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Patient Eloped From Psychiatric Care: Court Finds Grounds For Family's Lawsuit.
Legal Eagle Eye Newsletter for the Nursing Profession
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The patient was not a voluntary psychiatric admission and was not free to leave the hospital on her own accord.
After her suicide attempt the police told her they were going to have her involuntarily committed. At that point she agreed to cooperate with EMS personnel summoned to take her to the hospital and to admit herself to the hospital when she got there. The triage nurse noted it was a suicide crisis and that the protocol for involuntary psychiatric admission had been initiated. The patient's street clothes and shoes were taken and she was issued a paper hospital gown and hospital socks.
Close observation was supposed to have been started for her.
SUPERIOR COURT OF PENNSYLVANIA January 17, 2017Right after a suicide attempt a patient with a history of mental health problems was brought by ambulance to the hospital's emergency department from a hospital that did not have the capacity to treat a psychiatric patient in an acute crisis. She asked for voluntary admission as a mental health patient. However, she had agreed with the police who responded to the scene of her suicide attempt to admit herself voluntarily as an alternative to their expressed intention to take her to the hospital and admit her involuntarily.
She was given a nursing triage in the emergency department and interacted with the emergency department nurses several times before she eloped. She verbalized her suicidal intent several times during her encounters with the nurses. However, she was never seen by a physician or any member of the crisis intervention team in the hospital. The nurses took her street clothes and shoes and gave her a paper gown and hospital socks and left her in an exam room.
More than an hour later the patient just got up and walked out, past the charge nurses station and the billing clerk's desk and through two doors into the emergency department lobby, in her paper gown and hospital socks. No one tried to stop her. The patient walked on to a nearby state highway and was struck and killed by a passing motor vehicle.
The Superior Court of Pennsylvania upheld her family's right to sue. According to the hospital's own protocols a patient in a suicidal crisis was to be given close one-to-one monitoring in the emergency department. Instead the patient was left alone in an exam room. The patient was never seen by a psychiatrist, emergency department physician or member of the hospital's mental-health crisis intervention team, while she sat in an exam room for nearly ninety minutes.
It came to light in the family's lawsuit that nine mental health crisis patients had eloped from the same emergency department in the preceding one-hundred days, yet nothing had been done by way of retro-fitting the doors with keypads or alarms.
In its defense the hospital argued the nurses were initiating an involuntary mental health hold. Further, state law in Pennsylvania as in other states immunizes healthcare workers, the police and others from liability in civil lawsuits for taking part in involuntary mental health holds. However, the mental health commitment law does not provide legal immunity in a case of gross negligence, a failure in patient care more serious than an inadvertent lapse in professional judgment. The Court saw evidence of gross negligence here.
Martin v. Hospital, __ A. 3d __, 2017 WL 164483 (Penna. Super., January 17, 2017).