Legal Eagle Eye Newsletter for the Nursing Profession (7)2 Feb 99
Quick Summary: The psychiatric facility did not adhere to its own procedures for a patient on a thirty-minute observation level.There is no solid proof anyone saw the patient or accounted for her presence during the two and one-half hour interval before she was raped by another patient.
Every healthcare facility has the general legal duty to use reasonable care to protect a patient from harm that is foreseeable.
It is not significant that the male patient who raped this female patient had no prior history of violent or sexually inappropriate conduct.
It is foreseeable that a heavily sedated female psychiatric patient on an inpatient psychiatric unit could be raped by another individual, including a patient.
There is no basis for claiming this patient was negligent herself for going to sleep while heavily sedated in a room other than the room assigned to her.
The facility was negligent in how it supervised this patient. The facility was negligent, but in this case its negligence cannot be characterized as medical malpractice.
COURT OF CLAIMS OF NEW YORK, 1998.
The twenty year-old female patient was admitted to a psychiatric facility after a suicide attempt. Prior to her suicide attempt she had been wandering the streets in her pajamas and throwing eggs at storefronts. She reported that she was hearing voices.
In the hospital she was being given lithium, Ativan and Cogentin. When she became highly agitated and began threatening staff she was also given IM Haldol and sent to the quiet room. She wandered from the quiet room to another room and fell asleep for two and one-half hours before she was raped by a male patient.
The Court of Claims of New York said the quiet room should have been locked for her safety, to prevent anyone from having access to her and to keep her from wandering.
The court also found the facility negligent in that no staff member physically accounted for the patient during the two and one-half hour interval from when she got the Haldol until she first complained of having just been assaulted, even though the patient was on a thirty-minute observation level.
A patient on a thirty-minute level had to be accounted for every thirty minutes. An entry was to be made by a nurse or mental health aide on the observation flow chart every thirty minutes to indicate that the patient had been accounted for.
A letter "U" was entered on her observation flow sheet every thirty minutes during the interval in question, to indicate she was on the unit. But the unit was two floors containing patient rooms, bathrooms, multi-purpose rooms and a dining room. The court did not see the flow chart as reliable proof, nor would the court take it for granted, that anyone actually saw the patient or accounted for her presence during the interval in question. In fact, it was charted elsewhere she did not come to dinner, and no one indicated why, which contradicted the notion anyone had actually been checking on her. Genao v. State of New York, 679 N.Y.S.2d 539 (N.Y. Ct. Cl., 1998).