Half an hour later the p.m. nursing supervisor came in to take over.  The a.m. supervisor mentioned to him that she had not let the patient leave as he wanted. Soon the patient asked the p.m. nursing supervisor if he could leave.  The p.m. nursing supervisor phoned the on-call physician.  He told the physician the patient wanted to leave the hospital and go to a friend’s house nearby.  The physician told the p.m. nursing supervisor to let him go, provided the patient was willing to sign the hospital’s standard release form for a patient who was leaving against medical advice, which the patient did.

    The p.m. nursing supervisor let the patient leave wearing only pants, a dress shirt and moccasin type shoes.  Outside it was a blizzard in Maine in January.  Thirty minutes later the p.m. nursing supervisor finally got the a.m. shift nursing report and learned for the first time of the patients suicidal comments earlier that day.  At that point the p.m. nursing supervisor started making phone calls.  The patients wife told him to report to the local police that her husband was missing.