationship "between college
    26
    and student that imposed a duty on the college to exercise
    control over student conduct and, reciprocally, gave the
    students certain rights of protection by the college").
    University students are young adults, not young children.
    Indeed, graduate students are adults in all respects under the
    law.   Universities recognize their students' adult status, their
    desire for independence, and their need to exercise their own
    judgment.    Consequently the modern university-student
    relationship is respectful of student autonomy and privacy.     See
    Bradshaw, 
    612 F.2d at 138
     ("Trustees, administrators, and
    faculties have been required to yield to the expanding rights
    and privileges of their students"); Furek v. University of Del.,
    
    594 A.2d 506
    , 516-517 (Del. 1991) (describing "realities of
    modern college life where students are regarded as adults in
    almost every phase of community life" [quotations and citation
    omitted]).   This includes students' personal mental health
    decisions.   Indeed, the privacy of student mental health records
    are generally protected, absent the student's consent or an
    emergency where disclosure is necessary to protect the health or
    safety of the student or other persons.    See Family Educational
    Right and Privacy Act of 1974, 20 U.S.C. § 1232g (2012).      See
    also Health Insurance Portability and Accountability Act of
    1996, 42 U.S.C. § 1320d-6 (2012) (imposing limitations on rights
    of nonclinicians in obtaining or disclosing individually
    27
    identifiable health information); Massie, Suicide on Campus, 91
    Marq. L. Rev. at 648.15
    In deciding whether a special relationship and accompanying
    duty exists between a university and a student in regard to
    suicide prevention, and whether a breach of such a duty has
    occurred, we must therefore take into account a complex mix of
    competing considerations.    Students are adults but often young
    and vulnerable; their right to privacy and their desire for
    independence may conflict with their immaturity and need for
    protection.    As for the universities, their primary mission is
    to educate and they no longer are acting in loco parentis, but
    they still have a wide-ranging involvement in the lives of their
    students.   See, e.g. Mullins, 
    389 Mass. at 52
    ; Bradshaw, 
    612 F.2d at 138
    .   See also Regents, slip op. at 17.
    d.   A university's duty regarding suicide prevention.    In
    analyzing whether a duty to prevent suicide falls within the
    scope of the complex relationship that universities have with
    their students, we consider a number of factors used to
    delineate duties in tort law.    Irwin v. Ware, 
    392 Mass. 745
    , 756
    15Universities must also be attentive to the requirements
    of the Federal Rehabilitation Act of 1973, 
    29 U.S.C. § 794
    (a)
    (2012), which states, "No otherwise qualified individual with a
    disability in the United States . . . shall, solely by reason of
    her or his disability, be excluded from the participation in, be
    denied the benefits of, or be subjected to discrimination under
    any program or activity receiving Federal financial assistance."
    28
    (1984).   See Massie, Suicide on Campus, 91 Marq. L. Rev. at 639.
    "Foremost among these is whether a defendant reasonably could
    foresee that he [or she] would be expected to take affirmative
    action to protect the plaintiff and could anticipate harm to the
    plaintiff from the failure to do so."     Irwin, 
    supra.
       A related
    factor is "reasonable reliance by the plaintiff [on the
    defendant], impeding other persons who might seek to render
    aid."   
    Id.
       Other factors that have been considered relevant to
    special relationships and the creation of a duty in the
    university context are the "degree of certainty of harm to the
    plaintiff; burden upon the defendant to take reasonable steps to
    prevent the injury; some kind of mutual dependence of plaintiff
    and defendant upon each other, frequently . . . involving
    financial benefit to the defendant arising from the
    relationship; moral blameworthiness of defendant's conduct in
    failing to act; and social policy considerations involved in
    placing the economic burden of the loss on the defendant."
    Massie, Suicide on Campus, supra.     See Mullins, 
    389 Mass. at
    51-
    53.   See also Lake, Still Waiting:   The Slow Evolution of the
    Law in Light of the Ongoing Student Suicide Crisis, 
    34 J.C. & U.L. 253
    , 257-277 (2008) (Still Waiting) (catalog of key cases
    and factors used by courts to determine duty); Regents, slip op.
    at 18 ("Students are comparatively vulnerable and dependent on
    their colleges for a safe environment.     Colleges have a superior
    29
    ability to provide that safety with respect to activities they
    sponsor or facilities they control").
    With these considerations in mind, we conclude that a
    university has a special relationship with a student and a
    corresponding duty to take reasonable measures to prevent his or
    her suicide in the following circumstances.   Where a university
    has actual knowledge of a student's suicide attempt that
    occurred while enrolled at the university or recently before
    matriculation, or of a student's stated plans or intentions to
    commit suicide,16 the university has a duty to take reasonable
    16The Columbia Lighthouse Project, under the auspices of
    Columbia University, created the Columbia-Suicide Severity
    Rating Scale(C-SSRS), a suicide risk assessment tool that
    provides useful guidance. See Columbia-Suicide Severity Rating
    Scale. http://cssrs.columbia.edu/the-columbia-scale-c-
    ssrs/about-the-scale/ [https://perma.cc/TR7Y-S8JB]. More
    specifically, C-SSRS category four or five behavior is
    informative of what constitutes a student's stated plans or
    intentions to commit suicide:
    "4. Active Suicidal Ideation with Some Intent to Act,
    without Specific Plan -- Active suicidal thoughts of
    killing oneself and subject reports having some intent to
    act on such thoughts, as opposed to 'I have the thoughts
    but I definitely will not do anything about them.'
    "5. Active Suicidal Ideation with Specific Plan and Intent
    -- Thoughts of killing oneself with details of plan fully
    or partially worked out and subject has some intent to
    carry it out."
    (Emphasis in original.) See Posner, Brent, Lucas, Gould,
    Stanley, Brown, Fisher, Zelazny, Burke, Oquendo, & Mann,
    Columbia-Suicide Severity Rating Scale (C-SSRS), Lifetime
    Recent, Version 1/14/09 m9/12/17 (2008).
    30
    measures under the circumstances to protect the student from
    self-harm.   See Mullins, 
    389 Mass. at 52
     ("Parents, students,
    and the general community still have a reasonable expectation,
    fostered in part by colleges themselves, that reasonable care
    will be exercised to protect . . . students from foreseeable
    harm"); Schieszler, 
    236 F. Supp. 2d at 608-609
     ("relationship
    between a college or university and its students can give rise
    to a duty to protect students from harms of which the school has
    knowledge," including risk of suicide); Restatement (Third) of
    Torts, § 40(b)(5); Massie, Suicide on Campus, 91 Marq. L. Rev.
    at 631 ("where college or university personnel are aware that a
    student has made serious suicidal threats or attempts, they have
    a duty to take reasonable steps to protect the student's
    safety").    See also Pavela, Questions and Answers on College
    Student Suicide:    A Law and Policy Perspective 8-9 (2006)
    ("[I]nstitutions of higher education face heightened risk of
    liability for suicide when they ignore or mishandle known
    suicide threats or attempts. . . . The main obstacle to better
    suicide prevention on campus is underreaction, especially the
    failure to provide [perhaps even require] prompt professional
    evaluation and treatment for any student who threatens or
    attempts suicide" [emphasis in original]).    We have sought to
    define here the circumstances creating the special relationship
    and the duty realistically recognizing the scope of the suicide
    31
    problem on university campuses, the capacities of nonclinicians,
    and the nature of the modern university-student relationship.17
    17It is estimated that 1,100 university students die by
    suicide ever year. See Jed Foundation's Framework for
    Developing Institutional Protocols For the Acutely Distressed or
    Suicidal College Student 2 (2006), available at
    https://www.jedfoundation.org/wp-content/uploads/2016/07
    /framework-developing-institutional-protocols-acutely-
    distressed-suicidal-college-student-jed-guide_NEW.pdf
    [https://perma.cc/8MLG-2T3U] ("Jed Framework"). "According to
    the Center for Disease Control and Prevention (CDC), suicide is
    the 'second leading cause of death among [twenty-five to thirty-
    four] year olds and the third leading cause of death among
    [fifteen to twenty-four] year olds.' Thus, suicide prevention
    is not simply a focus for traditional college- and university-
    aged populations, but must also be a focus for graduate and
    professional schools. The [twenty-five to thirty-four] year-old
    demographic factors prominently in most graduate and
    professional school programs and applies to the many college and
    university students who extend their education" (footnote
    omitted). Lake, Still Waiting: The Slow Evolution of the Law
    in Light of the Ongoing Student Suicide Crisis, 
    34 J.C. & U.L. 253
    , 254–255 (2008). See Center for Disease Control, National
    Center for Injury Prevention and Control, 10 Leading Causes of
    Death by Age Group, United States -- 2015, https://www.cdc.gov
    /injury/wisqars/pdf/leading_causes_of_death_by_age_group_2015-
    a.pdf [https://perma.cc/A8TN-N2HQ] (from most recent statistics
    available from CDC, in 2015, suicide was second leading cause of
    death among both fifteen to twenty-four and twenty-five to
    thirty-four year olds).
    The number of students with suicidal thoughts is even more
    alarming. According to an Internet-based survey of 26,000
    undergraduate and graduate students administered by the National
    Research Consortium of Counseling Centers in Higher Education,
    six per cent of undergraduate and four per cent of graduate
    students reported seriously considering suicide within the past
    twelve months. See Drum, Brownson, Denmark, & Smith, New Data
    on the Nature of Suicidal Crises in College Students: Shifting
    the Paradigm, 40 Prof. Psychol.: Res. & Prac. 213, 214-216
    (2009). Similarly, in the American College Health Association's
    National College Health Assessment, which surveyed over 63,000
    students at ninety-two colleges and universities in 2017, 10.3
    32
    It is important to understand the limited circumstances
    creating the duty.    It is definitely not a generalized duty to
    prevent suicide.     Nonclinicians are also not expected to discern
    suicidal tendencies where the student has not stated his or her
    plans or intentions to commit suicide.    Even a student's
    generalized statements about suicidal thoughts or ideation are
    not enough, given their prevalence in the university community.
    The duty is not triggered merely by a university's knowledge of
    a student's suicidal ideation without any stated plans or
    intentions to act on such thoughts.
    As previously explained, this duty hinges on
    foreseeability.    See Irwin, 
    392 Mass. at 756
    ; Mullins, 
    389 Mass. at 52
    .   See also Massie, Suicide on Campus, 91 Marq. L. Rev. at
    639.   Where a student has attempted suicide while enrolled at
    the university or recently before matriculation, or has stated
    plans or intentions to commit suicide, suicide is sufficiently
    foreseeable as the law has defined the term, even for university
    nonclinicians without medical training.    Reliance of the student
    per cent of students reported that they had "seriously
    considered" suicide within the previous twelve months, and 1.5
    per cent of students had attempted to commit suicide within the
    previous twelve months. See American College Health Association
    National College Health Assessment (2017), at 2, 14,
    http://www.acha-ncha.org/docs/NCHA-II_SPRING_2017_
    REFERENCE_GROUP_EXECUTIVE_SUMMARY.pdf [https://perma.cc/F3NN-
    U9XD].
    33
    on the university for assistance, at least for students living
    in dormitories or away from their parents or guardians, is also
    foreseeable.   Universities are in the best, if not the only,
    position to assist.   See Mullins, 
    supra.
       They have also
    "fostered" expectations, at least for their residential
    students, that reasonable care will be exercised to protect them
    from harm.   
    Id. at 52, 54
    .   See Irwin, 
    supra.
    The probability of the harm must of course be considered
    along with its gravity including the death of the student.      See
    Schieszler, 
    236 F. Supp. 2d at 609
     ("there was an imminent
    probability that [the decedent] would try to hurt himself");
    Lake, Still Waiting, 34 J.C. & U.L. at 284 & n.204 (referencing
    in article on risk of student suicide and violence Justice
    Learned Hand's United States v. Carroll Towing Co., 
    159 F.2d 169
    , 173 [2d Cir. 1947], formulation that "if the probability be
    called P; the injury, L; and the burden, B; liability depends
    upon whether B is less than L multiplied by P: i.e., whether B
    [is] less than PL"); Eisel v. Board of Educ. of Montgomery
    County, 
    324 Md. 376
    , 386 (1991) (discussing magnitude of harm
    and statistical possibility of risk of suicide).   Thus, where a
    student has attempted to commit suicide while enrolled at the
    university or recently before matriculation or stated plans or
    intentions to commit suicide, that probability is sufficient to
    justify imposition of a duty on the university.    See Eisel,
    34
    
    supra.
        The burden on the university is not insubstantial, but
    so is the financial benefit received from student tuition.     See
    generally Mullins, 
    389 Mass. at 53
     (relating tuition to duty to
    provide adequate protection);   Regents, slip op. at 13.   Moral
    blameworthiness on the part of a university in failing to act to
    intervene to save a young person's life, when it was within the
    university's knowledge and power to do so, is understood and
    accepted by our society.    See Eisel, 
    supra at 391
     ("if
    classmates of [a middle school decedent] found her lying on the
    floor of a lavatory, bleeding from slashed wrists, and those
    students told one or more teachers of the emergency, society
    would be outraged if the teachers did nothing and [the decedent]
    bled to death"); Ames, Law and Morals, 
    22 Harv. L. Rev. 97
    , 112-
    113 (1908) ("We should all be better satisfied if the man who
    refuses to throw a rope to a drowning man or to save a helpless
    child on the railroad track could be punished and be made to
    compensate the widow of the man drowned and the wounded child").
    Reasonable measures by the university to satisfy a
    triggered duty will include initiating its suicide prevention
    protocol if the university has developed such a protocol.18    In
    18One resource that provides universities with guidance for
    drafting is Jed Foundation's Framework for Developing
    Institutional Protocols For the Acutely Distressed or Suicidal
    College Student. See Jed Framework, supra at 2-3, 10-16.
    35
    the absence of such a protocol, reasonable measures will require
    the university employee who learns of the student's suicide
    attempt or stated plans or intentions to commit suicide to
    contact the appropriate officials at the university empowered to
    assist the student in obtaining clinical care from medical
    professionals or, if the student refuses such care, to notify
    the student's emergency contact.19   In emergency situations,
    reasonable measures obviously would include contacting police,
    fire, or emergency medical personnel.   By taking the reasonable
    measures under the circumstances presented, a university
    satisfies its duty.
    We stress that the duty here, at least for nonclinicians,
    is limited.20   It is created only by actual knowledge of a
    19We recognize that for college and university students the
    emergency contact will often be the student's parents. But it
    might not always be a parent or guardian, such as where the
    student is married or where the student has informed the
    University that the suicide attempt or stated plans or
    intentions to commit suicide derive in part from a toxic home
    environment (including parental pressures or abuse inflicted by
    a parent). See Susan R. Furr, Westefeld, McConnell, & Jenkins,
    Suicide and Depression Among College Students: A Decade Later,
    32 Prof. Psychol.: Res. & Prac. 97, 98 (2001) (survey of 1,455
    college and university students demonstrated that twenty per
    cent of students who identified themselves as having suicidal
    thoughts considered "parental problems" to be contributor to
    their suicidal ideation and behavior).
    20For university-employed medical professionals, the duty
    and standards of care are those established by the profession
    itself. See Stepakoff v. Kantar, 
    393 Mass. 836
    , 841 (1985)
    ("plaintiff has not directed our attention to any case in which
    36
    student's suicide attempt that occurred while enrolled at the
    university or recently before matriculation, or of a student's
    stated plans or intentions to commit suicide.   It also is
    limited to initiating the university's suicide prevention
    protocol, and if the school has no such protocol, arranging for
    clinical care by trained medical professionals or, if such care
    is refused, alerting the student's emergency contact.    Finally,
    the duty is time-bound.   Medical professionals may, for example,
    conclude that the student is no longer a suicide risk and no
    further care or counselling is required.
    This limited duty takes a number of the complex and
    competing considerations discussed above into account.    First,
    it respects the privacy and autonomy of adult students in most
    circumstances, relying in all but emergency situations on the
    student's own capacity and desire to seek professional help to
    a court has bifurcated the duty owed by a psychiatrist to a
    suicidal patient by declaring that, when diagnosing a patient,
    the psychiatrist must exercise the care and skill customarily
    exercised by an average qualified psychiatrist, while, after
    diagnosing a patient as suicidal, the psychiatrist's duty to
    take preventive measures becomes one of 'reasonableness.' We
    are unwilling to disturb our longstanding rule that a physician,
    practicing a specialty, owes to his or her patient a duty to
    comply in all respects with the standard set by the average
    physician practicing that specialty"). See also McNamara v.
    Honeyman, 406 Mass 43, 49 (1989), citing Stepakoff, 
    supra at 840
    ("psychiatrist must exercise the same degree of skill and care
    as is exercised by the average qualified practitioner in that
    specialty, taking into account the advances in that profession
    and the resources available to the physician").
    37
    address his or her mental health issues.    Second, it recognizes
    that nonclinicians cannot be expected to probe or discern
    suicidal intentions that are not expressly evident.   It also
    acknowledges the scope of the suicide risk on campus and seeks
    to impose realistic duties and responsibilities on the
    universities, allowing them to respond with their own suicide
    prevention protocols if such protocols have been developed.
    Finally, this limited duty is consistent with the modern
    university relationship with its students, which is no longer in
    loco parentis but rather provides for the students' independence
    and self-determination.
    e.   Whether a duty was created in this case and, if so,
    whether a breach of that duty occurred.    For reasons that will
    be explained in detail below, we conclude that there was no duty
    created in the instant case, and if there arguably was such a
    duty two years before Nguyen's death, the defendants did not
    commit a breach of it as a matter of law.   In sum, Nguyen never
    communicated by words or actions to any MIT employee that he had
    stated plans or intentions to commit suicide, and any prior
    suicide attempts occurred well over a year before matriculation.
    He also was a twenty-five year old adult graduate student living
    off campus, not a young student living in a campus dormitory
    under daily observation.   Nguyen repeatedly made clear that he
    wanted to keep his mental health issues separate from his
    38
    academic performance problems and that he was seeking
    professional help from psychiatrists and psychologists outside
    the MIT Mental Health system.
    i.     The relationship with Dean Randall in 2007.   In the
    instant case, the question whether Randall, and therefore MIT,
    had a special relationship with Nguyen to take reasonable
    measures to prevent suicide in 2007 requires consideration of
    Randall's knowledge of Nguyen's prior suicide attempts and
    Nguyen's statements about present suicidal thoughts.     First,
    Nguyen's prior suicide attempts in December, 2002, and April,
    2005, were as an undergraduate student at a different university
    and preceded his September, 2006, enrollment as an MIT graduate
    student.   Additionally, although Nguyen had frequent suicidal
    thoughts, which, in the light most favorable to the plaintiff,
    can be read as present not past suicidal thoughts, Nguyen denied
    suicidal ideation in 2007.    Thus, Randall had no actual
    knowledge of Nguyen having attempted suicide while enrolled at
    or recently before matriculating to MIT, or whether Nguyen had
    stated plans or intentions to commit suicide.    Consequently,
    Randall had no special relationship with Nguyen and thus no duty
    to take reasonable measures to prevent Nguyen's suicide two
    years before his death.    Nonetheless, Randall properly
    encouraged Nguyen to seek professional help at MIT, which
    Nguyen, as was his right, refused.   Nguyen also informed Randall
    39
    that he was seeking professional help elsewhere and Randall
    sought permission to communicate with that psychiatrist, which
    Nguyen allowed and then promptly revoked.
    Finally, Randall invited further conversations with Nguyen,
    which he declined.     That being said, Randall left Nguyen in the
    care of competent outside professionals as Nguyen demanded.      In
    these circumstances, as a matter of law, a twenty-five year old
    graduate student's rights to privacy, autonomy, and self-
    determination were properly respected.
    ii.   The relationship with Professors Wernerfelt and
    Prelec.   In contrast to Randall's circumstances, no such special
    relationship was even arguably created between Nguyen and the
    defendants Wernerfelt and Prelec.    There was no evidence that
    Wernerfelt and Prelec had actual knowledge of Nguyen's plans or
    intentions to commit suicide.    Both were academics; neither was
    a trained clinician.    Nguyen's communications to them about his
    mental health problems related to insomnia and test-taking, not
    to suicidal thoughts.    There was also no evidence that
    Wernerfelt or Prelec were informed by MIT Mental Health, the
    student support office, or Randall about Nguyen's two suicide
    attempts in 2002 and 2005.    Even if Wernerfelt or Prelec had
    such knowledge, the prior attempts were not close in time to
    Nguyen's enrollment at MIT.    Given Nguyen's express request that
    his academic issues be kept separate from his mental health
    40
    issues and his assurances that he was being treated elsewhere,
    there also was no duty to communicate this information to either
    Wernerfelt or Prelec.    Finally, even though Wernerfelt commented
    about possible "blood on their hands," it was stated
    metaphorically in the entirely different context of persuading
    his colleagues to allow Nguyen to pass his examinations.    We
    note that Wernerfelt's expressed anxieties at the time of the
    general examinations that Nguyen might harm himself were not
    based on express statements or actions by Nguyen or information
    from trained clinicians and were more than five months before
    the time of the suicide.    As none of the medical professionals
    treating Nguyen considered him "imminently suicidal," this was
    certainly not something Wernerfelt could have intuited on his
    own.21    Because the circumstances at hand did not trigger a
    21Dr. Worthington, who treated Nguyen over the course of
    forty-three appointments over more than two years, testified
    that he "never thought [Nguyen] was at that imminent risk [of
    suicide] that he had to be admitted." Dr. Jeffrey Fortgang, the
    last medical professional that Nguyen saw, also noted that
    Nguyen did not seem "imminently suicidal or hopeless."
    Although clinicians commonly assess the "imminence of the
    risk of suicide," such assessment, even for clinicians, is
    difficult and disputed. See, e.g., Hawes, Yaseen, Briggs, &
    Galynker, The Modular Assessment of Risk for Imminent Suicide
    (MARIS): A proof of concept for a multi-informant tool for
    evaluation of short-term suicide risk, 72 Comprehensive
    Psychiatry 88 (2017); Simon, Imminent Suicide: The Illusion of
    Short-Term Prediction, 36 Suicide and Life-Threatening Behavior
    296 (2006). We do not here in any way impose such assessment on
    a nonclinician.
    41
    special relationship, we need not consider the duty of
    reasonable care and whether a breach of such a duty occurred.
    f.   Voluntary assumption of a duty of care.   The plaintiff
    also claims the defendants had a duty stemming from their
    voluntary assumption of a duty of care.     "[A] duty voluntarily
    assumed must be performed with due care."     Mullins, 
    389 Mass. at 52
    .   This duty, however, can lead to liability only where a
    "failure to exercise such care increases the risk of such harm,
    or "the harm is suffered because of the other's reliance upon
    the undertaking."    
    Id. at 53
    .   Although MIT voluntarily offers
    mental health student support services, there is no evidence
    that these services increased Nguyen's risk of suicide.
    Additionally, there was no evidence that Nguyen relied on MIT's
    mental health services.    The facts bear out Nguyen's rejection
    of such services.    Nguyen briefly consulted with MIT Mental
    Health and the student support office for only a few months in
    2007, nearly two years before his death.     Nguyen wanted
    assistance from MIT only as it pertained to test-taking and
    wanted to keep his mental health treatment separate.    Nguyen
    declined further MIT services and instead engaged with nine off-
    campus mental health professionals while remaining enrolled as
    an MIT graduate student.    Cf. Mullins, 
    supra at 54
     (prospective
    residential students rely on university's security features).
    Accordingly, the plaintiff cannot succeed on a "voluntarily
    42
    assumed duty" theory.
    3.   Punitive damages for wrongful death, conscious pain and
    suffering, and breach of contract.   The plaintiff asserts that
    he is entitled to punitive and emotional distress damages
    because the defendants' reckless or grossly negligent conduct
    was the proximate cause of Nguyen's death.    As we concluded
    above, there was no evidence of the defendants' negligence and
    consequently the plaintiff cannot succeed on such claims.       The
    plaintiff also cannot succeed on his breach of contract claim,
    as references to MIT Mental Health and the student support
    office's coordination of services is merely generalized and not
    sufficient to form an enforceable contract.   See Guckenberger v.
    Boston Univ., 
    974 F. Supp. 106
    , 150 (D. Mass. 1997).    Further,
    even if such a contract existed, the claim would still fail, as
    Nguyen rejected assistance from both MIT Mental Health and the
    student support office.
    4.   Motion to amend.   The plaintiff contends that his
    motion to amend the complaint to assert claims against former
    MIT chancellor Clay should have been allowed.   The Superior
    Court judge denied the motion on grounds of futility.
    We review the denial of a motion to amend the complaint for
    abuse of discretion.    Murphy v. I.S.K.Con. of New England, Inc.,
    
    409 Mass. 842
    , 864 (1991), cert. denied, 
    502 U.S. 865
     (1991).
    Although leave to amend should be "freely given when justice so
    43
    requires," Mass. R. Civ. P. 15 (a), 
    365 Mass. 761
     (1974), such
    leave may be denied where there is undue delay, undue prejudice
    to the opposing party, or futility in the amendment (citation
    omitted).   Mathis v. Massachusetts Elec. Co., 
    409 Mass. 256
    , 264
    (1991).   Here, Clay, who served as chancellor of MIT from 2001
    through 2011, directed efforts in implementing MIT's mental
    health task force.   At the time of Nguyen's death, several key
    recommendations had not yet been implemented.    There was no
    indication that Clay had any personal knowledge of Nguyen's
    mental health issues or was personally involved with Nguyen in
    any other way.   Clay had no common-law duty to prevent Nguyen's
    suicide, nor any special relationship with Nguyen, and he had
    not voluntarily assumed a duty of care.    Furthermore, Clay had
    no individual liability solely on the basis of his "general
    supervisory role."   Lyon v. Morphew, 
    424 Mass. 828
    , 833 (1997).
    Consequently, the proposed claims against Clay would be futile,
    and we conclude that there was no abuse of discretion in denying
    the plaintiff's motion to amend.
    5.    Workers' compensation.   The plaintiff argues that
    Nguyen was not an MIT employee at the time of his death and
    consequently his tort claims were not barred by the exclusivity
    provision of the workers' compensation act, G. L. c. 152.       The
    defendants claim that Nguyen was acting as an MIT employee and
    the tort claims were barred.   We conclude, as did a judge in the
    44
    Superior Court in his written decision on cross motions for
    summary judgment that were filed on this issue, "that there are
    too many conflicting pieces of material evidence presented for
    this court to determine, as a matter of law, the unique question
    of whether or not Nguyen was an MIT employee at the time of his
    death."   The factual record is undeveloped and unclear and the
    briefing inadequate on this difficult question involving paid
    summer research outside of Nguyen's ordinary graduate school
    activity for which he received a stipend.   Further complicating
    matters, the financial and other documentary evidence is unclear
    as to Nguyen's work status at MIT on June 2, 2009.
    Additionally, whether the June 2, 2009, telephone call prior to
    the suicide was work or school-related is also in question.
    Consequently, there was no error in the denial of summary
    judgment on this issue.   See Maxwell v. AIG Domestic Claims,
    Inc., 
    460 Mass. 91
    , 97 (2011).
    Conclusion.    For the foregoing reasons, we conclude that
    summary judgment was properly granted for the defendants on the
    tort claims as a matter of law.   We further conclude that the
    Superior Court judge properly denied summary judgment on the
    workers' compensation claim, as there are material disputed
    facts.
    So ordered.