Posted on 07/12/2005 11:44:40 AM PDT by Born Conservative
A dead patient, violations of hospital policies and allegations of abuse from former patients are placing increased scrutiny on the psychiatric ward on the top floor of Community Medical Center.
What's next?
Frank Salini, 54, died June 22 while a patient in the psychiatric at CMC. Another patient said he overheard staff discussing whether Mr. Salini’s death was caused by sedatives. State government inspectors are investigating.
Leaders of state and local patient advocacy organizations have gotten involved and said Monday they plan to meet with CMC officials Friday. A dead patient, violations of hospital policies and allegations of abuse from former patients are placing increased scrutiny on the psychiatric ward on the top floor of Community Medical Center.
Inspectors from the Pennsylvania Health Department are now on site after a patient, Frank Salini, died unexpectedly in the ward June 22.
Those same inspectors, who are investigating the death, faulted the facility for four policy violations earlier this year, according to an agency report. It is unclear when the examination into the patient death will be completed.
While local advocates for patients’ rights are meeting with hospital officials Friday to seek answers about Mr. Salini’s death, they say concern is growing about the quality of care at the facility. The status and quality of care are important because it is the only inpatient psychiatric unit available in the area.
Other allegations by former patients have come to light since Mr. Salini’s death was publicized. One man said he was shocked by a stun gun seven times, then tied to a bed for almost a whole day. Another patient reportedly was physically and verbally abused.
Hospital officials say they are limited in commenting on some of the cases because of patient privacy considerations. They also say steps have been taken to right procedural lapses cited by the agency.
The staff at the facility handles people with sometimes extreme emotional and behavioral problems, challenges beyond those of the typical hospital patient.
Violations found
Health department investigators on March 4 checked records of four patients who were given electroshock therapy. They found the hospital had no therapy plan or goals in place for the treatment, according to an inspection report.
“It is very serious,” said Kathy Wallace, director of advocacy and community services for the Advocacy Alliance, a patient advocacy group. “Someone should not be getting that unless it is definitely in their treatment plan, signed off by a doctor.”
In a written response, CMC told the state it plans to have the unit’s nurse manager educate the staff and monitor treatment plans daily. Two previous spot inspections — in 2002 and 2003 — found no violations.
“Corrective actions have been taken on all deficiencies identified by the Department of Health during the March 4, 2005, survey,” said Jane Gaul, a CMC spokeswoman.
The same health department review cited the psychiatric unit for three other violations:
¦ Patients inadequately clothed. Hospital policy says the patients should be dressed each morning casually and comfortably. That was not the case March 3, when a patient was walking through the hallway wearing hospital scrub pants and two hospital gowns draped over one shoulder. Another patient was walking down the hallway wearing two hospital gowns, one tied in front and one in back.
¦ Treatment not planned properly. Within 72 hours of a patient’s admission, the facility must develop a plan of care reviewed by a doctor, social worker, activity therapist, occupational therapist, nurse and the patient. The health department found staff either did not develop or properly review such a plan for five of 19 patients reviewed.
¦ Inadequate treatment plans. As part of the treatment-planning process, the facility must assess a patient’s activity abilities within 72 hours of admission. Investigators found CMC did not complete an activity assessment for 12 of 19 patients reviewed.
It was not clear Monday how many patients are treated at the 30-bed facility. State inspections found no violations in the psychiatric unit on March 6, 2003, and Feb. 13, 2002.
Patients complain
In a meeting with advocates Feb. 7, hospital officials said they would no longer allow electric stun guns in the psychiatric unit, said Mrs. Wallace of the Advocacy Alliance. That came after advocates presented hospital officials with photos of scars sustained by a patient who had been shocked repeatedly by security guards’ stun guns.
“I remember the whole situation, and it was totally uncalled for,” said Charles Marcy, 46, of Dickson City, who was in the unit for schizophrenia treatment in early February.
On Jan. 31, hospital staff told Mr. Marcy to put on a hospital gown. He initially refused, he said, in part because there were five female nurses in the room along with two therapists.
“I may have sounded excited, but I meant no harm,” Mr. Marcy said.
Two security guards were called, and Mr. Marcy said he agreed to wear the gown but warned a therapist he would punch him if approached.
Mr. Marcy — who stands 5 feet, 2 inches tall and weighs about 145 pounds — said he never attempted to hit any staff and had no history of threats or violence during his stay.
“I got hit (with stun guns) six times on my back and once on my stomach,” he said.
Mr. Marcy said he lost consciousness and eventually came to with a security guard in the room. He was fed once while restrained in a seclusion room, received no medication, and no doctors or nurses came to check on him, he said.
State guidelines say that mechanical restraints and seclusion should be used rarely and the patient should be checked on every 15 minutes by a nurse.
“We cannot comment on the allegations of this patient,” said Michael Perry, an attorney representing CMC, citing laws that protect patient privacy. “I think it is very unfair for the paper to print one-sided allegations of patients when the hospital’s hands are tied by mental health privacy laws.”
The hospital has internal policies on topics such as the use of force by security guards and the use of seclusion and restraint on mental health patients, Mr. Perry said. He declined to detail those policies, except that they generally align with government and industry standards.
Another patient, Frank Lepaglia, may have been mistreated by staff a couple years ago, according to a letter received by CMC administration on May 28, 2003, and obtained recently by The Times-Tribune.
A friend, Jason Helik, wrote the letter complaining that a nurse called Mr. Lepaglia “just an idiot” and that other patients said Mr. Lepaglia had been “slapped around.”
CMC had no comment on the incident because of federal laws protecting patient privacy, Ms. Gaul said.
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