Did the ER drop the ball?

[Chief Drizzt]

So - not sure if I mentioned this here or not - but when my wife attempted suicide a couple of weeks ago she was brought to our local ER where she waited until they brought her to the behavioral unit.  While in the ER she was left alone in a room with needles on a tray by her bed.  She took the needles and tried stabbing herself in the neck and wrists. Thankfully she didn’t hit her carotid and just bled all over the place.  She told me it was a good couple of hours before they checked on her.

Am I off in thinking the ER screwed up?  Aren’t they supposed to have a staff member watching people like that?  Now that things are settling down since she has been home I’m starting to think about that and am not sure if I should just let it go or what.

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[kells76]

If it was a general ER, not a behavioral-specific ER, then they may not have known the issues before she got assessed/transferred. Doesn't make it right, but my thought is that they may not have had anyone there with the specialized knowledge about SI/SH/behavioral stuff.

Seems like it couldn't hurt to call up the behavioral unit, share your concern, and see what they have to say about the ER incident. Or, if you aren't sure if the behavioral unit would "take sides" or not, consider looking up the hospital's "Feedback" phone number or "customer issue" number or "complaint" line -- not sure if there is one, but it seems like a hospital would have some kind of staff member interfacing with patient complaints. I'd suspect hospitals want to avoid being sued.

Or again, if you want to avoid "showing your cards" right away, consider doing an initial consultation with a local medical lawyer -- describe the situation and ask if the L has any experience with "ER responsibilities" or minimum standards of care. Ask if this situation qualifies as the ER not performing its responsibilities.

I'm almost thinking an online forum like reddit may also be a way to crowdsource a bunch of feedback, both on whether this is an issue, and on how to find out next steps.

You could also start Googling things like "emergency room minimum standards" and see if that gets you anything.

[Pook075]

I know from experience with my kid that "suicidal" people in hospitals aren't a good mix.  Why?  First, their behavioral unit is always packed full, so there's no beds available and you end up in a holding area while waiting for an evaluation.  My local hospital where they keep criminals/mentally ill looks like a mini jail cell with six rooms (cells w/ secure doors).  It usually takes anywhere between18-36 hours to get an evaluation and by that point, the "suicidal person" is so incredibly bored, they just want to go home.

I shared that to paint somewhat of a picture of the process.  Step 1, triage (get vitals)  Step 2, regular room.  Step 3, holding cell or psych unit (if it's not full...which it always is).  Step 4, get sent home or transferred to a short term facility (if they have any beds, which they don't).

I guess my question would be- what was your person when this happened?  It could have happened early on, but it would be almost impossible once they're admitted unless there was some gross negligence.  Or, the hospital was so full that your person was in an area not meant for patients to wait in- like the triage area where there might be accessible needles.

Overcrowding for mental health is a nationwide epidemic that's almost completely ignored, even with all the recent school shootings, etc.  Every politician says fixing mental health is a priority, yet people can't even get seen in most places during a suicide attempt.  It's a massive, massive problem.

[Pook075]

Oops, double post.

[Chief Drizzt]

Hiya Pook -

Well we had to call 911 for my wife who ingested pills - so you would think that would preclude them being a little extra vigilant.  She was taken away in high distress - and my guess is she wound up there in that state. 

Fortunately there were plenty of beds in our behavioral unit at the same hospital - but she was stuck in the ER for about 12 hours because of the pills - they needed to monitor her for a reaction I suppose.   Not that they were doing a good job of it…

I’ll probably not make an issue of it - but if she would have hit a carotid and bled to death I would definitely have tried to hold them accountable.

[SaltyDawg]

In addition to what others have said, you can find out the state licencing board and file a complaint for in your state, they are required to investigate, and it will prod the hospital to do a better job in the future.  Unlikely any disciplinary action will result though; however, it will put the hospital administration to act as they don't want too many complaints lodged against them for the state to yank their license.

It will also flag you/your pwBPD for more vigilant treatment the next time they visit, which hopefully will not occur.

[Woolspinner2000]

Hi Chief Drizzt,

I just wanted to chime in and say that all hospitals have a process in place to internally investigate 'miss or near miss' high risk situations like this. You may not be aware of the process, but it does take place. The fact that your wife helped herself to hospital items for self harm would not go unnoticed. Everything has to be so thoroughly documented in medical records that it would indeed have been discussed and under investigation on the hospital/ER side of things so that this doesn't happen again in the future.

Wools