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US hospital told family their daughter had checked out when in fact she’d died
(www.theguardian.com)
this post was submitted on 22 Aug 2024
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I've worked IT systems for hospitals my entire career; this Hospital franchise uses Epic Systems as their EMR, I know it well, I have like 7 certs for Epic System modules. There is a TON of paperwork associated with a discharge against medical advice since the hospitals definitely want to cover their butts in such cases.
There is ZERO chance the hospital mixed her release as leaving against medical advice and/or have the documentation to back that up. Even if the person just sneaks out of the hospital, that is considered a "code" alert (colour depends on the hospital) until they can determine the patient is not in danger to themselves or others. Again, ZERO chance this happened without more than one person knowingly falsifying records... best I can imagine to give the Hospital the benefit of doubt, is criminal negligence
Moreover, death in hospitals and handling (as in moving and storing) of human remains has an even bigger avalanche of regulations and documentation, all of which would have to be completely missing for them not to notice.
Am nurse. You are allowed to walk out AMA without signing shit if you have capacity and you're generally assumed to have capacity unless indicated otherwise. I would like you to sign the documents, but I cannot force you or imprison you and I'm not going to call security. Going AMA without signing something or seeing a doctor is not elopement.
Since she called her mother saying she needed a ride on the 8th and they stated she went AMA on the 8th, I honestly believe she went AMA, maybe even signed it, and then ended up dying off the unit. It's the most plausible scenario. How everything else got fucked up is another situation. If they already discharged her maybe they didn't readmit once she died? Everyone thought it was someone else's job? Saw she was "discharged" on the board and thought someone else already handled the death checklist?
Edit: the filing https://prod-portal-sacramento-ca.journaltech.com/public-portal/?q=downloadFile/18267732/2204994 she died two hours after she called her mother for a ride. No fillings from the defendants yet to see what else was going on.
Sure you are allowed but that is documented. In Canada if someone gets out of bed and leaves the hospital, the patient and/or next of kin are contacted. If that fails and it is determined there is no risk, the fact the patient left without announcing it is documented and it's not the same form as the regular AMA (where patient do sign)
The above part of the scenario may be muddy but there is zero justification for the handling of the remains. This person clearly died in the hospital or close enough to be returned. How is that part mishandled for a year when they also have a patient missing??!
Also, all my respect to nurses, you are the life blood of the hethcare system. However, this is an administrative fuck up, not something nurses are expected to deal with (again, at least not in Canada). A nurse would announce a patient just walked away and it's the job of admins and sometime social workers from there on
In my state, nurses handle discharge entirely, whether it's to the door or to the pearly gates. Someone may look over our work later, but we're the ones who set the chart to be flagged as discharged and we're the ones who ensure they're correctly tagged and carted to the morgue. Generally we do not notify someone's next of kin of their AMA in the US as that would be a HIPPA violation unless they're deemed to be in danger and without capacity. Everything, as always, has carve outs and grey areas.
What happened with the body makes it sound like a Jane Doe unclaimed, but regardless there was systemic fuck ups going on here.