Wednesday, March 18, 2009

Patient Safety Alert: How Safe Are You in a Tennessee Hospital

Please read this carefully, and sign YOUR name if you can relate to single thing I have written below. Please keep in mind that I committed myself to a complete an online project related to healthcare by March 21, 2009, and right now this is the best I can do... recognize that this article is still very much a work a progress... but I need the your help and support personally, professionally and for our brothers and sisters here and across the world who are unable to speak for themselves or access the Internet to join in my campaign for an army of one. Thanks guys... especially to those tweeters and twackers (and we know who you are!) who helped carry me through this difficult time... Thx...


After refusing to sign several documents while seeking treatment at the emergency room on March 7, 2009, I found myself locked up on a 6044 hold at a local hospital in Nashville, Tennessee.

The most critical documents included a complicated consent form (informed consent for treatment) and several others regarding the assignment of benefits, insurance forms, HIPAA compliance, payment responsibility forms, and a few others.

When I requested that I be given a few minutes to read and process the legally binding agreements I was being given, they became angry and impatient.

In retrospect, I suppose it really didn't matter what I was signing, since I clearly have a good argument for diminished capacity, especially now that I have had time to reflect on the sick irony of it all.

After all, how could I be asked to sign a document accepting financial responsibility if I was clearly out of my freakin' mind?

And although one could argue diminished capacity, or no fault by reason of mental defect or disease, hind-sight is 20/20, so I assumed that I would be held to that contract much like I was held to the terms of my student loans, my car loan, the non-compete clause from my last employer, or even the Columbia music club I signed up for when I was twelve.... you know the one where they send you 12 CD’s for the price of a penny???

Yes, they all held me to the terms of my contract... either by hunting me down and harassing me endlessly over the phone; reporting adversely to the credit bureaus, sending me to collection; and even a few times to court in an attempt to collect a debt from a creditor. They all held me to the terms of my contract. So I thought I should be cautious before entering into any others...

In fact, I was in Civil Court yesterday for a being sued for a $21 balance on my water bill. Granted it has since been paid in full and the check has been cashed... but now they have added late fees, attorney fees, court costs and a bunch of other things to the complaint, so I with the addition of a late fee of $4.50, so you can expect to see me in Court again next Friday, hopefully with an attorney present if I can find one to represent me against this ridiculous claim.

Keep in mind that it will cost me $12 to park; the fact that balance has been paid in full, and for those of you who have been following along and paying attention, don't forget about the four days I went without hot water.

Add to that the 12-24 hours I spent in constant contact with the police regarding a shooting in the just below mine, clearly I must be hysterical, on drugs, or both to make repeated calls to 862-8600 non-emergency police hotline, and then escalating it by making several calls to 911. Is it any wonder that I am acting just a little bit strange?

Well, to get back to the reason I am writing without reservation today, I currently face eviction and that makes me a bit anxious... because no sooner than I could return home from the Psychiatric Unit and take a hot bath at "my" apartment, the someone showed up from the Sheriff's office to serve me with a warrant (that was written on carbon paper and modified multiple times making it difficult to read or understand what I was being charged with, when I needed to be in court, and what I needed to do to adequately defend myself.

So within hours of being medically cleared and released from a 5-day stay at "Club Head." the Sheriff shows up with eviction papers, and my mother became extremely concerned that I she might lose money if she has to change the flight... well since then she has severed the "family plan contract" and removed me a primary account holder on my cell phone contract, turned off the e-mail and text messaging feature, changed MY password, and has sworn never to speak to me again.

My cell phone number is being held hostage through T-Mobile so I cannot take my number with me to another carrier (even if I had the money or the credit to open an account with another provider, and has promised to cut off my cell service on the last day of the contract, at midnight tonight (March 22, 2009. All this because I wanted to change my flight to Las Vegas to attend her fourth wedding to a man she met less than six months ago... but, I digress... and there I go, talking crazy again...


(and now back to the original program...)

At the hospital... I refused to sign the admission papers until and unless I was given the opportunity to read the forms, process the information, and make an educated decision about the treatment I was requesting for whatever the hell was wrong with me.

Apparently this was an unreasonable request. By refusing to sign without being given the opportunity to consult with a member of my immediate family who serves both as my medical proxy and healthcare decision maker, and power of attorney, I was escorted by two security guards to the third floor where all of my personal belongings and cell phone were quickly confiscated.
Simply because I refused to sign a blank consent?

It was my understanding that informed consent is the standard of care for medical treatment in the United States. Furthermore, to be denied the opportunity to consult with my medical decision maker, it seems that they should have done so especially if they were planning to administer medical treatment without my consent.
My medical proxy is clearly identified in my medical records, and even listed on the back of my driver’s license with a "MR / ICE" [Medical Record / In Case of Emergency

So, I refused to sign.
Hospital personnel did not pull my primary care records or even attempt to take a medical history report, or locate my next of kin / emergency contact.

I chose this hospital because it is conveniently located on the same medical campus as my primary care provider, radiologist, and has a contract with my insurance company as a participating (and preferred) provider.
Given the fact that all of this information was readily accessible [my medical records and providers are conveniently located within the same medical facility and hospital network] I do not feel I was making an unreasonable request.
By refusing that request, I feel the hospital failed to take reasonable safety precautions that are the accepted standard of care within the medical community, and considered to be among the "best practices" identified by the state health boards, accreditation bureaus, professional licensing and certification boards.
After clearly stating my requests, and subsequent objection, I was promptly escorted upstairs by two uniformed security officers who refused to give me there name, employee ID number, show me any type of identification badge or ID number within plain sight or marked on their uniforms.

Once inside the unit, I tried to call my sister, (my medical proxy and emergency contact) to alert her that I was being at the emergency room. They listed the wrong name and MR number on my ID bracelet. I actually had two ID bracelets on with conflicting information, yet neither contained allergy information, or medical history alerts.

Security would not allow me to make a phone call and used excessive force to grab me by the arm and take the cell phone out of my hand.
I explained that I had a medical allergy, and was intolerant to Haley, and have a lesion on my thoracic spine T1-T6 with cord damage and nerve root compression concentrated at T2-T3.
The nursing staff also refused to pull my medical records or take reasonable precautions to ensure my medical or physical safety and did not make any attempt to contact my primary care provider or my sister.

In fact, they claimed that my repeated requests were not only unreasonable, but a threat to my safety and the safety of others. Really???

At that point I held on tight to my deactivated old Nokia cell phone, circa 2001, and attempted to call 911. They quickly and forcefully pulled the phone out of my hands and physically began to restrain me through the use of physical force and medical intervention.

First they grabbed my left arm. pulled the dead cell phone out of my right hand; and escorted me into a room with no windows, no call buttons, no bathroom, no fire exists or intercom, and no way to contact emergency medical or emergency personnel.
I was forced into submission by two men, for what seemed like a couple of minutes, though I can't be sure since there were no visible clocks and it was right around 2 am on the day we change the clocks for daylights savings time.
After being pushed me into the ground face and stomach against the floor, my arms were twisted behind my back.

I was then placed into a room with no emergency call buttons, intercom, bathroom, fire alarms and forcibly pushed into a plastic mattress in the corner. I must have either feel asleep or lost consciousness because I woke up several hours later in the same room, with no emergency call buttons, intercom, bathroom, fire alarms, and laying on a plastic mattress in the corner.

With my head still pushed into the plastic mat, my hands behind my back, one of them removed my black leggings and injected me with an unknown substance.

One of the men returned a few minutes later to taunt me through the observation window.

The man who injected me refused to give me his name, an employee ID number, or the name of the medication I was injected with. He told me he was "self employed" and taunted me about through the observation window. He threatened me, and laughed when I told him that I hope he remembers my face the next time he looks his own daughter in the face.

He thought this was absolutely hysterical, and was laughing uncontrollably and made physical gestures towards me and kept moving towards me despite my repeated requests that to stand two feet away from my body. He kept making rapid threatening movements towards me and removed his identification badge, from his uniform, and told me that unless I sit down he would be forced to physically restrain using whatever means he deemed necessary.

I am trained and certified in TAPS (therapeutic assault prevention) and I can assure you that there was nothing therapeutic in the way I was restrained.

Kindly take note of this complaint and I will follow up when I have better access to a computer. I was then held on 6044 [2-PC: Two Physician Commitment] involuntary from March 7 - March 13.
I have cuts, multiple bruises ,and injuries that were not treated or evaluated medically during my stay, given multiple injections, and discharged without meds. They refused to acknowledge that I have an allergy / intolerance to Haldol.
I had a 4 day supply of Geodon, Klonopin, out of pocket. Trazodone was covered. I was released without any medication, just three prescriptions and returned to my apartment, without my car, or any way to get to the pharmacy. The 18 day prescription the doctor gave me cost $243.19. I could only afford a 5 day supply since they hospital staff did not get the medication pre-authorized by my insurance company as promised.
Just before leaving, I asked, just as I had each time I took my meds for the 5 days I spent on the unit, if they were able to locate the record for the second injection that I was given while unconscious on the plastic mat.

I am waiting for my Celexa to be approved at the pharmacy, since Effexor was not covered. I have at least puncture wounds from at least 7 injections, cuts and bruises and abrasions that were not medically treated or evaluated during my stay.

In short, I need Geodon prior-authorization, med transport to pharmacy and medical transport to appt on Wednesday, 10am' Effexor prior authorization, a copy of my medical records from the psych unit ASAP, and do not feel I should have to pay $2.00/page for a copy. I had to pay $54 in cash for parking, and this is all I can type for right now. Maybe I'll write more on this later, maybe not..." Elyssa Durant, March 17th, 2009.

I have a primary care appointment scheduled for Wednesday, and must file more appeals. I have no fax machine and I am running low on gasoline. I am writing this email from my cell phone which is rather inefficient at best.
Please join me in an Alliance for Compliance to protect both individual rights, encourage medical compliance, and enhance patient safety, by letting you voice be heard.

Click to call your member of Congress and demand quality, affordable health care!

Thank you all,

Elyssa Durant

Sent via BlackBerry from T-M

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Elyssa D. Durant, Ed.M.