University of Maryland hospital apologizes for its failure to discharged patient found on street in hospital gown

and Contact ReporterThe Baltimore Sun

The University of Maryland Medical Center’s top executive apologized to a patient who was discharged and found on the street wearing only a thin hospital gown and socks outside its midtown facility, calling it an isolated incident.

“We take full responsibility for this failure,” Dr. Mohan Suntha said during a Thursday afternoon news conference. The hospital did not provide “basic humanity and compassion,” he added.

Suntha, the Baltimore hospital’s president and CEO, said the hospital system is investigating the incident and is talking to everyone who came into contact with the woman, including guards, nurses and doctors. It also is reviewing its discharge policies.

The hospital was thrust into the national spotlight and social media erupted with outrage after a viral video showed security guards leaving a disoriented woman from the University of Maryland Medical Center Midtown on the street, barely dressed, when the temperature was in the 30s. It’s the latest hospital across the country accused of a practice known as “patient dumping” or “hospital dumping” in which patients who are homeless, mentally ill or both are released to the streets.

The state Office of Health Care Quality said it is investigating the incident.

The widely shared video was posted to Facebook by Imamu Baraka, a psychotherapist who was leaving his office across the street from the hospital when he saw the woman.

Baraka said that he stopped videotaping at some point to call 911 and an ambulance crew came and took the woman back into the hospital. He said he waited for two hours to make sure they didn’t bring her back out to the bus stop. He said he heard her say “thank you” as she was led away.

Baraka has since spoken with the woman’s mother, who contacted him after seeing the video. During the three-hour discussion, she told him her daughter was 22 years old. The woman is now safe with family and being well taken care of, he said.

The family told Baraka that the hospital had put the woman in a cab to a homeless shelter and that was where the mother found her. He declined to describe her mental or medical conditions or why her family didn’t know where she was.

“She said her daughter had been missing,” he said. “She did some momma bear stuff to find her after she saw the video.”

Hospital officials have not said what the woman was treated for in the emergency room or why she was left out in the cold near a public transit bus stop. Mohan said she received proper care while in the hospital and that the incident happened after discharge.

The unidentified woman appeared to be unable to speak in the video, which drew national and international attention. Baraka, a psychotherapist, attempts to speak to her, but she doesn’t answer him.

Suntha declined to give details about the patient, citing privacy laws.

“Something was clearly going on,” said Adrienne Breidenstine of Behavioral Health System Baltimore, which oversees substance use and mental health treatment in the city.

The issue of people being put out of hospitals is a nationwide problem. The New York Times first began writing about the issues in the 1870s, when private hospitals were sending patients to the city’s public hospital, according to a 2011 report in the American Journal of Public Health.

The 1986 Emergency Medical Treatment & Labor Act forbids emergency rooms to deny hospital services if patients can’t pay. Hospitals must transfer patients they can’t stabilize. The Joint Commission, which accredits hospitals, also requires that hospitals have a discharge plan. But the discharge policies can differ by hospital and the practice of hospital dumping persists.

The city of Los Angeles began a crackdown on hospital dumping about a decade ago after several incidents there, particularly along Skid Row, where many of the city’s homeless people live. The city has imposed millions of dollars in fines on hospitals for the practice.

Good Samaritan Hospital had to pay $450,000 to settle allegations that it dumped a homeless patient on the street in 2014 after he was treated for a foot injury. The hospital admitted no wrongdoing. In 2007, a paraplegic man was found crawling around Skid Row and Hollywood Presbyterian Medical Center was accused of taking him there without a wheelchair. The hospital paid $1 million to settle that case.

In May 2017, two Howard University police officers and their supervisor were fired in May after being recorded dumping a patient from a wheelchair outside the university’s hospital in Washington, according to reports in The Washington Post. A video of the incident showed a male officer pushing the barefoot woman to a bus stop. Two other officers watched as she fell onto the sidewalk.

It is unclear how prevalent hospital dumping is in Baltimore or across the country because it is not tracked by federal or state officials.

“This incident is very visual because it happened on camera,” Breidenstine said. “I am sure it happens more than we know. But it is hard to know how much because we don’t have the data.”

Kevin Lindamood, president and CEO of Health Care for the Homeless, said he doesn’t think hospital dumping is widespread in Baltimore and that hospitals have gotten better at connecting the homeless with services and community groups.

“We are working with many hospitals regularly, including the University of Maryland, and those collaborations have resulted in dramatically improved care for with vulnerable people,” he said.

Breidenstine said more mental health services in the community could help prevent patients from ending up in emergency rooms. Some facilities have better relationships with social service agencies than others, Breidenstine said.

Suntha said it’s challenging for urban hospitals to address all of the complex social problems that are common with their patients. The University of Maryland Medical Center works with city agencies and nonprofits to try to get patients the non-medical care that they need.

Suntha said the incident didn’t reflect the mission of the medical system.

“We do not believe what happened defines who we are as an organization,” he said.

The union that represents hospital workers, including University of Maryland’s midtown campus, said that hospital workers sometimes have to manage a delicate balance between providing good care and protecting their workers. There are some patients who become violent, said Ricarra Jones, political organizer for the 1199 SEIU United Healthcare Workers East labor union.

“There are examples of patients who abuse our employees,” she said. “We have to figure out how to deal with those situations when it happens. We have to protect our employees in those cases.”

When Baraka saw the woman and the guards walking away, his first thought, he said, was to protect her interests.

So he began shooting the video, which shows a woman dressed in a gown and socks near the bus stop outside the hospital on the outskirts of Mount Vernon as what looks like four security guards, one with a wheelchair, walk away. Her belongings are packed in plastic bags that have also been placed at the bus stop.

“I just witnessed this with my own eyes,” Baraka wrote in a Facebook post. “I had no choice but to give this young lady a voice in this moment.”

He is heard in the video asking the hospital’s security officers several times why they put the woman out of the hospital.

“Y’all are just going to leave this lady out here with no clothes?” Baraka asks, noting how cold it is outside.

One of the guards eventually responds: “Due to the circumstances of what happened.”

Baraka then asks why they don’t call police. He also asks to speak to a supervisor. One of the security workers responds that he is the supervisor.

Baraka asks the woman, who looks disoriented, if she needs help. She screams and moves her hands around but doesn’t talk.

In the Facebook post, Baraka admonished the hospital for the way the woman was treated.

“University of Maryland Medical Center Midtown Campus (UMMC) as a Doctor of Healthcare Administration (DHA) student — may I remind you of the importance of the VISION of your MEDICAL CENTER,” he wrote. “ ‘UMMC will be known for providing high value and compassionate care, improving health in Maryland and beyond, educating future health care leaders and discovering innovative ways to advance medicine worldwide.’ You can do better. You must do better.”

Hospital officials said they are still working to determine how to respond and could take a personnel action.

“We share the community’s anger and concern,” Suntha said.

Baraka said the results of the investigation should be made public.

“You’re telling me no doctor or nurse or social worker asked where she was going?” Baraka asked. “And why were they taking her outside with no clothes on? Someone called for security? Was this the cultural norm?”

amcdaniels@baltsun.com

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