This case takes place in New Hampshire and involves an older female who was admitted to an inpatient medical facility for medical treatment over the course of several days. While she was in the hospital, she was paired with another female roommate with a known history of sexual misconduct. It is documented that there was no screening of this roommate prior to the pairing, despite the fact that this particular hospital did have screening procedures in place. The woman was subsequently abused by her roommate on several occasions during the course of her stay. The abuse was ongoing, hospital staff was made aware of the issue on multiple occasions, however the roommates were no separated and procedures were not put in place to protect the victim.
Question(s) For Expert Witness
- 1. Please explain you qualifications to review this case.
- 2. What best practices are in place to prevent an incident such as this from occurring? Please explain.
- 3. Are you able to review this case and opine on liability? Have you ever reviewed a similar case as an expert witness?
Expert Witness Response E-023472
Although, I have not served as an expert in this specific subject matter area (a patient inadequately screened and another patient inadequately protected from sexual abuse), I have consulted, taught, and written based upon my work with over 1,000 healthcare organizations in all 50 states over the past 12 years in matters pertaining to accreditation and legal compliance, with applicable standards and elements of performance. For instance, in this particular case, the following Joint Commission accreditation standards apply: PC.01.02.09: The hospital assess the patient who may be a victim of possible abuse and neglect Rationale for PC.01.02.09:……By assessing patients who may be possible victims of abuse or neglect, health care organizations fulfill an important role in helping to protect patients. Elements of Performance for PC.01.02.09: A1: The hospital has written criteria to identify those patients who may be victims of physical assault, sexual assault, sexual molestation, domestic abuse, or elder or child abuse and neglect (criteria may be based on age, sex, and circumstance) A2: To assist with referral of possible victims of abuse and neglect, the hospital maintains a list of private and public community agencies that can provide or arrange for assessment and care C3: The hospital educates staff about how to recognize signs of possible abuse and neglect and about their roles in follow up A4: The hospital uses its criteria to identify possible victims of abuse and neglect upon entry into the hospital and on an ongoing basis A5: The hospital either assess the patient who meets criteria for possible abuse and neglect or refers the patient to a public or private community agency for assessment A6: The hospital internally reports cases of possible abuse and neglect RI.01.06.03 The patient has the right to be free from neglect; exploitation; and verbal, mental, physical and sexual abuse A1: The hospital determines how it will protect the patient from neglect, exploitation, and abuse that could occur while the patient is receiving care, treatment, and services A2: The hospital evaluates all allegations, observations, and suspected cases of neglect, exploitation, and abuse that occur within the hospital A3: The hospital reports allegations, observations, and suspected cases of neglect, exploitation, and abuse to appropriate authorities based on its evaluation of the suspected events, or as required by law In addition, each state has specific licensure requirements for psychiatric facilities that impact the facilities ability to meet state based compliance. Therefore, I would be happy to review the findings of fact, corroborate it with all federal, state, and accreditation requirements and opine as to whether the organization was or was not in compliance and was therefore liable from a corporate standpoint.
Expert Witness Response E-007082
This case is right in my area of expertise and I am glad to assist. I am an associate professor of child and adolescent psychiatry and I used to run an inpatient unit with shared rooms at my academic health center. Two of those years was on a transitional age unit (10-14yo) with about half of the beds on the units being shared. I continue to be involved with the inpatient procedures with the inpatient child psychiatric hospital at my university. There are many safeguards in place to prevent this problem. We also start all new patients in private rooms and only allow the safest patients to room together toward the end of their stay if we feel comfortable putting them together. We also never allow them to be awake together in the same room. For example, they don’t have the same bed time and we let one fall asleep before we let the other one go to bed. Alternatively staff member watches both fall asleep until they are both asleep. When we have a pairing we are not comfortable with, one of the two roommates actually sleeps on a couch in the day area even though they are assigned to the room on paper. Lastly, it is critical that we screen for a history of sexual inappropriateness, sexual orientation, mania, sexualized behavior and history of aggressive bx/assault/conduct d/o. Glad to assist with this case and discuss further.