The attorney for a woman left outside a Baltimore hospital wearing only a patient gown and socks on a cold night last week said the medical institution turned its back on her when she was having a psychotic episode.
J. Wyndal Gordon, who said Wednesday that he was hired to represent the patient on behalf of the family, said the woman named Rebecca was now at an undisclosed inpatient facility undergoing mental health treatment.
He called the actions of the employees at the University of Maryland Medical Center Midtown “cruel and inhumane” in a phone interview Wednesday.
“It was a completely unacceptable response from someone who you give great trust to handle your medical affairs and people need to be held accountable,” Gordon said.
Hospital officials said that they could not discuss specifics of the case and that they are still investigating why the woman was escorted out of the hospital by uniformed security personnel and left at a city bus stop after being discharged from the emergency room. They said in a statement that they already have started to implement changes to discharge procedures as a result of the widely publicized incident.
“We are nearing the conclusion of the investigation and are implementing appropriate personnel actions,” the statement said. “We have added additional layers of consultation and accountability around the post-discharge process in certain situations, as well as enhanced coordination of the range of services to meet the social needs of patients.”
The state’s Office of Health Care Quality and the federal Centers for Medicare & Medicaid Services also are examining what happened.
The state agency is a branch of the Maryland Health Department that licenses and certifies health facilities and programs throughout Maryland. The Medicare and Medicaid office enforces a federal law that forbids emergency rooms from denying hospital services if patients can’t pay. Under the law, hospitals must “stabilize” patients before releasing them or transfer those they can’t to other facilities that can help them. Still, precise discharge policies can differ by hospital.
“The investigation is ongoing, and the report will be released once it has been finalized,” said Brittany Fowler, a spokeswoman with the Maryland Health Department, in an email. “I do not have an exact timeline at this point of when that will occur.”
The incident, which occurred in the late evening of Jan. 9, was caught on video by local psychotherapist Imamu Baraka, who saw hospital security personnel leave her on the street. The woman in the video appears disoriented and unsteady, and she stumbles a few times. What appear to be four security guards are shown walking back into the hospital. One of them pushes an empty wheelchair. The woman seems to have trouble speaking or responding when Baraka asks if she needs help.
Baraka, who narrated what was happening in the video, called 911 for help and the woman was transported back to UMMC Midtown’s emergency room. The hospital later sent her to a homeless shelter by taxi.
City officials said they will work with hospitals to house homeless patients.
"We try and accommodate all homeless individuals regardless of the circumstances,” said Amanda Rodrigues-Smith, spokeswoman for Mayor Catherine Pugh. “Once they are discharged from the hospital, we accommodate those individuals. It's based on hospital policy if they choose to call us first. The service is available. That's a standard provision."
Gordon said that his client never should have been sent to a homeless shelter but instead should have been given psychiatric treatment. He plans to talk more about her case at a press conference Thursday afternoon.
“They knew or should have known when they examined her what her condition was,” Gordon said. “She was dumped twice in the same evening.”
The University of Maryland Medical Center’s top executive, Dr. Mohan Suntha, apologized last week for what happened to the patient, but called it an isolated incident.
“We take full responsibility for this failure,” he said during a news conference Thursday. The hospital did not provide “basic humanity and compassion.”
Gordon said he believes the employees committed reckless endangerment and abuse of a vulnerable adult.
In a Facebook post, Gordon called Baraka an angel and thanked him for saving his client’s life.
“Baraka literally saved Rebecca from hypothermia which could have easily claimed her life within hours or less without intervention,” Gordon wrote. “Rebecca was already at a deficit because of her naturally impaired mental capacity rendering her unable to respond to the frigid temperatures and physical trauma caused by those who so recklessly endangered her life.”
It is unclear how often such incidents of so-called “patient dumping” occur because it is not tracked. But patients rights advocates say it does happen.
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“I’ve been monitoring reviews for hospitals for two years and I can tell patient dumping is definitely occurring in the state,” said Anna Palmisano, the coordinator for Marylanders for Patient Rights, a coalition of 13 advocacy groups, that has been trying for several years to update the Hospital Patient's Bill of Rights to better protect vulnerable patients including those who are mentally challenged, elderly or disabled.
Vulnerable patients are required to be signed out by a surrogate, and the discharging hospital must have a plan to make sure patients have help when they go home or to a facility, she said. The proposed patient bill would include training for hospital staff.
"If the hospital staff had gotten training they would not have treated the woman this way,” Palmisano said.
Gordon called on the General Assembly to address the issue of patient dumping.
“It is our intention to show by example that emergency medical screening and treatment is a federal statutory right reserved to all — not just those who have insurance or the ability to pay,” he said in his Facebook post.