How to Survive a Stay in the Hospital: Lifesaving

The Olivia and Howard Geller Foundation for Patient Safety
How to Survive a
Stay in the
Hospital:
Lifesaving
Advice for
Patients and
Their Families
Be there…and be aware! Be the patient’s advocate!
Elderly patients need someone with them all the time.
Trust your instincts. If it “feels” wrong, it probably is.
Have knowledge of the Patient’s Bill of Rights.
Ensure the patient is given correct medications.
Record, review, and report maltreatment or neglect.
Employ the use of a “patient sitter” or “granny cam.”
Bring a voice recorder, phone, and camera.
Expect respect, and make needs understood.
Ask questions and demand answers.
Write down the names of caregivers.
Assertiveness is vital.
Review medical records for mistakes.
Execute a power of attorney.
1
WHY I CREATED “THE OLIVIA AND HOWARD GELLER
FOUNDATION FOR PATIENT SAFETY”
A BRIEF BACKGROUND
My mother was a survivor. At age 79, she had survived several bouts of cancer, COPD
and emphysema. There was no reason to believe that she would not be able to
continue living independently for many more years. That is, until she became a hospital
patient, or rather a hospital “victim.” Never in a million years could I have imagined that
my mother would die, not from a terminal disease, but from a fatal head injury she
sustained under suspicious circumstances in the hospital where she was being treated
for pneumonia. And, I could never have imagined that her story would be all over the
media after I started an investigation into her death that culminated in the exhumation of
her body for an autopsy that was ordered and performed by the Ramsey County
Medical Examiner two months after her death.
My mother died unexpectedly in what I can only describe as a “perfect storm” where
everything went wrong. As a result, my family and I never got to say goodbye to her.
Why do I call this a perfect storm? First, my mother was so weak that she could not
even turn herself over in bed, let alone get out of it herself; she was catheterized with
tubing attached to her bed; and, she was wearing a full oxygen mask with a hose
connected to the wall. Yet, she was found on the floor, without her hospital gown, not by
her bed, and sustained a fatal brain injury after she smashed her head on the steel base
of an IV pole. Second, even with severe facial bruising, medical staff did not
immediately order diagnostic tests to determine if she had a head injury. Instead, they
took x-rays of her spine. Third, nursing staff did not notice neurological changes before
she became comatose. It was too late at that point, and my mother died from a subdural
hematoma approximately 24 hours after she was injured. Finally, the hospital failed to
comply with state law requiring notification to the medical examiner when a patient dies
under suspicious circumstances, and my family had to endure an exhumation and
autopsy that resulted in the issuance of a new death certificate that changed her cause
of death and manner of death from natural to “undetermined.”
Until my mother’s death, I was unaware of how dangerous a hospital can be –
especially for elderly patients, and especially at night. Because I thought that patients
are more susceptible to harm during the day when they are being given medication,
being moved around, and when there is more of a demand on nursing staff, I made sure
that I, or another family member, stayed with my mother at all times during the day. I
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naively assumed that patients are actually safer in the hospital at night because patients
are sleeping and there are nurses present throughout the night.
I, like most people, did not know the extent to which patients suffer harm while in the
hospital – from medical negligence, mistakes, falls, or criminal activity. Yet, there really
was no way in which I could have known. Hospitals do not publicize this information.
Patients and their families may not talk publicly about what happened to them because
the memories are too painful or they are prevented from talking about what happened
because they signed a confidentiality agreement as part of a settlement with the
hospital.
Although hospitals are required to report hospital-acquired injuries, or “adverse events,”
many incidents still go unreported. Worse yet, the agency responsible for investigating
“adverse events” reported by a hospital, as well as complaints made by others, has
been accused of doing less than thorough investigations. I experienced that firsthand.
The investigative report regarding my mother’s death contained many inconsistencies
and inaccuracies, and even though I provided photos to the investigator it was apparent
they were never considered in the investigation. Although the hospital was cited for not
reporting her death, the hospital was not penalized in any way and my complaint was
concluded to be “unsubstantiated.”
DANGERS NOT DISCLOSED
It was not until shortly after my mother’s death that I discovered some disturbing
information about the hospital. Had I not trusted my instincts and taken matters into my
own hands and contacted the police, my mother would have become just another
statistic with a death certificate erroneously stating that her “manner of death” was
“natural.”
Unbeknownst to me and my family, and the public in general, there had been numerous
reports of trespassing, thefts, drug possession and assaults by persons not authorized
to be in the hospital. In addition, the Minnesota Department of Health had previously
investigated five complaints. The most disturbing discovery, however, was that police
had investigated an 81-year-old woman’s complaint that she had been sexually
assaulted in that same hospital, on that same floor, and in a room near my mother’s,
just two years earlier. Because hospital officials were aware of this, and aware of how
my mother was discovered, they should have immediately called the police to
investigate. However, they did not report my mother’s suspicious injury and death to the
police or to the medical examiner, or to the Minnesota Department of Health, and they
never informed me or my family about any previous criminal or negligent activity at the
hospital. I met with the daughter of the woman who alleged she had been sexually
3
assaulted and, in comparing experiences, we learned that hospital officials responded
almost identically to both of us. I also found out that another woman in the same
hospital was discovered on the floor and died under eerily similar circumstances six
months after my mother’s death. In that case, however, neither the family nor the
hospital reported the incident, so there was no investigation. Unfortunately, as in many
cases, the family did not know that there was anything they could do and initially
believed everything they were told.
NO HELP FROM HOSPITAL OFFICIALS
Hospital officials were in no way helpful and, in fact, tried to dissuade me and my family
in every way possible in our pursuit of the truth. They would not waver from their
position that my mother’s death was a result of an accidental fall, and consistently
repeated their refrain that “falls are common,” “even the weakest patients can get
superhuman strength,” and “you may never know what happened.” Hospital personnel
were told not to speak with us, and although some did, it was on the basis of anonymity
because they were afraid of losing their jobs. Even a year later, when my family and I
“picketed” outside the hospital handing out flyers and holding large posters offering a
$10,000 reward for information leading to the person or persons responsible for my
mother’s death, hospital personnel were afraid to stop and talk because they were being
observed from the upper windows. Those who did stop did not talk long because they
did not want to jeopardize their jobs.
THE DEATH OF AN ELDERLY PERSON HAS MINIMAL VALUE IN A LAWSUIT
Believing that my mother’s death was not due to an accidental fall and because the
medical examiner could not determine her manner of death, I began my search for a
medical malpractice attorney. In my opinion, not only should her injury not have
happened, but the care she received after the injury, and the way in which the hospital
responded afterwards, was appalling to me. Surely, this was a good case. Or so I
thought. I was wrong. After contacting dozens of attorneys, I discovered that the life of
an elderly person has very little monetary value. Unless there is undisputed evidence of
wrongdoing on the part of a hospital, and unless the wrongdoing is egregious enough to
justify a large punitive damages award, most attorneys are not willing to take a financial
risk. Over and over again, I kept hearing from attorneys that even though they believed
someone was negligent, the value of an elderly person’s life is just not significant
enough to make taking the case worthwhile.
Hospital officials are aware that patients and their families are not likely to succeed even
if they do find an attorney to bring a lawsuit against the hospital. It is very difficult to
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meet the requirements to bring a medical malpractice lawsuit to court. For the most part,
any damning evidence is likely in the hands of the hospital and not available to the
patient. And, a lawsuit is not really about what happened; it is about what you can
prove. When an elderly patient is injured or dies, it becomes that much more difficult.
Too often, elderly patients are viewed as expendable, bothersome, and just not worth
the effort. The same philosophy seems to carry over into the legal system. However, I
refused to give up.
IS THERE AN ATTORNEY WHO CARES MORE ABOUT MORALS THAN MONEY?
I continued my search to find an attorney with strong moral principles, someone who
would be able to see the injustice and wrongdoing that I saw in my mother’s case. After
almost three years, I found an attorney who took my case because he cared more about
morals than money. I am sure he never believed that he would even break even on this
case. Yet, against all odds and despite several attempts, the hospital was unsuccessful
in convincing the judge to dismiss my lawsuit. We ultimately reached a settlement and
did not go to trial.
THE NEED FOR A NON-PROFIT FOUNDATION FOR PATIENT SAFETY
After thinking long and hard about what to do after the settlement, I decided to create a
non-profit foundation in the name of my parents. The purpose of The Olivia and Howard
Geller Foundation for Patient Safety is to: 1) provide educational and advocacy
resources to patients and their families to ensure patient safety and facility
accountability; 2) increase public awareness of the dangers to patients in medical care
facilities; and 3) to reduce the number of preventable injuries and deaths of patients,
especially elderly patients in those facilities. Several years before my mother’s death,
my father had been admitted to a St. Paul nursing home for short-term rehabilitative
care after surgery. He had been there for only two days when we brought him home
because of the horrendous treatment he received in that facility. While stories about
nursing home abuse are prevalent now, such accounts were not common then. Few
people knew about what was going on behind closed doors, and those who did never
talked about it. Without knowledge of a problem, there can be no change.
Similarly, you cannot protect yourself against a danger you do not know exists. My
primary reason for creating this foundation is to make sure that patients and their
families know about the dangers patients commonly confront in the hospital and what
they can do to ensure their safety. The focus is on the kind of harm that patients have
some ability to prevent, not events that would be out of their control. This pamphlet
discusses ways in which a patient can survive their hospital stay without injury. It offers
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some lifesaving advice for patients and their families with information about what to do
before going into the hospital, what to do to stay safe while in the hospital, and what to
do if something bad does happen.
MORE TO COME…
I also hope to soon have a website set up for the foundation and intend to create a
database of health care facility complaints as well as a blog. I want patients and their
families to have a place where they can report their experiences and problems with a
particular facility, even if the complaint was not reported to the Minnesota Department of
Health or the agency concluded that the complaint did not warrant an investigation.
Furthermore, I anticipate providing additional advocacy resources so that people will
know who to contact if an incident occurs. And, although I am still researching the
relevant law and liability issues, I would like to make The Olivia and Howard Geller
Foundation for Patient Safety a source for “granny cams” (hidden cameras) that could
be used by family members who suspect that their loved one is being harmed by
someone in a healthcare facility. Finally, I hope to be able to provide a “patient sitter
service” that would be available for patients who do not have family members or friends
who are able to stay with them at the hospital.
My goal is to educate patients and their families about the dangers in the hospital
environment so they can take precautionary measures to avoid a preventable “adverse
event.” While I would like to make a difference in the lives of many patients, if just one
patient and their family is spared the trauma that my family experienced I will have
succeeded in reaching that goal.
Linda Geller Axelrod
[email protected]
(651) 243-0911
6
A HOSPITAL CAN BE A DANGEROUS PLACE
You probably think your loved one is safe in a hospital. In fact, you were probably
relieved when the doctor admitted them. There is no reason to believe a patient would
not be well cared for in that haven of healing. Right? And, like most people, you
probably assume that your loved one is much safer in the hospital than at home
because there are numerous nurses and medical staff around, especially at night.
Unfortunately, you have a false sense of security. And, nighttime is an especially
high-risk time for a patient in the hospital.
The fact that a hospital can be a dangerous place for a patient, especially an elderly
patient, is not well known and not well publicized. The statistics are alarming. 1 in 3
people who are admitted to a hospital suffer from a medical error or accident while
hospitalized, and patients have a 1 in 300 chance of being killed by one of those errors
or accidents. [http://health.lifegoesstrong.com/article/most-dangerous-place as reported in the journal
Health Affairs -] Compare that to the likelihood of dying in a plane crash, which is about 1
in 10 million. [http://health.usnews.com/health-news/managing-yourhealthcare/treatment/articles/2011/07/22/health-buzz-hospital-admission-more-dangerous-than-flying]
Many factors have contributed to hospitals becoming less safe than they were in the
past. As a result of budget cuts, there are fewer nurses to care for more patients. When
hospitals are short staffed, nurses who should be caring for patients are forced to
handle more administrative duties. And, in most cases, the patient’s own physician is
not seeing the patient in the hospital on a regular basis. Usually a doctor with little or no
knowledge about the patient and their history is “treating” the patient. If a patient is
elderly, they are more likely to be hard of hearing, confused, or overly medicated, and if
a family member does not stay with them during their hospital stay there is a significant
risk that harm will occur.
In addition to potential harm resulting from the mistakes and negligence of hospital staff,
patients are vulnerable to harm from other people in the hospital, such as visitors, other
patients, or trespassers. Because hospitals are open to the public and have a constant
stream of visitors, criminals can easily avoid detection. Some hospital personnel may
have a criminal history and a violent past that goes undetected due to the lack of a
thorough background check. Prison inmates may be hospitalized and staying in the next
room or across the hall. A patient’s roommate, or another patient, may have a criminal
history and wander the halls at night looking for an unsuspecting victim. Even nighttime
security measures can be evaded if an intruder is determined.
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Furthermore, if a criminal event occurs at a hospital, it is likely to be kept confidential,
and not reported to the police. There are many reasons why hospitals do not want this
information to become public. Negative publicity, lawsuits, increased scrutiny, and
damage to a hospital’s reputation are just a few. Yet, the safety of unsuspecting patients
is in jeopardy, and they and their families are not even given a chance to take
precautionary measures because they do not know about the danger. Because of the
non-disclosure of criminal activity, safety statistics are often misleading. Because of
confidentiality statutes, patient victims are prevented from obtaining relevant
information. Because internal hospital incident reports are kept confidential, if an
incident is not reported, there are no public records to review.
MOST ADVERSE EVENTS AT HOSPITALS GO UNREPORTED
So, why aren’t patients and their families outraged by these facts and statistics? The
reality is that most people just don’t know about them.
A 2010 report by the Office of the Inspector General of the Department of Health and
Human Services found that hospital staff failed to report 86% of serious reportable
events. [https://oig.hhs.gov/oei/reports/oei-06-09-00091.pdf] A serious reportable event is an
incident involving the death or serious harm to a patient that resulted from a lapse or
error in a healthcare facility. These events are referred to as “never events.” While it is
hard to believe that only about 1 in 7 incidents resulting in patient harm in a hospital
actually gets reported, it is even more disturbing to learn that the rate at which Medicare
beneficiaries suffer an “adverse event” has been estimated at 130,000 per month.
[http://ideas.time.com/2012/01/09/american-hospitals-the-most-dangerous-place/][(From Time Ideas); An
American Hospital: The Most Dangerous Place? - By Shannon Brownlee Jan. 09, 2012] [From the
Inspector General’s Report: Report (OEI-06-09-00091) / 01-05-2012 Hospital Incident Reporting Systems
Do Not Capture Most Patient Harm https://oig.hhs.gov/oei/reports/oei-06-09-00091.asp]
This shocking
statistic is unacceptable.
In Minnesota, hospitals have a legal obligation to report “adverse events” to the
Minnesota Department of Health. Below is a list of what are considered reportable
“adverse events” under Minnesota statutes 144.7065:
Surgical Events
1.
2.
3.
Surgery performed on a wrong body part that is not consistent with the documented informed
consent for that patient. Reportable events under this clause do not include situations requiring
prompt action that occur in the course of surgery or situations whose urgency precludes obtaining
informed consent;
Surgery performed on the wrong patient;
The wrong surgical procedure performed on a patient that is not consistent with the documented
informed consent for that patient. Reportable events under this clause do not include situations
requiring prompt action that occur in the course of surgery or situations whose urgency precludes
obtaining informed consent;
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4.
5.
Retention of a foreign object in a patient after surgery or other procedure, excluding objects
intentionally implanted as part of a planned intervention and objects present prior to surgery that
are intentionally retained; and
Death during or immediately after surgery of a normal, healthy patient who has no organic,
physiologic, biochemical, or psychiatric disturbance and for whom the pathologic processes for
which the operation is to be performed are localized and do not entail a systemic disturbance.
Product or Device Events
1.
2.
3.
Patient death or serious disability associated with the use of contaminated drugs, devices, or
biologics provided by the facility when the contamination is the result of generally detectable
contaminants in drugs, devices, or biologics regardless of the source of the contamination or the
product;
Patient death or serious disability associated with the use or function of a device in patient care in
which the device is used or functions other than as intended. Device includes, but is not limited
to, catheters, drains, and other specialized tubes, infusion pumps, and ventilators; and
Patient death or serious disability associated with intravascular air embolism that occurs while
being cared for in a facility, excluding deaths associated with neurosurgical procedures known to
present a high risk of intravascular air embolism.
Patient Protection Events
1.
2.
3.
An infant discharged to the wrong person;
Patient death or serious disability associated with patient disappearance, excluding events
involving adults who have decision-making capacity; and
Patient suicide or attempted suicide resulting in serious disability while being cared for in a facility
due to patient actions after admission to the facility, excluding deaths resulting from self-inflicted
injuries that were the reason for admission to the facility.
Care Management Events
1.
2.
3.
4.
5.
6.
7.
8.
Patient death or serious disability associated with a medication error, including, but not limited to,
errors involving the wrong drug, the wrong dose, the wrong patient, the wrong time, the wrong
rate, the wrong preparation, or the wrong route of administration, excluding reasonable
differences in clinical judgment on drug selection and dose;
Patient death or serious disability associated with a hemolytic reaction due to the administration
of ABO/HLA-incompatible blood or blood products;
Maternal death or serious disability associated with labor or delivery in a low-risk pregnancy while
being cared for in a facility, including events that occur within 42 days postdelivery and excluding
deaths from pulmonary or amniotic fluid embolism, acute fatty liver of pregnancy, or
cardiomyopathy;
Patient death or serious disability directly related to hypoglycemia, the onset of which occurs
while the patient is being cared for in a facility;
Death or serious disability, including kernicterus, associated with failure to identify and treat
hyperbilirubinemia in neonates during the first 28 days of life. “Hyperbilirubinemia” means bilirubin
levels greater than 30 milligrams per deciliter;
Stage 3 or 4 ulcers acquired after admission to a facility, excluding progression from stage 2 to
stage 3 if stage 2 was recognized upon admission; and
Patient death or serious disability due to spinal manipulative therapy; and
Artificial insemination with the wrong donor sperm or wrong egg.
Environmental Events
9
1.
2.
3.
4.
5.
Patient death or serious disability associated with an electric shock while being cared for in a
facility, excluding events involving planned treatments such as electric countershock;
Any incident in which a line designated for oxygen or other gas to be delivered to a patient
contains the wrong gas or is contaminated by toxic substances;
Patient death or serious disability associated with a burn incurred from any source while being
cared for in a facility;
Patient death or serious disability associated with a fall while being cared for in a facility; and
Patient death or serious disability associated with the use of or lack of restraints or bedrails while
being cared for in a facility.
Criminal Events
1.
2.
3.
4.
Any instance of care ordered by or provided by someone impersonating a physician, nurse,
pharmacist, or other licensed health care provider;
Abduction of a patient of any age;
Sexual assault on a patient within or on the grounds of a facility; and
Death or significant injury of a patient or staff member resulting from a physical assault that
occurs within or on the grounds of a facility.
While it is difficult, if not impossible, to prove how many cases involving adverse events
go unreported in Minnesota, it would be a mistake to assume that a hospital will act
responsibly and report an incident to the Minnesota Department of Health. You must
take it upon yourself to file a complaint and report it yourself.
FALLS ARE THE NUMBER ONE CAUSE OF INJURY TO HOSPITAL PATIENTS
Even in Minnesota, the number of patients who suffer serious harm or death related to
preventable errors in medical care continues to increase. In its January 31, 2013 report,
the Minnesota Department of Health found that while the total number of adverse
events in hospitals stayed about the same as the previous year, more hospitalized
patients suffered serious harm or death related to these events. Worse yet, most of the
increase in the serious harm or death of a patient occurred as a result of a serious fall,
an incident that can, and should, be prevented in a hospital. According to the Centers
for Medicare and Medicaid, inpatient hospital falls are considered to be “preventable,”
and healthcare facilities are held accountable for the costs of treating any injuries that
result from the fall.
A fall is the number one cause of injury to a hospitalized patient. And, patients who
suffer a fall in the hospital are often left with a severe injury, such as a traumatic brain
injury, which can result in death. [http://www.jacksonwhitelaw.com/az-personalinjury/2012/05/04/patients-falling-in-hospitals-causes-widespread-concern/] About 30% of inpatient
falls result in serious injury, with the majority of falls occurring in patients’ rooms and in
bathrooms. [Evidence-based Falls Prevention in Critical Access Hospitals – Policy Brief #24 Dec. 2011]
Nurses heard a loud thud then discovered that a 90-year old Massachusetts
hospital patient had fallen in her room and hit the back of her head on the metal
sill of a closet. The woman got up and, at first, she seemed okay. She was
awake, talking, and complaining only about a sore back. Shortly thereafter,
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however, she became unresponsive and died a few hours later. Cause of death –
traumatic brain injury due to the fall.
An 81-year-old woman at high risk for falling was hospitalized in Virginia, fell out
of bed, fractured her hip, and then suffered a stroke. She was permanently
disabled and won a $3.5 million verdict against the hospital, which for decades
had problems with in-patient falls. In this case, the nurses failed to turn on the
patient’s bed alarm because it often was set off by accident and they were too
often inconvenienced.
YOU MAY NEVER KNOW WHAT HAPPENED!
Most people are not aware of the dangers in hospitals, and when something happens
they do not know who to turn to or what to do. Usually, they rely on hospital personnel
for answers. But, hospital officials can rarely provide an explanation. When confronted
with questions after an injury, a standard response tends to be “it just happens,” or
“unfortunately it’s a common occurrence,” or “you may never know what happened.”
This is a lot like what school administrators said in the past to the parents of children
who were bullied at school or what employers said to employees who were being
sexually harassed in the workplace. This type of reaction and response is no longer
acceptable in schools or the workplace and should no longer be acceptable in
healthcare facilities.
Hospitals have a duty to protect their patients, yet with nursing shortages, high patientto-staff ratios, inefficient work environments, and with more interest in the bottom line
than in patient safety, there will likely be more patient falls. Also, without consistency in
staffing and with insufficient communication, a patient may be cared for by a nurse who
is not aware of the patient’s risk of falling. Many of the hospital nursing staff may be
part-time, substitutes, or weekend employees only. The nurse may not take time to read
the patient’s chart, may not understand English, may be tired from working a double
shift, may not want to bother anyone else for additional help, or they may just not want
to be bothered at all – especially at night. Patients may be left alone leaning against a
bed or a wall, or even propped up in a chair. In the blink of an eye, that patient can
suffer a fatal fall. And, without anyone else in the room, it is unlikely you will ever find
out what happened or who is to blame. Hospital administration may tell you that “you
may never know what happened,” “falls are very common,” or, if the patient was too
weak to even turn over on their own, “patients sometimes get super-human strength!”
Cases involving elderly neglect, abuse or even murder often go unreported,
unrecognized, and therefore may never be investigated. Without intervention by
concerned family members or a whistleblower, the truth may remain hidden forever.
Frequently, an elderly patient’s physician will report that the patient’s death resulted
from natural causes when, in fact, an investigation would have revealed something else.
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In a recent study, nearly half of the doctors surveyed failed to identify the correct cause
of death in an elderly patient who sustained a brain injury caused by a fall. And, in most
states, a physician can issue a death certificate without ever seeing the body of the
deceased. This is how a doctor in Pennsylvania stated her 83-year-old patient died of
natural causes when he had actually been beaten to death by an aide. The doctor did
not see the 16-inch bruise that covered the patient’s left side.
[http://www.propublica.org/article/gone-without-a-case-suspicious-elder-deaths-rarely-investigated]
Today, autopsies are rarely performed on elderly patients. One concerned physician,
however, took it upon himself to expose the problem of inaccurate death certificates and
misdiagnoses. In 2008, the chief medical examiner in Seattle, Washington, started a
program to confirm fatalities that listed the cause of death as “natural.” By 2010, the
program discovered 347 serious misdiagnoses, with two being homicides and more
than 100 caused by falls or choking. [http://www.propublica.org/article/gone-without-a-casesuspicious-elder-deaths-rarely-investigated] Because Medicare, Medicaid, and private
insurance do not generally cover autopsies, hospitals have a strong monetary incentive
to avoid performing them. [http://usaforensics.com/faqs/]
DON’T LET THE HOSPITAL BURY ITS MISTAKES
Researching the hospitals in your area is a good idea, but it is not always possible to
get a clear picture of what complaints were previously made about a particular facility.
The Office of Health Facility Complaints (OHFC), a part of the Minnesota Department of
Health, determines whether a complaint warrants an investigation, and it will issue a
report concluding whether the complaint is substantiated, unsubstantiated or
inconclusive. There has been some concern about the quality and accuracy of the
investigations conducted by the OHFC, as well as the fact that the investigative reports
are only available for a limited period of time. Consequently, the information you do
obtain about a hospital may give you a false sense of security.
If a hospital patient’s death is unexpected or suspicious, do not assume that they died
from the illness for which they were hospitalized. Trust your instincts. If something
doesn’t feel right or look right, there is probably a need for an investigation. In many
situations, hospital personnel will not admit that they made a mistake or that they were
negligent in any way. In other circumstances, hospital administration may even try to
cover up mistakes by directing staff to alter or destroy records or not speak to anyone
about what they know. In too many cases, a hospital can just bury its mistakes. Without
an autopsy, and with a treating physician who issues a death certificate listing an
inaccurate cause of death and the manner of death as “natural,” you will never know
what happened!
If not for concerned family members of patients and ethical hospital employees who
refuse to be silenced, many cases of hospital mistakes and negligence would go
unnoticed and unreported.
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A student resident doctor in Queens, New York, blew the whistle on a hospital
which refused to tell the family of a patient how their loved one actually died.
Medical staff failed to properly monitor the patient and the resident doctors were
directed to not tell the family what actually happened. The hospital withheld the
patient’s medical records and the family was continually informed that “these
things happen...” Neither the family nor the Health Department would have
discovered the truth if it had not been for the resident doctor who put justice and
ethical behavior above obeying orders.
[http://abclocal.go.com/wabc/story?section=news/investigators&id=7737042]
A Minnesota hospital employee left the hospital with more than 200 pages of
confidential patient files. The employee claims that she was told by her
supervisor to remove and destroy any information that might be unfavorable to
the hospital in any future negligence case because it could not afford to pay out
another large settlement. Fearing that someone else would destroy the files if
she didn’t, the employee took the records home for safekeeping. The hospital
denies the employee’s allegations, but a federal judge has allowed the employee
to keep the files in her home until the trial is over.
[http://www.startribune.com/local/185820902.html?refer=y]
PATIENTS HARMED BY CRIMINAL ACTS
Not only are patients in danger of being harmed by medical errors and accidents, such
as falling, there are other dangers to them that lurk in the hospital. The reality is that
crimes, such as physical assault, sexual assault, theft and even murder, also occur in
hospitals, typically at night. The criminal act is often committed by a trespasser or
intruder, but a patient may also be harmed by another hospitalized patient or even
hospital personnel. These types of criminal acts are often not reported by the hospital,
and the offender may never be found or punished.
A 54-year-old woman was asleep in her hospital bed when she was sexually
assaulted by another patient at a St. Paul hospital. The male patient was charged
with criminal sexual conduct after he entered her room around 6:00 a.m. and
groped her while she slept. [http://www.twincities.com/localnews/ci_21376729/st-paul-stjosephs-hospital-patient-sexually-attacked]
An elderly woman was asleep in her hospital bed when she was sexually
assaulted during the early morning hours in a St. Paul hospital. She awoke to
find a man next to her bed, pulling the curtain shut. Although she reported the
crime to the hospital and to the police, no one was ever charged with the crime
because she never saw his face. [Star-Tribune Article published December 24, 2005 by
Curt Brown]
13
A woman who had given birth the previous day was assaulted by a hospital
trespasser while she was a patient at a hospital in St. Paul. The patient was
alone in her room around 2:00 a.m. when a man, who had previously been seen
trespassing in the hospital and suspected of several hospital thefts, attacked and
severely injured her. Before the attack on this patient, there had been other
incidents of trespassing, theft, and undesirable conduct of persons within the
hospital.
[http://www.leagle.com/xmlResult.aspx?xmldoc=19861236380NW2d856_11156.xml&docbase=C
SLWAR2-1986-2006]
A hospital employee stole money and jewelry from a female patient while she
was asleep. The male employee was arrested on charges of grand larceny,
forgery and identity theft charges after police said he took a purse from the
woman’s hospital room. [http://www.newsday.com/long-island/nassau/cops-hospital-workerstole-from-patient-1.3611862]
An Alabama woman, admitted to the hospital for kidney stone treatment, became
the victim of a sexual assault. A male intruder entered her hospital room at
approximately 6:00 a.m. He found the patient lying in her hospital bed, helpless
from being heavily sedated from a pain medication injection, and sexually
assaulted her. [http://scholar.valpo.edu/cgi/viewcontent.cgi?article=1940&context=vulr]
An elderly woman’s wedding ring was stolen in the middle of the night while she
was asleep and a inpatient at a St. Paul hospital. It was never recovered.
The Office of Health Facility Complaints (OHFC) is part of the Minnesota Department of
Health (MDH) and is responsible for investigating complaints regarding in licensed
health care facilities in Minnesota and for reviewing and investigating complaints under
the federal Medicare and Medicaid certification requirements.
[http://www.health.state.mn.us/divs/fpc/2011ohfcfinalrpt.pdf] In addition, the
Department of Human Services (DHS) has the responsibility of protecting vulnerable
adults, such as the elderly, by preventing individuals from working in licensed programs
if they are more likely than others to harm people or steal property - in other words,
people with a criminal history.
[http://www.msgc.state.mn.us/projects/collateral_sanctions/Collateral_Sanctions_DHSReport_2008.pdf ]
Although health care workers are subject to criminal background checks, their new
employer can ask the Minnesota Department of Health to ignore any previous
wrongdoing and allow them to work. In other words, the law does not prevent the
14
Minnesota Department of Health from granting a waiver to a convicted felon that will
allow them to work with vulnerable adults in a health care facility.
WHAT CAN PATIENTS AND THEIR FAMILIES DO?
So, now that you have read about some of the dangers in the hospital environment,
what can patients and their families do to ensure a safe hospital stay?
Following is some lifesaving advice about what to do before going into the hospital, how
to stay safe while in the hospital, and what to do if a patient is harmed in the hospital.
The information provided in this pamphlet considers ways to prevent harm that are not
completely outside of the control of patients and their families.
You will also find resources and contact information for various agencies and Web sites
in the event you need to obtain medical records, research a hospital or healthcare
provider, or file a complaint against a healthcare facility or caregiver.
15
WHAT TO DO BEFORE GOING INTO THE HOSPITAL
It is always scary when you, or someone you love, must be hospitalized. But, doing a
little research beforehand and following the recommendations below may help to
alleviate some of that fear and improve the safety of the hospital stay.
•
ASK QUESTIONS!
And, make sure you get sufficient answers to those questions.
•
UNDERSTAND WHY YOU ARE BEING HOSPITALIZED.
Is there an option of being treated at home instead?
•
IS THERE ONLY ONE HOSPITAL AVAILABLE?
Or do you have a choice among several? If so, do some research to find
out which one is the best for your needs.
•
RESEARCH THE QUALITY OF CARE AT THE CHOSEN HOSPITAL.
Determine whether, and how many, adverse events have been reported
and/or investigated at that facility.
•
DO AN INTERNET SEARCH.
Search the name of the hospital and the doctor(s) involved in your care.
There is often additional information online that may not be found in state
investigative reports or on quality of care websites.
16
•
IF YOU ARE HAVING SURGERY, ASK THE DOCTOR ABOUT HIS OR
HER EXPERIENCE IN PERFORMING THE PROCEDURE.
Ask specific questions, such as how many procedures the doctor performs
each year, what the success rate is, how long the doctor has been
performing the procedure, and whether the doctor is board certified. You
can find out whether a doctor is board certified at
http://www.certificationmatters.org/.
•
RESEARCH YOUR DOCTOR.
Go to the Minnesota Medical Board of Practice Database at
http://www.docboard.org/mn/df/mndf.htm to get license information and
find out whether the doctor has been subject to any disciplinary action.
•
CHECK THE MINNESOTA TRIAL COURT PUBLIC ACCESS
RECORDS.
You can search criminal and civil records in Minnesota at
http://pa.courts.state.mn.us/default.aspx to find out if there have been any
lawsuits involving your hospital or doctor.
•
ASK THE DOCTOR IF HE OR SHE HAS ANY CONCERNS ABOUT THE
HOSPITAL.
Although the doctor may not have knowledge about problems with a
particular hospital, ask him or her if they have any concerns about the
hospital in which you will be staying and if there is anything you can, or
should, do to ensure your safety and well-being.
•
LET THE DOCTOR AND HOSPITAL STAFF KNOW IF YOU HAVE ANY
CONCERNS ABOUT YOUR SAFETY IN THE HOSPITAL AND ASK
ABOUT PATIENT SAFETY.
17
Do not be afraid to tell the doctor and hospital staff if you have any
concerns about your safety in the hospital, whether it has to do with
medical errors, infections, falls, or criminal acts. Be sure to ask about what
is being done to ensure patient safety.
•
BE SURE THAT YOU UNDERSTAND WHY YOU ARE BEING
HOSPITALIZED.
You need to know why you are being hospitalized, what will be done to
you while you are in the hospital, and what you should expect after you go
home.
•
MAKE A LIST OF THE MEDICATIONS YOU ARE CURRENTLY TAKING
AND BRING IT TO THE HOSPITAL WITH YOU.
Ask your doctor what medications will be given to you in the hospital, and
find out whether you need to bring any of your current medications to the
hospital. After you are admitted, be sure that you are, in fact, being given
the correct medications at the appropriate times.
•
BRING A SPIRAL NOTEBOOK AND PENS TO THE HOSPITAL WITH
YOU.
Bringing a notebook and pens to the hospital will give you something in
which to keep track of the names of your caregivers and a place to record
any concerns you may have about your treatment and hospital care.
•
BRING A DIGITAL VOICE RECORDING DEVICE TO THE HOSPITAL.
18
Bring a voice recorder with you and keep it within an easy reach. It can be
used to record conversations with caregivers in case there are questions
about the information or instructions provided to you. Also, if any abuse or
maltreatment is suspected, a recording can be made of the improper
conduct.
•
SPEAK UP IF YOU DO NOT FEEL THAT ALL QUESTIONS AND
CONCERNS HAVE BEEN ANSWERED OR ADDRESSED.
If the patient is unable or unwilling to ask the necessary questions, a
family member or friend must act as an advocate on their behalf.
•
GIVE POWER OF ATTORNEY TO A RELATIVE OR FRIEND WHO CAN
ACT ON YOUR BEHALF.
If something happens and the patient becomes unable to make his or her
own decisions, a power of attorney will give someone else the right to act
on the patient’s behalf. This is especially important if medical records are
needed.
•
BRING A COPY OF YOUR HEALTH CARE DIRECTIVE TO THE
HOSPITAL.
A health care directive is a written document that informs others of your
wishes about your health care. It allows you to name a person to act on
your behalf and make decisions for you if you are unable to do so.
•
BE AWARE OF THE PATIENTS’ BILL OF RIGHTS.
You should know what your rights are before you are admitted to the
hospital so that you can be sure they are not being violated.
19
•
ASK YOURSELF IF YOU FEEL COMFORTABLE WITH THE CHOSEN
HOSPITAL AND THE SELECTED DOCTOR.
After considering the answers given in response to your questions and
concerns, ask yourself if you feel comfortable with the chosen hospital and
the selected doctor. If not, make a change.
HOW TO STAY SAFE WHILE YOU ARE IN THE HOSPITAL
•
KNOW THE NAMES OF ALL OF YOUR CAREGIVERS.
If there is a whiteboard in the room, have each caregiver write their name
on it. Also, make sure that your name is on the whiteboard and that your
caregivers know who you are and that they call you by name. If there is
not a writing surface in the room, be sure to jot down the names on a
piece of paper or in a notebook.
•
CONFIRM THAT EVERYONE WHO COMES IN CONTACT WITH YOU
HAS WASHED THEIR HANDS.
Hospitals are full of germs, and it is not rude, and no one should be
offended, if you ask them to wash their hands before touching you. Hand
sanitizer should be available inside your room or just outside the door in
the hallway.
•
HAVE SOMEONE STAY AT THE HOSPITAL WITH YOU.
It is important to have someone stay with you in the hospital as much as
possible. Family and friends can act as your advocate, provide extra eyes
and ears when a doctor or nurse is discussing your treatment plan, and
will be able to speak on your behalf if you are sedated, critically ill, or not
as alert as you need to be. It is especially important to have someone with
you overnight.
•
KNOW WHAT MEDICATIONS YOU SHOULD BE GIVEN – AND WHEN.
20
Even though the hospital and your nurses have your medication schedule,
write it down yourself and know what you are supposed to be given, and
when.
•
BE SURE THAT ALL NURSES AND DOCTORS READ YOUR CHART.
Mistakes can often happen after a shift change when a caregiver is not
given necessary information about your care or does not bother to read
through your chart.
•
AVOID A DANGEROUS AND POTENTIALLY FATAL FALL.
If you are a “falls risk” be sure that everyone caring for you knows what
they need to do to keep you safe. If you require two people to get you out
of bed, do not be afraid to say something if one person thinks they will be
able to move you without help. Do not get out of bed without help,
especially if you feel lightheaded, dizzy or unsteady. Use the nurse call
button to ask for assistance. If there is no response to your light within a
reasonable time, ask someone in your room to find a nurse, use your
phone to call the hospital operator and tell them what room you are in and
that you need help right away, or simply yell for a nurse.
•
BE SURE THAT YOUR CAREGIVERS CAN SPEAK AND
UNDERSTAND YOUR LANGUAGE.
If you have reason to believe that someone assigned to your care does
not understand you, or you cannot understand them, demand that they be
replaced with someone who can clearly communicate with you. Mistakes
happen when there is miscommunication and confusion, and those
mistakes can be deadly. If a caregiver cannot communicate with you, it is
likely they will not understand instructions given to them about your
treatment.
•
BE CONCERNED IF A NURSE LOOKS EXHAUSTED OR
DISTRACTED, ASK THEM IF THEY ARE WORKING A DOUBLE SHIFT
OR ARE CARING FOR TOO MANY PATIENTS.
Be aware that with staff reductions, increased administrative duties, and
higher patient-to-nurse ratios, nurses are working under less than ideal
conditions. Patient safety suffers when nurses are required to work longer
hours or double shifts. If this is the case, you should be extra cautious and
have someone verify that you are being given the correct medications,
receiving proper care, and will have sufficient and timely help if you need
it.
21
•
BE POLITE, BUT BE ASSERTIVE.
Your care is in the hands of strangers who do not know you and may not
be aware of your needs. If you require help, if you think something is
wrong, or if you have questions about your care, do not hesitate to ask.
And, do not stop asking until you have a satisfactory answer. But, ask
nicely. Being rude, confrontational and belligerent will not get you what
you want.
22
WHAT TO DO IF A PATIENT SUFFERS HARM IN THE HOSPITAL
If a patient suffers harm in the hospital, whether it is from a medical error, infection, fall
or criminal act, immediate action must be taken by the patient’s family. It is important to
protect the patient from additional harm, determine what happened and who is
responsible, and obtain and preserve evidence that will aid in an investigation.
•
BE THERE and BE AWARE!
After a patient suffers an injury acquired in the hospital, a family member
or close friend must act as the patient’s advocate. They must “be there
and be aware” of everything that is happening, and of everything being
said and done about the incident and injury.
•
GET A COPY OF THE PATIENT’ S MEDICAL RECORDS.
Every patient has a legal right to obtain their medical records, and it is
important to get a copy of these records as soon as possible after any
harm occurs. The medical records can provide crucial evidence about the
patient’s care, or any lapse in care, and the sooner they can be obtained
the less likely they can be altered or “lost.” The patient, or someone with
power of attorney, can request a complete copy of the patient’s medical
records from the hospital’s medical records department. If the patient’s
condition is serious and likely to result in death, request those records
immediately. Have the patient sign the request for medical records if they
are able to do so, or have the person with power of attorney make the
request. It is important to know that a power of attorney is effective only
while the person who granted it is alive – the power of attorney ends with
the person’s death.
If the patient died from the injury before a request for medical records
could be made, the records will be more difficult to get. In Minnesota, a
surviving spouse or parents of the deceased have the right to obtain the
medical records. Otherwise, only a court-appointed representative, such
as a personal representative, executor, or estate administrator may be
able to get the patient’s medical records.
It is also important to note that there is a charge for copying the records
and sometimes the files can be quite large. More specific information
about how to obtain medical records can be found at the end of this
booklet.
23
•
DOCUMENT EVERY DETAIL-- ON PAPER, ON A COMPUTER, ON A
VOICE RECORDER, AND/OR WITH A CAMERA.
As soon as possible, write down everything you can remember about what
happened. Include names, dates, times and all details, even if they seem
irrelevant at the moment. Make a timeline of what occurred. Document
everything on paper, on a computer, on a voice recorder, and with a
camera – whatever is readily available.
If you have a digital recording device or a video camera, record the
patient’s description of what happened. This is important because if there
is a change in the patient’s condition, and they are no longer able to
provide a report of the incident, you will still have their first-hand account
of what they remembered.
A digital voice recorder is indispensable. In addition to using it to record an
account of what happened, you can also use it to record your
conversations with hospital personnel and others while discussing the
incident. This is legal in Minnesota if just one party in the conversation is
aware that the conversation or call is being recorded. This means that if
you are making the recording, only you need to know that the
conversation is being recorded. [Minn. Stat. §626A.02, Subd. 2(d)
provides that it is legal for a person to record an oral or electronic
communication if that person is a party to the conversation or if one of the
parties being recorded has consented to the recording so long as there is
no criminal or tortious intent.]
If you have a camera, take photos of everything that may be relevant. This
may include photos of the patient and close-up photos of the injury, photos
of the room, photos of equipment and other medical devices, and anything
else that could be relevant in an investigation.
•
REPORT THE INCIDENT IMMEDIATELY TO THE HOSPITAL.
Ask hospital personnel for the name of the person to whom the incident
should be reported. An accredited hospital is required by law to report
“adverse events” to the state health department. It must also conduct its
own internal investigation in an effort to determine what happened and
how the patient was injured.
If a patient suffers a hospital-acquired injury, it is likely that a hospital
representative will “visit” the patient – or the patient’s family – to begin the
reporting process. However, do not wait until this happens before
reporting the injury yourself. Most importantly, do not expect a hospital
representative to be unbiased and do anything other than protect the
interests of their employer – the hospital.
24
•
CALL THE POLICE IF THE INCIDENT IS SUSPICIOUS AND YOU
BELIEVE IT MAY INVOLVE A CRIMINAL ACT.
If the circumstances under which the patient was injured are suspicious, or
if you think hospital personnel are not providing truthful information about
the incident, or if you believe the patient was injured as a result of a
criminal act, do not hesitate to call the police. You will be asked to provide
information about what happened and the police will determine whether an
investigation is warranted. If you believe that the police should be
involved, do not let any hospital employee intimidate, threaten, or coerce
you into not making that call.
•
DEMAND AN AUTOPSY IF THE PATIENT DIED.
Demand an autopsy if the death of the patient was unexpected and/or a
result of the hospital-acquired incident. Do not assume that the patient
died from “natural causes” or let a doctor or other hospital employee
persuade you that an autopsy is not necessary. Unfortunately, many
patients, especially those who are elderly, are buried along with the truth
about their cause of death.
•
CALL AN ATTORNEY WHO SPECIALIZED IN MEDICAL
MALPRACTICE.
If a patient suffers harm while in the hospital, you need to contact an
attorney who specializes in the area of medical malpractice as soon as
possible. Ask family or friends if they know of anyone, search online for
medical malpractice attorneys in your area, check the yellow pages of
your phone book, call the Minnesota State Bar Association, or contact the
Olivia and Howard Geller Foundation for Patient Safety at
[email protected] or 651-243-0911. Medical malpractice
attorneys generally work on a contingent fee basis, which means that an
attorney will not receive a fee for their work unless there is a recovery or
award in the case. Therefore, try to get the most experienced attorney
possible. If the first attorney you talk to does not take your case, do not
give up! It may take some time, but continue the search. You may have to
talk to several attorneys before someone is willing to represent you.
•
MEET WITH HOSPITAL ADMINISTRATORS.
When a patient is admitted to the hospital for a medical problem, they do
not expect to suffer additional injuries, infections, or other serious
conditions as a result of medical negligence or intentional harm and they
should not be charged for the cost of any additional care. Set up a
25
meeting with hospital administrators as soon as possible and demand that
any additional medical bills relating to the hospital-acquired condition be
waived. Medicare and some other medical insurers will no longer pay for
additional care needed as a result of a hospital-acquired condition, and
the patient should not be billed for any of these costs. Record the
conversations between you and any hospital officials so that you have
some evidence about what was agreed to, and also be sure to get any
agreement in writing.
•
REPORT THE INCIDENT TO THE APPROPRIATE AGENCIES.
Do not assume that the hospital will report a hospital-acquired injury.
Studies have shown that a high percentage of reportable adverse events
are not reported by the hospital even though it is required to do so. There
are several different agencies in which you can file complaints, depending
upon what happened.
The Office of Health Facility Complaints (OHFC) is part of the Minnesota
Department of Health (MDH) and is responsible for investigating
complaints regarding licensed health care facilities in Minnesota. See
http://www.health.state.mn.us/divs/fpc/ohfcinfo/contohfc.htm for
information about filing a complaint.
File complaints regarding physicians with the Minnesota Board of Medical
Practice. See http://mn.gov/health-licensing-boards/medicalpractice/public/complaints/ for information about filing a complaint.
File complaints about nursing staff with the Minnesota Board of Nursing.
See http://mn.gov/health-licensing-boards/nursing/public/complaints/ for
information about filing a complaint.
Information about filing complaints about the quality of care or other
services a patient gets from a Medicare provider can be found at
http://www.medicare.gov/claims-and-appeals/file-acomplaint/complaints.html.
Medicare patients may also get help from Stratis Health, Minnesota’s
Medicare Quality Improvement Organization (QIO) if they have quality of
care concerns. Stratis Health’s Medicare Helpline phone number is 1-800444-3423.
The Joint Commission’s Office of Quality Monitoring evaluates complaints
about a health care organization that it accredits or certifies to determine if
it is in compliance with required standards. It does not resolve individual
complaints or disputed matters. A complaint may be filed online at:
http://jcwebnoc.jcaho.org/QMSInternet/IncidentEntry.aspx; by email at
26
[email protected]; by fax to 630-792-5636; or by mail to
Office of Quality Monitoring, The Joint Commission, One Renaissance
Blvd., Oakbrook Terrace, IL 60181.
27
ADDITIONAL RESOURCES
YOUR RIGHT TO MEDICAL RECORDS AND HOW TO GET THEM
Federal law requires hospitals and doctors to release medical records to patients who
ask for them. How to make sure you get your medical records:
1. KNOW YOUR RIGHTS - The federal Health Insurance Portability and
Accountability Act (HIPAA) governs access to medical records, gives hospitals
and doctors 30 days to respond to your request for medical records. Some states
have laws with a shorter time frame.
2. MAKE YOUR REQUEST IN WRITING – Bring your request to the hospital in
person, or fax the request, but either way get confirmation that the hospital
received it.
3. BE ASSERTIVE, AGGRESSIVE, AND GET MAD IF YOU HAVE TO if you are
denied the right to your medical records.
If you are not given access, you can file a complaint with the Office of Civil
Rights at the U.S. Department of Health and Human Services.
HOW TO OBTAIN MEDICAL RECORDS IN MINNESOTA
The process for requesting medical records, whether from a doctor’s office or a hospital,
is governed by the federal law known as HIPAA (Health Insurance Portability and
Accountability Act). HIPAA entitles every person the right to access his or her medical
records, obtain copies of them, and request amendments to them.
To request medical records, contact or visit the healthcare provider’s health information
management (HIM) department, sometimes called the medical records or health
information services department. If there is no HIM department, speak with the person
in charge of releasing patient records. The first thing you will need to do is complete an
authorization form.
Requesting another person’s records involves a different process. A patient’s records
will not be released to anyone other than the patient without a direct authorization
signed by the patient. If the patient is incapacitated or judged incompetent, legal
documents must be drafted and submitted to the HIM department before someone else
can access the records.
28
Another process is required when a person seeks to access the medical records of a
deceased person. The rights someone has under a healthcare proxy or power of
attorney will expire upon a patient’s death, and then only an executor of the estate can
gain access to records. [http://journal.ahima.org/2012/03/01/how-to-request-yourmedical-records/]
For yourself
In Minnesota you have the right to 1) look at and get a copy of your medical record; 2)
amend your medical record to make it more accurate or complete; 3) file a complaint
with the U.S. Department of Health and Human Services - Office for Civil Rights if you
believe your right to see, get a copy of, or amend your medical record has been
violated; and 4) you may bring a lawsuit in state court to obtain your medical record.
For a deceased relative
In Minnesota, a surviving spouse or the parents of a deceased patient have the right to
get the deceased patient’s medical records. A personal representative, executor, or
administrator of the deceased person’s estate also has the right to get a deceased
persons medical records.
For more specific information about your medical record rights in Minnesota at
http://www.hpi.georgetown.edu/privacy/stateguides/mn/mn.pdf
WHERE TO FIND MORE INFORMATION ABOUT A PATIENT’S RIGHT TO MEDICAL
RECORDS
The Minnesota Health Records Act provides information about a patient’s right to obtain
their medical records and is found in Minnesota Statutes 144.291-.298. See
https://www.revisor.mn.gov/statutes/?id=144.291
Section 144.291 definitions
Section 144.292 patient rights and access to their medical records, cost of copying
medical records, when records can be withheld
Section 144.293 release or disclosure of health records
Section 144.294 mental health records
Section 144.295 disclosure of health records for external research
Section 144.296 when copies of videotapes can be released
Section 144.297 independent medical examinations
Section 144.298 penalties when there is a violation of the statute
29
Below you will find more specific information about how to obtain medical
records from specific healthcare providers in Minnesota:
Allina Hospitals – United Hospital, Abbott Northwestern Hospital, Phillips Eye
Institute
You must submit a release form to obtain medical records. The release form for
Allina hospitals can be found at:
http://www.allinahealth.org/ahs/medicalservices.nsf/page/ROI_form.pdf/$FILE/R
OI_form.pdf
Send the request for to:
Health Information/ROI – Mail Route 10203
Allina Hospitals & Clinics
PO Box 43
Minneapolis, MN 55440-0043
Phone: 612-262-2300
Fax: 612-262-2323
Children’s Hospitals – Minneapolis and St. Paul
To obtain medical records you must submit an Authorization for Release/Request
of Information at:
http://www.childrensmn.org/web/hospitalservices/017968.pdf
You may submit your request to:
Children’s – Minneapolis’
Health Information Management
2525 Chicago Ave. So.
Mail stop 32-B701
Minneapolis, MN 55404
Phone: 612-813-6216
Fax: 612-813-6934
Children’s – St. Paul
Health Information Management
345 North Smith Ave.
Mail stop 70-102
St. Paul, MN 55102
30
Phone: 651-220-6150
Fax: 651-220-5079
Fairview Health Services
You must submit an Authorization for Release of Protected Health Information
release form to obtain medical records. The release form can be found at:
http://www.fvfiles.com/155306.pdf
You may submit your request form to:
Fairview Lakes Medical Center
Health Information Management
5200 Fairview Blvd., Wyoming, MN 55092
Phone: 651-982-7870; Fax: 651-982-7122
Fairview Northland Medical Center
Health Information Management
911 Northland Dr., Princeton, MN 55371
Phone: 763-389-6522; Fax: 763-389-6545
Fairview Ridges Hospital
Health Information Management
201 East Nicollet Blvd., Burnsville, MN 55337
Phone: 952-892-2000; Fax: 952-892-2024
Fairview Southdale Hospital
Release of Information, LL25
6401 France Ave. S., Edina, MN 55435-2199
Phone: 952-924-1414; Fax: 952-924-8443
HealthEast Hospitals – St. John’s Hospital, St. Joseph’s Hospital or Woodwinds
Health Campus
You must submit a release form to obtain medical records. The release form for
HealthEast hospitals can be found at:
http://www.healtheast.org/images/stories/forms/hospital-releaseform.pdf
Send the request form to:
HealthEast Hospitals Release of Information Services
University Park Medical Building, Suite 180
1690 University Ave. W.
St. Paul, MN 55104
31
Phone: 651-232-4999
Fax:
651-232-4887
Hennepin County Medical Center – HCMC
To obtain medical records, you must submit the Authorization to Release Health
Information form at
http://www.hcmc.org/a_z/documents/patientinformationreleaseform.pdf
You may submit your request by:
Faxing it to 612-904-4332; or
Sending it to:
HIM Dept. at Hennepin County Medical Center
701 Park Ave.
Minneapolis, MN 55415
Mayo Clinic – Rochester, MN
You must submit a release form to obtain medical records. The release form for
the Mayo Clinic can be found at:
http://www.mayoclinic.org/mcitems/mc0001-mc0099/mc0072-01.pdf
To obtain medical records, call 507-284-4594 for further information. You can
also fax your request to 507-284-0161.
Regions Hospital – St. Paul, MN
You must contact Regions Hospital Release of Information at 651-254-2468 to
request copies of medical records.
University of Minnesota Medical Center, Fairview
University of Minnesota Amplatz Children’s Hospital
You must submit a release form to obtain medical records. The release form can
be found at:
http://www.fvfiles.com/155306.pdf
You may submit your request form to:
University of Minnesota Medical Center, Fairview
University of Minnesota Amplatz Children’s Hospital
Health Information Management Services
32
West Bank: 2450 Riverside Ave., Minneapolis., MN 55454
Phone: 612-273-4359
Fax: 612-273-4069
East Bank: 420 Delaware St. S.W., Minneapolis, MN 55455
Phone: 612-626-3238
Fax: 612-273-2345
WHERE TO FIND INFORMATION AND FILE COMPLAINTS ABOUT
HOSPITALS AND OTHER HEALTHCARE FACILITIES
The Minnesota Department of Health and the Minnesota Hospital Association produce
an annual report of adverse events in Minnesota hospitals, ambulatory surgery centers
and regional treatment centers.
Minnesota Department of Health – Patient Safety Home Page
Search for adverse events at Minnesota hospitals and other facilities at:
http://www.health.state.mn.us/patientsafety/
Minnesota Adverse Health Events Reports and Fact Sheets
Search Minnesota Department of Health publications and reports on patient safety and
adverse events at:
http://www.health.state.mn.us/patientsafety/publications/index.html
Minnesota Office of Health Facility Complaints (OHFC)
The OHFC is part of the Minnesota Department of Health. Contact the OHFC regarding
complaints, questions, or concerns relating to licensed facilities, such as
hospitals; nursing homes; boarding care homes; supervised living facilities; assisted
living; and home health agencies at:
http://www.health.state.mn.us/divs/fpc/ohfcinfo/contohfc.htm
How to contact the OHFC:
By telephone at (651) 201-4201 or Toll Free 1-800-369-7994
In writing to:
Office of Health Facility Complaints
P.O. Box 64970
St. Paul, MN 55164-0970
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By Email: [email protected]
Minnesota Consumer Guide to Adverse Health Events
In the Minnesota Consumer Guide to Adverse Health Events you can find a list of
adverse events reported by each hospital and surgical center in Minnesota in 2012. A
copy of this publication can be found at:
http://www.health.state.mn.us/patientsafety/publications/consumerguide13.pdf
Call the Minnesota Department of Health at 1-800-369-7994 to file a complaint about a
hospital. Or call 651-201-5807 with questions about adverse events.
The Joint Commission
An independent, not-for-profit organization, The Joint Commission accredits and
certifies more than 20,000 health care organizations and programs in the United States.
Joint Commission accreditation and certification is recognized nationwide as a symbol
of quality that reflects an organization’s commitment to meeting certain performance
standards. Its mission is to continuously improve health care for the public, in
collaboration with other stakeholders, by evaluating health care organizations and
inspiring them to excel in providing safe and effective care of the highest quality and
value.
The Joint Commission uses information from a variety of sources to improve the quality
and safety of the health care organizations it accredits and certifies. One of these
sources is complaints from patients, their families, government agencies, and the public,
as well as from an organization’s own staff and the media. When the Joint Commission
receives a complaint, it will initially evaluate whether it relates to one or more Joint
Commission standards. If so, the evaluation will then focus on assessing the
organization’s overall compliance with those standards.
Complaints can be reported online, by e-mail [email protected], phone
800-994-6610, fax 630-792-5636, or mail: Office of Quality Monitoring, The Joint
Commission, One Renaissance Boulevard, Oakbrook Terrace, Illinois, 60181.
A complaint can be filed at: http://jcwebnoc.jcaho.org/QMSInternet/IncidentEntry.aspx.
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COMPARING MINNESOTA HOSPITALS
The Minnesota Hospital Quality Report website provides information by hospitals on
quality of care and patients’ experiences. Consumers can use this information to
compare hospitals in order to help them make decisions about future hospital care.
This website is at: http://www.mnhospitalquality.org/
WHERE TO FIND INFORMATION AND FILE COMPLAINTS ABOUT
PHYSICIANS
Minnesota Board of Medical Practice – Health Professional Database
Find licensing information about physicians and surgeons, respiratory therapists,
physician assistants and other health professionals. Information provided includes
license number and type, date of original license and expiration date, and whether any
disciplinary action has been taken against health professional at:
http://www.docboard.org/mn/df/mndf.htm
WHERE TO FIND INFORMATION AND FILE COMPLAINTS ABOUT
NURSES
Minnesota Board of Nursing –
Look up a nurse's license information:
https://www.hlb.state.mn.us/mbn/Portal/DesktopDefault.aspx?tabindex=0&tabid=41
Download lists of recent and current actions taken by the board against a nurse's
license:
http://mn.gov/health-licensing-boards/nursing/public/discipline/
Review the Minnesota Board of Nursing report of all individuals for whom disciplinary
action has been taken: http://mn.gov/health-licensing-boards/images/Report-of-AllIndividuals-Under-Action.pdf
Obtain information about nursing assistants who have substantiated finding of abuse,
neglect, and misappropriation of property
http://mn.gov/health-licensing-boards/nursing/public/nursing-assistant-registry/
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How to contact the Nursing Assistant Registry for information about a specific nursing
assistant:
By telephone, between 9:00 a.m. to 3:00 p.m., Monday through Friday, at
(651) 215-8705 or Toll Free, Greater Minnesota 1-800-397-6124
In writing to:
Nursing Assistant Registry
P.O. Box 64501
St. Paul, Minnesota 55164-0501
By Email: [email protected]
How to file a complaint about a registered nurse (RN), advanced practice registered
nurse (APRN), or licensed practical nurse (LPN) with the Board of Nursing:
http://mn.gov/health-licensing-boards/nursing/public/complaints/how-to-file-complaint.jsp
For assistance or to report an actual or suspected violation of the Nurse Practice Act,
contact the Minnesota Board of Nursing at (612) 617-2282 or 1-888-234-2690.
WHERE TO FIND INFORMATION AND FILE COMPLAINTS ABOUT
OTHER HEALTH PROFESSIONAL PROFESSIONALS
Physical Therapists
Minnesota State Board of Physical Therapy – license and disciplinary information
www.physicaltherapy.state.mn.us/search.asp
Chiropractors
Minnesota Board of Chiropractic Examiners - license and disciplinary information
https://www.hlb.state.mn.us/chi/publicaccess/search.asp
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YOUR RIGHTS AS A PATIENT – THE MOST IMPORTANT PROVISIONS
Minnesota Patients’ Bill of Rights
Legislative Intent: Purpose is to “promote the interest and well-being of the
patients of health care facilities.” A patient, guardian, conservator, or an
interested person may seek enforcement of these rights on behalf of a patient.
Paragraph 2 – Courteous Treatment: “Patients have the right to be treated with
courtesy and respect for their individuality by employees of or persons providing
service in a health care facility.”
Paragraph 3 – Appropriate Health Care: “Patients shall have the right to
appropriate medical and personal care based on individual needs.”
Paragraph 6 – Information about Treatment: “Patients may be accompanied by a
family member or other chosen representative or both” when being given
information by physicians.
Paragraph 11 – Freedom From Maltreatment: “Patients shall be free from
maltreatment as defined in the Vulnerable Adults Protection Act, or the
intentional and nontherapeutic infliction of physical pain or injury, or any
persistent course of conduct intended to produce mental or emotional distress.
Paragraph 15 – Responsive Service: “Patients shall have the right to a prompt
and reasonable response to their questions and requests.”
If you have any questions, need additional information, or would like
to speak to someone about The Olivia and Howard Geller Foundation
for Patient Safety, please contact Linda Geller Axelrod
at [email protected] or 651-243-0911
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