Idiot’s Rebuttal

Hospital ‘Arrests’ Severe Mentally Ill Patient Who GetsTortured4HoursByJail DeputiesNursesLeadership

Riverside Summary: Events, Actions & Inactions

• On June 6^th Mike left home in a highly emotional state to try to calm down.
• Later that day Mike’s wife received text messages indicating that her husband could be in serious trouble from a mental health, alcohol intake, suicide and safety perspective.
• She contacted Suburban Police who intercepted her husband, safely and professionally even though in his confusion, paranoia and general disrepair he attempted to escape and had to be ‘taken down’, took him into protective custody and had him transported to Riverside by ambulance. (Suburban police conduct was nothing less than exemplary, by the way…) 72 Hour Hold began at 19:20 per Dr. Christianson, Riverside ER
• Mike, while still confused, paranoid and intoxicated attempted multiple escapes from the Riverside E.R. and x-ray (cat scan) departments, but eventually calmed down and was transferred to a locked mental health unit.
• On June 7^th while discussing ‘what happened’ with his wife, Mike and she agreed that with the mental illness issues still be treated, coped with, etc., being so severe, especially when compounded by including alcohol into the mix, it was now clear, and maybe should have been earlier but just simply wasn’t, that alcohol for Mike had to be taken off the table. Although social drinking was not a problem, alcohol added to full mental illness decompensations and even lesser manifestations was now obviously a very serious risk factor. It was agreed by Mike, his wife and Riverside (albeit reluctantly from Riverside for some reason) that he should be assessed for chemical dependency treatment and would go into treatment immediately upon discharge from Riverside.
• On June 9^th Riverside attempted to discharge Mike without doing the work Riverside had agreed to regarding setting up what was then supposed to be outpatient chemical dependency treatment at another Riverside facility (‘West’) and had said was normal for Riverside (and other hospitals presumably per my experience at Abbott).
• As the result of multiple attempts by Riverside to discharge Mike involuntarily because he needed Riverside to do the work they said they would do and that everyone had agreed needed to be done before discharge Mike fell into a state of great despair, decompensation and virtually non-responsiveness while still on the locked mental health unit. As suggested by Riverside (West), who stated that the set up work he and his wife expected was normal and that she, “apologized on behalf of the whole Riverside system”. Mike, who was by now laying on the common area couch, did, per the advice of Riverside (West), when the discharge nurse again after many previous attempts asked him to leave, ask who the supervisor of the unit was. The nurse told him that that was, “the charge nurse and that she was aware of the situation”. Mike then asked if he could speak to her supervisor’s supervisor. The nurse left without a word and Mike immediately fell back into the very non-responsive – standstill – stay safe like a turtle and pull one’s legs in until it’s ‘safe’ – mode that ‘works’ for him.
• The next thing Mike heard was the Riverside Security walkie-talkies. At this sound, he fell into even deeper despair/disrepair/whatever it’s called and when completely non-responsive to security was lifted into a wheelchair and rolled out to the curb and “off the property”. Still non-responsive and afraid to move Mike did not get up out of the wheelchair and security after discussing and deciding they shouldn’t really lay him down at the curb rolled him into the E.R.
• The E.R. personnel were greatly upset by the idea that he was brought in, had ‘refused’ to leave the mental health ward (“Nobody wants to stay on a mental health unit!” - paraphrased), and was non-responsive there as well. They briefly discussed and quickly rejected the options to re-admit or seek a psychiatric consult. Someone suggested calling the police, which they did.
• There are massive discrepancies in what Riverside claims in Mike’s medical record compared to actual events and experiences by both him and his wife, including not calling or even informing her of her husband’s status when she called out of concern for the fact that he hadn’t shown up at home as anticipated. When she called Riverside what she received as responses to her desperate, worried inquiries were very brief statements such as, “He’s not here.” (and the phone being hung up on her without anything further); “He has left.” (hang up); He’s an adult and you’re not his guardian so he can choose to do whatever he wants.” (hang up) — multiple times while Riverside knew he was either still in the E.R. or had been arrested and turned over to the police and jail. As late as 9–11 pm when Wife called she was told by Riverside that there probably wasn’t much they could find out about him at this point because, (paraphrased) “When patients are discharged we just shred their files.”
• Riverside’s actions and inactions put, what under State of XYZ and Federal law, a seriously mentally ill Patient/Vulnerable Adult, at the time this and following events through Saturday all occurred, into great jeopardy, and as it turns out great suffering on multiple fronts, including serious physical and emotional abuses, injury, longstanding and great pain to the point of literal, and as legally defined under international treaty law, torture. Riverside put a Vulnerable Adult in harm’s way…and the harm that many in the mental health community readily anticipate, when the combination of mental illness and law enforcement is put into play, under those exact circumstances happened…full force…excruciating agony for 3+ hours,…but not death.

Riverside: Detailed Discussion (Pertinent Events, Actions & Inactions)

Items associated with Mike are in black

Items associated with wife are in burgundy

6/6/06 Admission until 6/9/06 Dragged Out of Riverside E.R. by Police

1. Tue 6/6 early afternoon: Mike left home in emotionally reactive state to watch movie to calm down

1.1. When he arrived at theater, movie didn’t begin for approx. 1 hr

1.2. Mike impulsively went to bar to add alcohol to mix to ‘escape life’ further than just movie

1.2.1. Consumed two large beers and 3 shots of alcohol in approx. 45 min.

1.3. Mike returned to theater to watch movie while intoxicated

1.3.1. Mike text messaged scary/suicidal notes to Wife before & during movie (unknown to him)

1.22pm - I haven’t got what it takes to be fair. It’s that simple. It’s not fair. Sorry.

1.33pm - I’m going to watch Mission Impossible. It’s the perfect title for Michael Mike’s life right now. Maybe I’ll feel better after. I don’t know.

3.06pm - Movie just started. Had two large beers - three Peppermint Schnapps. Feels like I’ll be drinking more when the movie’s over. I am a total mess. Sorry.

3.46pm - I am horrible. I get that. I think I should drink myself to oblivion and act accordingly.

3.58pm - Mission Impossible is too much bullshit.

4.01pm - I am leaving the movie. Time to get shmashed. After that, who cares?!

1.3.2. Wife called 911 because she feared for Mike’s safety/life due to suicidal threat nature of text messages, his severe mental health problems of the past 3 ½ years & the fact that Mike never responded to any of her text messages to him.

1.3.3. Mike encountered Suburban Police as he exited theater

1.3.3.1.Mike identified self to police when asked

1.3.3.2.Suburban Police stated that they had been called by Wife due to suicidal text messages

1.3.3.3.Mike denied Suburban Police statement that Wife reported receiving suicidal text messages

1.3.3.4.Mike did not then and still does not remember any text messages from 3:06 on

1.3.3.5.Mike asked if he was under arrest and police said no, that they were taking him into protective custody to take him to the E.R. for a psych eval.

1.3.3.6.Mike filled with fear, attempted escape (ala – Mike remembers his brain being fixated on Keiffer Sutherland/24 escape at any cost thinking & consequent behavior), was quickly taken down, brought under control

1.3.3.7.Mike intermittently struggled to escape Suburban Police until placed into ambulance

2. Mike admitted into Riverside Hospital E.R. (Riverside)

2.1. Mike made two significant attempts to escape in hospital (Note: Mike was in an extremely confused, fearful, ‘escape mode’ paranoid state & his blood alcohol was 1.5)

2.1.1. One - in E.R.

2.1.2. Two - in Cat Scan room as coming out of Cat Scan

2.1.2.1.Pulled I.V., jumped off table & turned away from entrance in hope of an escape exit behind Cat Scan

2.1.2.2.Pursued by security

2.1.2.3.Mike grabbed I.V. pole and held it up to stop security from advancing on him – unsuccessful – security quickly brought him under control & returned him to E.R. where he was held, restrained for his safety, until transferred to Mental Health Unit

2.1.2.4.While in E.R. (drunk, scared & confused, etc.) Mike protested being held in restraint.

2.2. Tue 6/6 Evening: Wife called E.R. to see if she could talk to Mike; thru nurse Mike told Wife we could talk

2.2.1. Outside Riverside Wife called switchboard; Mike not yet admitted; would not tell Wife Mike’s status or whereabouts

2.2.2. Wife explained that Mike had said she could talk with him

2.2.3. Switchboard transferred call to Unit where being transferred to

2.2.4. Unit said that they might be able to talk with Wife if she came to Unit

2.2.5. Unit would not let Wife into Unit; told her to wait and maybe someone would come out and talk with her

2.2.6. RN Nurse A_ came out and talked with Wife

2.2.6.1.Nurse A_ said Mike had been given a shot or pill; that he was in isolation and couldn’t see Wife; Nurse A_ said he thought Mike was so ‘bad’; one of the worst he had seen (altercations with police & hospital personnel); Nurse A_’s best guess was he would be committed/Regional Mental Illness Ctr

2.2.6.2.Wife responded that that seemed pretty extreme/misguided at this early stage and that they would see a completely different person in the morning.

2.2.6.3.They also discussed that Wife would not need to be involved in the commitment process; that that would be Riverside’s responsibility; that they would take care of it without her involvement/permission?

3. Mike admitted to Locked Mental Health Unit 12 (MI Unit)

3.1. ?? timing ?? Mike, at Wife’s request, discussed with Nurse A_ the concern that Wife had been told by him that Mike was highly likely to be referred to Regional MI Ctr because he was about the worst he had ever seen. Nurse A_ denied to Mike that he had said any such thing to Wife. Mike updated Wife who was very shocked and upset that Nurse A_ was covering his ass like this, but said to just drop it as it wasn’t important at this point as it didn’t happen.

3.2. (Wed 6/7am): Mike’s mood was significantly better

3.3. Wife visited by Suburban Police who:

3.3.1. said that Mike had been in the worst shape he’d seen and he’d done many crisis interventions

3.3.2. commented on question of whether Mike should be around kids (Wife’s in-home preschool)

3.3.2.1.Wife explained that Mike wouldn’t be coming straight home

3.3.3. returned Mike driver license taken at theater

3.4. In discussions with Wife, Mike discovered that he had in fact text messaged suicidal notes, but still had no memory of it; this caused both Mike and Wife to discuss how very serious adding alcohol to the mix when under emotional stress could be explosively dangerous and even deadly – he could in a sense kill himself ‘intentionally’ without really even being aware of it. Mike told Wife that Unit was planning to DC him Thur am. Wife said “no, no, no.” They decided jointly that at this point the alcohol/CD issue which had been discussed on 1 or 2 previous emergency hospitalizations as a potentially critical complication had become an obvious problem and that alcohol/CD tx was now paramount to insure that Mike did not again risk going down the deepened depression path that adding alcohol to the ‘escape mode’ created. Both agreed that Mike should ask for a CD evaluation – also in part due to previous MDs have told Wife that if Mike ended up in a similar situation again that he would recommend CD tx.

3.4.1. The above was discussed by Mike and separately by Wife with Unit staff.

3.5. (Thu 6/8): am consult w/’MD’ (Vine’s asst? Vine never seen) & SW/Case Mgr (K_B_)

3.5.1. ‘MD’ & K_B_ seemed to have trouble understanding/believing need for CD assessment, felt like I had to push it quite a bit to get them to understand/agree, but ‘MD’ / K_B_ agreed to have it ordered & to review/advise per results on Fri; discussion of ins concern characterized as premature at this point – in the chart Mike was characterized as being “rather demanding” about this.

3.6. Wife received one minute call from Case Mgr K_B_ telling her they would line it up before he was released if appropriate– just as Mike had told her he was told during the meeting.

3.7. Mike completed CD self-assessment (late am/early pm)

3.8. CD assessor, L_E_, met with Mike to review self-assessment & complete full assessment

3.8.1. L_E_ recommended OP CD tx based on result

3.8.2. Mike explained to L_E_ that there was a potentially major problem with BC ins per his call to them – they said they would cover IP CD tx & “Office Visits”, but did not know what that meant relative to OP CD tx – i.e. C/S person not sure if OP CD tx would be covered. This was potentially a very big problem because it was obvious to everyone, Mike, his family, etc., that CD tx was now clearly critical and that it needed to be all set up before he left the hospital, otherwise going home was not an option.

3.8.3. Mike & L_E_ agreed that L_E_ would recommend OP tx, but that if not covered by BC ins, IP tx was needed and said he would set it up

3.8.4. L_E_ gave Mike a file with info about the Riverside West CD program

3.8.5. Mike was sitting in rec area of Unit and L_E_ called over to him that normally he would set up the whole CD tx program, but that he was unable to find me in the computer system and needed to get to another meeting, so either he would have K_B_ take care of it or do it himself if she couldn’t; it was late – about 5:30 or so and K_B_ was gone for day.

3.9. Wife saw very disturbing text message on Mike’s T-Mobile cell phone: Sent Thur at 12:42pm “Free T-Mobile Msg. The Bonus Caller Tune will change on Friday June 9 to “Nothing Left to Lose” from Mat Kearney, the title track from his new album.” [emphasis added]

3.9.1. Wife feared Mike had been being so agreeable and calm because he was planning to do something scary when DC’d and that she would get that song instead of knowing what he did. She felt that this would be his style, but that it wasn’t his style to pretend he was okay, so it was very confusing and scary.

3.9.2. Wife called Unit to talk to Mike. Whoever she spoke with said he was in a meeting. When she asked who he was meeting with the other party was rude, saying that she didn’t know, that they didn’t want to interrupt the meeting, and that he was an adult and didn’t have a guardian and he could meet with whomever he wanted.

3.9.2.1.She got off the phone concerned that they didn’t know who he was meeting with since he had never mentioned anything about meeting with anyone.

3.9.3. Wife got the guts to call back afraid they would be rude again and asked for Mike. Again was told he was in a meeting. She asked if they knew the person he was meeting with.

3.9.3.1.The answer received was that, “He is his own guardian, so it isn’t any of YOUR business.”

3.9.4. After more time passed Wife decided to call again, specifically ask for a nurse, and tell them about the scary T-Mobile message. She explained the reason for her call – that she had received the “Nothing Left to Lose” message – and was concerned that he could be planning suicide or anything. She was met with further rudeness along with the statement/assurance that they wouldn’t let him do anything to harm himself in the hospital.

3.9.4.1.The nurse was concerned and said let me check…..then, no she didn’t know the person either……she asked if Mike was involved in the court system or something which made it clear Mike was meeting with someone that was unknown by their staff.

3.9.4.2.Wife asked her not to mention the concern about the song to Mike, figuring she would call back and talk with him about it and would be able to tell if he was lying.

3.9.5. Awhile later Wife called again to ask for Mike…and now they were REALLY rude…she said, “I am calling because I have reason to question if he is really okay or not – and he is scheduled to come home tomorrow”…to which the other party said, “We will not release him if he isn’t ready to go home.” To which Wife said, “My husband has an MBA in marketing and he could sell you on anything.”

3.9.6. Unit staff recorded Wife as possibly being: HISTRIONIC? (large, emphatic print in med record) …for being what, genuinely, reasonably, very concerned about one’s spouse’s mental state while on a locked mental health Unit?

3.10. When done with the CD eval, Mike called Wife. By this time, she was short of breath due to the treatment she had received on the phone. Mike could tell that Wife was short of breath and recognized this as at least like anxiety attack symptoms, if not an actual panic attack. He told her to just sit quietly for just 15 seconds and not do anything but breathe and to notice everything she could about the breathing. She did calm down enough for Mike to explain the T-Mobile message. He had not initiated it in any way; it was nothing but T-Mobile’s monthly offer of some phone option that he didn’t care about. He was not up to anything scary in the least. That the title so fitting the circumstances was completely coincidental and unfortunate, but nothing bad was behind it, and that her panic was understandable and he’d react the same way if the roles were reversed. He also explained that he had just finished meeting with the CD counselor.

3.11. Mike told Wife that he ‘passed’ the eval – that they thought he should get tx

3.12. (Fri 6/9am): ‘MD’ saw Mike in hall and asked him if CD assessment was done yet

3.12.1. Mike said that yes he had done the written assessment yesterday afternoon and that he had met with the CD assessor, L_E_, at the end of the day

3.12.2. “What did he say?”

3.12.3. L_E_ recommended OP CD tx if ins would cover it, otherwise Mike would need IP tx and that L_E_ said he would get it all set up

3.12.4. ‘MD’ said ok and that then he would DC Mike today

3.12.5. Mike agreed

3.13. Mike left voicemail message for K_K_ (a contact person identified in the CD tx file from L_E_) to call him regarding how the program worked

3.14. Later that am RN invited Mike to his room to discuss DC

3.14.1. When RN explained the 3 key discharge items [(1) appt w/Dr. Nelson – Mike explained that he had an appt scheduled, but did not remember the exact date -Mike & RN agreed to just call it 7/19; (2) continue with DBT tx – no problem; (3) “Riverside West OP CD tx”] Mike asked about the details for the CD tx. RN looked perplexed by the question, told me to look at the papers she had for myself and handed them to me. Mike said that he saw that CD tx was referenced but that there was no detail – date, time, ins problem resolved – and that both K_B_ and L_E_ had said that it would be taken care of for me.

3.15. RN said that this was all she had; Mike asked her to talk with the K_B_; that she’d be able to straighten it out.

3.15.1. RN returned to tell Mike that K_B_ was out for the day and that she thought I should talk to the Intern who was standing in for her. RN asked Mike to talk with her when done talking with Intern.

3.15.2. Intern Social Worker/Case Manager asked what the question was. Mike explained that the CD tx plan was not set up; there was nothing more than a reference to it & the detail needed to be completed. She replied that he seemed to her to be “perfectly capable of taking care of it yourself.”

3.15.3. Mike explained again that he needed to have it taken care of by K_B_, or whoever would in her absence, as L_E_ had said he would have her do, or that the intern should call L_E_, because he hadn’t been able to take care of it at the end of the day yesterday like he normally would.

3.15.4. Intern left saying she would check on this.

3.15.5. Somewhere in here, Wife called Mike to find out CD tx, DC status. She told him the Unit staff was soooooo much nicer this am. He said he had ‘dressed them down’ a little for treating her so poorly yesterday. Wife was surprised…this is more like the Mike I used to know.

3.15.6. Mike also described that he hadn’t called her earlier because he was getting the run-around – the case worker (K_B_) that had talked with him Thur, and with Wife, was out of the office and the nurse and ‘K_B_’s’ Intern didn’t know anything about all our discussions.

3.15.7. The RN was ready to DC Mike without having made the arrangements with the West CD tx facility that the case worker had told both of them individually that she was going to do.

3.15.8. They were telling Mike he would have to call them on his own when he got home. Mike told Wife not to worry, he was taking care of it and he’d have it taken care of before he left.

3.15.9. Mike made notes on DC papers re things that had not been done relative to the CD tx plan and that they hadn’t been done as described by K_B_ and L_E_.

3.15.10. Mike left DC papers at front desk, along with pointing out to someone standing there, how Riverside’s own descriptions of its services and responsibilities didn’t match up with what they were refusing to do, and a client Feedback Form that was quite complimentary re the ‘floor staff’ and quite pointedly negative re the CD tx process and how poorly the DC process was being handled.

3.15.11. Mike did not seek out RN after talking with Intern…he was too stressed out…

3.15.12. Somewhere in here Wife called Mike who told her he was still working on the problem. She also explained to him that she was leaving at about 3:30 to go to Jenna’s (their 26 yr old daughter) birthday and that he was not going to go because Jenna and Annie (20 yr old) were angry that he had lost it and ended up in the hospital.

3.15.13. Mike then requested a Coke from one of the ‘floor staff’ which he rcvd and then without even opening it, Mike flat out ‘crashed’, down on the couch with his eyes closed (it saves on energy) in the rec area to try to calm his brain from all this turmoil over something so simple and so clearly stated as to what they would do. All the conflicts, concerns, fears, inconsistencies betw what L_E_ had said, K_B_’s similar comments but what the RN was doing to just shove him out without the CD tx being set up as everyone promised, including Mike to Wife & family put him into crash – need to just lay here until my brain stops swirling – mode. This has become a patterned response to stress over the past few years – not always the easiest for others (non-professionals) to understand, but far safer with much fewer long term consequences than ‘bolting’ to ‘escape life’ with everything from excess –OH to abuse of meds, suicide ideation, self-harm, etc. To ‘standstill’ is to be safe. To take no risk that stepping in any direction will lead to more risk of harm, danger, etc. ‘Crash’ mode can last anywhere from 15-20 minutes to several hours or more – not typically a whole day unless it’s afternoon already.

3.16. While crashed/calming his brain on the couch, after about 20-30 minutes he thinks, Mike rcvd a call from K_K_, the Riverside West OP CD tx program contact.

3.16.1. K_K_ asked Mike what he wanted.

3.16.2. Mike noticed something in K_K_’s voice that made him feel like she was surprised he had called in this regard; that she didn’t usually do this; or something…not sure…it just felt to Mike like something wasn’t right.

3.16.3. Mike said he wanted to understand how the OP CD pgm worked – especially re family involvement – which K_K_ explained.

3.16.4. Mike then asked about how the program was set up in terms of things like start date, openings, insurance. K_K_ responded that this was the 1^st that she had heard of Mike’s name – again, Mike felt the sense of something being ‘unusual’ or ?

3.16.5. Mike described the experience he was having with the RN & Unit staff – specifically asking if it was typical for him to be being asked to do all this set up stuff for the CD tx pgm – she hesitated a little and he repeated the question – to which K_K_ said that no it wasn’t typical.

3.16.6. Mike explained that he felt like the Unit was trying to just dump him out the door as quickly as they could and leave him flapping in the wind even though he’d been told before this am that this stuff would get taken care of.

3.16.7. K_K_ said that this stuff was usually all set up by the Unit; that they worked with Central Intake, and that it wasn’t for me to do all the set up. She gave him the intake number that ‘shouldn’t be his responsibility’ which he wrote down.

3.16.8. Mike said that that’s what they seemed intent on doing and that he was literally crashed on the couch when she called trying to sort it all out and to try to just calm down from the RN constantly just trying to DC him without addressing the whole CD tx issue.

3.16.9. K_K_ said that she wanted Mike to know that she apologized on behalf of the entire Riverside system – to which Mike expressed ‘thanks a lot because he was feeling totally confused by it all’ – and then K_K_ also said that it sounded to her like he needed to talk to someone’s boss.

3.16.10. Mike thanked her and said he would follow up with the RN or someone to try again to get this mess straightened out, but that he was going to have to go back and crash on the couch for awhile 1^st…which is what he did.

3.16.11. For what he thinks was about another 20-30 minutes or so.

3.17. RN found Mike on couch with his eyes closed in rec area and said that we were ready to DC. Mike opened his eyes and asked if the CD tx with West was set up yet. RN said that she had done what she was going to do on it. Mike said that that wasn’t right. That this really needed to be taken care of before DC. RN repeated that she was done with it and that it was time to go. (somewhere in all this Mike closed his eyes again…he just couldn’t take it…his energy was about zero)

3.17.1. Mike repeated that L_E_ had made it very clear that this was their responsibility, not his and that he needed her to go get it done.

3.17.2. RN repeated that Mike needed to get up to leave/DC; there was nothing left to do.

3.17.3. Mike raised his voice some & stated assertively that, “I can’t talk to you anymore…all you do is stress me out!”

3.17.4. RN threatened that if Mike didn’t get up to leave/DC she was going to call security.

3.17.5. Mike responded that he had just gotten off the phone with K_K_, the CD person at West and that she had told him that this was their responsibility and that it sounded to her like I needed to talk to someone’s supervisor. Mike asked, “Who is the supervisor of this unit?”

3.17.6. RN, with a look of shock like who are you to be asking that, asked, “You mean the whole unit?”

3.17.7. “Yes – who’s in charge of the whole Unit?”

3.17.8. RN with that same look of shock (‘doe in headlights’ look) said, “The charge nurse is in charge of the unit and she is aware of the problem.”

3.17.9. Mike said then, “Well, who is her supervisor? Can a talk to whoever that is?”

3.17.10. RN gave Mike that same look of bewilderment & left. Mike closed his eyes & went back to crash mode.

3.17.10.1. It is important to note here that L_E_’s CD Assessment (Thur evening) includes his recommendations re ‘Initial Service Plan (immediate health, safety, service needs) = “Physical and psychological stabilization before discharge”. By now, the overwhelming, inconsiderate, single-minded without regard for input/statements directly from Mike or through Mike as stated by other Riverside staff, relentless drive to get Mike DC’d regardless of obviously important factors stressed Mike beyond his capacity to comprehend and drove him into nearly total ‘standstill mode’ to protect himself from what felt like the growing dangers at hand.

3.18. Mike crashed quietly for about 5 minutes or so until he next heard the sound of walkie-talkies. “Security…you’ve got to be kidding me!” he thought to himself. Mike slid deeper into crash/standstill mode, shaking his head, hoping someone would come to their senses.

3.18.1. Security static & talking that he couldn’t hear continued for a few minutes until someone came to in front of Mike on the couch eyes closed and asked if he was Michael Mike.

3.18.2. Mike did not respond.

3.18.3. Security said that this was security and repeated his question.

3.18.4. Mike did not respond.

3.18.5. Security went on like this for a few minutes, including instructing Mike that he was DC’d, that this was over, that he needed to get up, that he needed to leave the hospital, etc.

3.18.6. Mike did not respond.

3.18.7. Security stepped away and Mike heard talking in background something about taking him out of the hospital, off hospital property.

3.18.8. Security returned and instructed Mike to get up & to leave the hospital

3.18.9. Mike did not respond.

3.18.10. Security then lifted Mike non-responsive, eyes-closed, into a w/c and rolled him down the hall, into the elevator, down another hall, outside, along the sidewalk (raindrops? Yup, another one), out past the curb and told Mike that he needed to get up now, that it was over, that there was a cab voucher in his bag for him.

3.18.11. Mike did not respond.

3.18.12. Security repeated

3.18.13. Mike did not respond.

3.18.14. Security asked themselves, “Are we really supposed to just leave him here? Should we bring him back in? Should we bring him to the E.R.?”

3.18.15. Security wheeled Mike back off street, up the sidewalk – pretty long ride, into E.R.

4. E.R. had security bring him to a room (10?)

4.1. E.R. MD or RN? (MD) [probably C_S_ Stern per Police Report] asked what was going on and security explained how they had been called to Unit to escort me out of the hospital because of refusing to DC and that Mike had been non-responsive the whole time just like this.

4.2. MD had a holy fit. E.g. “No one doesn’t want to leave the mental unit!” “They all want to get out of there as fast as they can!” “This is ridiculous!”

4.3. E.R. instructed security to lift me onto the gurney.

4.4. MD asked multiple questions of Mike.

4.5. Mike did not respond.

4.6. MD discussed what to do with others - whether to re-admit, to call psychiatry, etc. – someone suggested maybe we should call the police.

4.7. MD agreed with that idea & had the police called.

5. Somewhere in here (about 2:15), Wife called Unit and asked to talk to Mike…they were once again very short with her….even more so than before, “He is not here!” and hung up on her.

5.1. “He is not here!”? Not, “He has been released.”? Not, “Security hauled him away”? Not, “We’ve had a problem and need to talk to you.” This was strange, doesn’t make sense…but Wife didn’t know what to think or do and because of earlier mistreatment by Unit staff figured she’d wait and call again in awhile.

6. Wife called Unit again at 3:30 and asked for more information on Mike because she and he had decided earlier that day that he would come home by cab and that he hadn’t come home or contacted her since 2:15 when she was told by Unit staff that he was not there at Riverside anymore.

6.1. Unit staff was again annoyed, said just a minute…came back and said, “He was released to home with a cab voucher & BANG!” No time to ask anything else - just BANG! - they hung up.

6.2. Wife soon called her sister from Costco parking lot (picking up cake) – completely rattled – couldn’t understand whatever it was that was going on…it made no sense…needed to talk to someone before going to Jenna’s party as if everything was okay – knowing that something was way very messed up, and she had no clue what it was or what to do about it – it was just plain hell and she was powerless.

6.2.1. Sister and brother-in-law all agreed it was all very strange. Did not know what to think about Mike being unaccounted for after having been so great about CD treatment, other changes discussed over the past two days regarding how to communicate, listen, & work together better.

7. 9pm - Wife got home; no Mike.

7.1. Annie called a friend to come over because Wife was so distraught. Annie was very worried about Wife’s emotional state. This was all so unbelievable.

7.2. Friend and Wife decided there were three possibilities:

7.2.1. Mike was BS’ing Wife and had NO intention of coming home all along, This didn’t fit very well because he could have just refused to sign the release and not talked to her, or gotten out without the whole pretense of being worried about CD treatment program being lined up

7.2.2. Mike was upset with the hospital on not giving him what he was supposed to have (CD treatment all lined up) and didn’t call or come home because he had ‘bolted’. He had credit cards so even without a car he could be doing just about anything he wanted

7.2.3. The hospital wasn’t telling Wife something.

7.3. We decided together that Wife needed to get the courage to call the hospital back again…she hated doing this because they had treated her so badly she was by now, because of this, “a wreck”.

7.3.1. Whoever answered the phone knew Mike’s name, very obviously, even though it was now the night shift…they connected me with the same nurse, Nurse A_, who I had talked with the first night I had gone down to the hospital and not been allowed to see Mike.

7.3.1.1.Nurse A_ told me, “I doubt I will be able to get any information because we tear up the file as soon as a patient is discharged.” (I am thinking, “Who are they kidding?!” but I didn’t comment.) I just acted like I was worried about Mike and didn’t want to tip my hand that they (Riverside) were also a worry to me.

7.3.1.2.He left for a bit and came back and said that Mike hadn’t wanted to leave and had lain down on a couch, refusing to leave if they didn’t do what he thought they were supposed to do. They got him into a wheelchair and brought him down to the curb and gave him a cab voucher. “If he didn’t go home, that was his choice.” I told Gail what Nurse A_ said about shredding files; neither of us could believe it.

7.3.1.3.Wife asked, “So he was distraught when he left?”

7.3.1.4.Nurse A_ made a comment. Wife does not remember exactly what the words were, but Nurse A_ clearly did not want to admit that Mike left distraught. He hung up quickly.

7.3.1.5.Wife and Friend thought they should and did call Suburban Police because of fear that Mike was missing & upset & had just text messaged suicidal, better off dead, notes three days ago.

7.3.1.6.This incident at Riverside with them not doing their job and treating him to wrongful premature forcible removal was the EXACT kind of thing the he would get extremely upset about.

Discrepancies: Actual Events versus ‘Official’ Medical/Security Record

A. Discharge Summary/Presenting Problem: “Pt report of [suicidal] text messages greatly minimized”

versus:

a. telling E.R. I did not remember them at all simply because I did not remember them at all…and still don’t

B. Discharge Summary/Hospital Course: “…wanted the case workers on the unit to intervene in his insurance to make sure that there would be payment…very inappropriate [wanting] of this financial guarantees that were not within the [purview] of the inpatient staff”

versus:

a. Admission Note p.3 Plan: “Possible discharge in am…but…we will have him talk with a case manager and make sure that there is a plan in place for him to return into the household and that his wife is aware of that plan.” [i.e. as it turned out – CD Assessor L_E_’s recommended aftercare f/up plan at Riverside’s ‘sister organization’ in Riverside West area for OP CD tx]

b. being told by K_B_ in our 1^st mtg (with ‘MD’) that it would get taken care of if appropriate per the CD assessment results

c. telling the same thing to Wife (see above para 3.11 re K_B_ call informing Wife Mike’s CD treatment would be lined up before DC)

d. being told by L_E_ (1) that he would take care of it while in the CD assessment mtg; (2) and then by L_E_ on his way out late Thursday that, “normally he would take care of it right away but couldn’t find my record…he would have K_B_ take care of it…”

e. being told by K_K_ that

i. it was not typical for me to be told to do it

ii. the Unit staff (i.e. case worker/social worker/CD assessor) took care of it)

iii. she apologized on behalf of all of Riverside

iv. it sounded to her that Mike should talk with someone’s supervisor.

f. Riverside had done exactly what was being discussed/expected here when Mike was moved from locked mental health unit inpatient status to Riverside’s Day Treatment program in 2003. Neither Mike nor Wife had to do anything in this ‘transfer’ / or ‘step down’ as it was called. They took care of the whole thing.

C. Discharge Summary/Hospital Course: “…was told that he would have to leave the unit or security would be called…patient capitulated and left sensibly for home” (per ‘MD’ who presumably was ‘informed’ by Unit staff)

versus:

a. no mention of multiple refusals by RN to meaningfully address no OP CD tx being set up as I was told it would be, and as I was told it should be – i.e. no mention of L_E_’s role/comments to Mike

b. no mention of request to speak to Unit supervisor

c. no mention of subsequent request to speak to Unit supervisor’s supervisor

d. no phone call to any concerned/interested parties: Wife, Daughters, Therapist, Psychiatrist, Psychologist or Family Physician – all clearly identified including most phone #’s – on p.1 of Adult CD Assessment in chart as of Thur.; Wife had filled out a 4 page Concerned Person form.

e. no offer to bring someone in to talk with and resolve situation; basically just “get out” because I say so regardless of what you have been told by others right here at Riverside

f. only response after 2^nd request for supervisor was that instead security was called

i. Also, no mention in Discharge Summary of security being called; hauling Mike away; hauling Mike back from street into E.R.; consult with E.R. per E.R. call to unit (presumably); E.R. calling police upon rejecting re-admission, psychiatric consult, emergency call to family or mental health professionals (i.e. bury the bad stuff in the details that no one will probably see)

ii. Also, no mention anywhere in chart re being brought into E.R. by Riverside security, discussing Mike’s situation, discarding suggestions to re-admit or even do a psych eval, deciding to and calling 911, consulting with police and internal MI Unit staff, E.R. staff standing by as police drove knuckle into pain/pressure point behind ear, handcuffing – without regard for patient safety (i.e. may not have been double-locked; or were slammed on tight and then double locked; there is no possible way that they were ‘finger-fit-under-cuffs’ and then double-locked; may have even been plastic kind that tightens due to ‘struggles’ or to activity such as officer and ?? causing cuffs to tighten because of lifting Mike up under arms (roughly and jerkily multiple times), and even assisting police in dragging Mike a long ways through E.R. to squad car.

iii. Officially – some of this simply never happened. Unofficially – it was hell, but only the beginning of the much worse hell that followed.

g. Absolutely no attempt on anyone’s part at Riverside to “…encourage and assist [patients] in the fullest possible exercise of these rights” per State’s Patient Bill of Rights.

D. Discharge Summary/Hospital Course: “…throughout the patient’s admission and hospital stay, it is clear …personality disorder…is largely responsible for much of his difficulties” [emphasis added]

versus:

a. Difficulty at admission was:

i. –OH (blood alcohol .15)

ii. fear, paranoia, shock at being picked up completely unexpected at theater

iii. all Mike could think of was Keiffer Sutherland in the show 24 and escaping the danger

b. Difficulty “throughout…stay” was:

i. virtually non-existent until wrongful premature discharge; classic ‘blame the victim

ii. described by ‘MD’ on Wed 6/7 – noon as “a friendly, cooperative Caucasian male” (Admission Notes p.3 Mental Status Exam)

iii. described by CD Assessment counselor, L_E_, as “Reality Based” “Impaired Insight” (re: impact of –OH on self/others? – I would agree that it took awhile for all of us to truly appreciate how -OH exacerbated MI issues, esp. ‘bolting’, ‘crashing’, ‘escaping’) “Logical” “Flight of Ideas” (certainly can ramble a bit and get quite detail oriented under stress) “Cooperative” “Dramatic” (expressive…under these circumstances…yes) “Mood – Appropriate” “Congruence/appropriate” “Expansive” (same as dramatic?)

iv. it is now widely known that Borderline Personality Disorder is brain-based like Bipolar, etc.; it is highly likely to be changed in DSM V to an Axis I disorder like Bipolar, Schizophrenia, etc., due to more recent knowledge gained since DSM IV was published; it’s a disorder of the brain – limbic system – amygdale – it leads to significant emotion dysregulation; even the name ‘Borderline’ is considered wrong/misleading and is likely to be changed to ‘Emotion Dysregulation disorder’ or ‘Limbic System Disorder’ etc. It is not a character/personality defect – for the Discharge Summary to put it in the terms it did is nothing short of disparaging & malicious given what the mental health field now knows.

E. Discharge Diagnoses/Axis IV: “…manipulative behavior, poor insight and judgment…”

versus:

a. See notes above – D) b.

F. Admission Note/Presenting Problem (2^nd para): “…protective custody…did not respond well…aggressive and assaultive…assaulted Riverside security”

versus:

a. Mike was not assaultive; he was escape-driven from Suburban Police, E.R., Cat Scan Rm…I.V. pole was held up to protect against aggressive approach by guard(s) – there was no “assault” that he remembers (get security video)

G. Admission Note/Presenting Problem (4^th para): “…resistant, oppositional, uncooperative and aggressive at times” – agreed – per para D)a. i-iii; also see para D) b.ii.

H. E.R. Encounter – agreed per para D)a. i-iii. with the notation that what I remember was grabbing an I.V. pole to stop security from pursuing me and only held it out to protect myself from security personnel aggressively advancing on me (admittedly for my protection). I think I remember holding the I.V. pole out and may have pushed it out toward security and released it (not hard enough to hurt anyone; just to protect myself) – the concept of me “swinging” the I.V. pole does not ring a bell – however as intoxicated, afraid, confused, paranoid (that Keiffer Sutherland ‘get out of danger’ feeling) as I was it does seem very remotely possible – would have to see video to know for sure.

I. See para 2.2.6. – Nurse A_’s report that I was likely to be committed to Regional MI Ctr. On what basis could he possibly determine that from a man coming in and behaving under the influence of –OH, fear, confusion, etc., without waiting until more information was gathered – can you imagine the emotional impact of being told this about one’s husband, under the circumstances, with so little information to go on. Nurse A_ denies this according to P_M_, Nursing Program Director and Dr. C_S_, Head of Psychiatry; it wasn’t a misperceived passing comment as they suggest; it was a full-blown conversation and led directly to Wife emailing family and friends in the middle of the night after she got home after hearing this. Nurse A_ explained that the hospital would make the determination; she wouldn’t have much say in it.

a. [pertinent email text] …“ He DID sign a release to let them talk to me, but I couldn’t see him.

THey, for the first time, talked about a 72 hour hold and then the possibility of getting a court order and committing him.” …

versus:

b. Patient’s Bill of Rights ([Pt Rights]) para. 7.a. Participation in Planning Treatment/Notification of Family Members: “Patients…right…to participate in the planning of their healthcare…right to include a family member…”

J. See para 3.9 – Unit Staff treatment of Wife regarding evidence of risk of Mike being in more danger, including suicidal than staff would know given the T-Mobile “Nothing Left to Lose” message.

versus:

a. [Pt Rights] para. 3. Appropriate Health Care “…based on individual needs…” How can they provide appropriate health care while being dismissive of critical information provided by a patient’s spouse acting on behalf of that patient, and on top of it, being rude to the spouse, creating an environment of hostility which would further limit potentially critical medical input? Also, how could this lead to a Medical Chart note regarding Wife being “Histrionic”

b. [Pt Rights] para. 7.a. as above in para. 9).

See para 5. – @ 2:15pm Wife told –– “He is not here.” “Bang!” They hung up.

versus:

c. Not calling her once throughout the am & early pm regarding the DC situation they had created

d. Not informing her that Mike had been forcibly removed (literally lifted him up non-responsive off the couch into a wheelchair) by security wheelchaired from Unit

e. Not informing her that security had wheeled him off Riverside property and back on it to bring him to the E.R.

f. Not informing her that Mike was in the E.R. right then as they spoke on the phone

i. Unit did likely not “not know” Mike was in E.R. at this time; E.R. had to have consulted with Unit regarding security having brought him into E.R. non-responsive and the discharge issue (Unit unlikely to have fully disclosed to E.R. how Mike had pointed out that they hadn’t completed their DC responsibilities, had been told by multiple Riverside staff that Riverside did have the responsibility to finalize CD treatment plan, had asked for two levels of supervisors, etc.)

g. Not forwarding her to the E.R. knowing that that’s where Mike was

h. Not informing her that the City Police had been called by the E.R.

K. See para 7. - @ 3:30pm Wife told –– “He was released to home with a cab voucher & BANG!” versus:

a. b. c. e. (where Mike had been) f. [as above in para 11)]

g. Not informing her that Mike had been arrested for trespassing, and literally dragged out of the E.R. (maybe with their literal physical assistance in lifting and dragging him out (roughly))

L. See para 8.3.1.1. - @ 9:00 – 11:00 pm Wife told ––

“I doubt I will be able to get any information because we tear up the file as soon as a patient is discharged.” and “If he didn’t go home, that was his choice.” and when Wife asked if Mike left “distraught” Nurse A_ attempted to avoid discussing that Mike was or even could have been “distraught” and when she tried to inquire further, he quickly abruptly hung up the phone without warning.

versus:

[Wife was sitting with our friend, Gail Parker when this happened and as soon as Nurse A_ hung up on Wife, she told Gail what Nurse A_ had just told her about shredding the file. They both were dumbfounded that anyone would say such a thing knowing that it couldn’t possibly be true.] [Feel free to contact me for Gail’s contact information – particularly Board of Nursing]

*******Second Set of Riverside Medical Record/Handpicked Pages vs Original Set Provided*******

M. Discharge Document:

Method of Discharge = Ambulatory; Transportation = Private; Accompanied By = Self

versus:

a. DC problem discussed multiple times with RN/Intern throughout am/pm as noted on DC doc

b. Discharged Involuntarily after two requests to speak with supervisors

c. via Wheelchair by Security to curb (off Riverside property); then wheeled into E.R.

d. where E.R. staff had Security call CITY POLICE who, with E.R. staff/Security, dragged me to squad car.

e. with No Communication to 911 Dispatch re situation or patient with mental illness

i. per 911 transcript Security denied any knowledge beyond what E.R. room Mike is in

ii. 911 operator did not probe at all to even attempt to ascertain mental illness situation

N. Case Manager Discharge Recommendations (never provided to me to discuss; I had no knowledge of its existence until requesting/receiving Medical Report in July/Aug. Quote: “It is my understanding that they will contact you to set up an intake appointment.”)

versus:

a. K_B_ originally told Wife & me independently that it would be set up before DC

b. L_E_ said he’d normally do it, but couldn’t find my file, and would have K_B_ set it up

c. Everyone understood that it was critical to have this set up before DC

d. K_K_ at OP CD tx program at Riverside West assured me they should set it up; it was not normal to expect me to do it; apologized on behalf of the whole Riverside system for their attitude/behavior/treatment; recommended talking with someone’s “boss” (when it was appropriate to do so with the nurse I used the term “supervisor” both times to not sound ‘overbearing’).

e. As of 6/9 afternoon, K_K_ had not heard of me except from me.

f. Remember, CD evaluation with L_E_ ran late beyond end of day Thursday and K_B_ was gone and then she was out Friday, so how could she have given it to me? It was either created (without ever showing it to me; the last discussion I had with K_B_ was with R_K_ that morning where I was considered “rather demanding” with respect to needing a CD evaluation) before the CD evaluation with L_E_ was done at around 5:30p, or it was created well after the fact…as in when she returned to work after her Friday off…and then back-dated to 6/8…in any case it was never provided to me by anyone, until I saw it many weeks later in my record.

O. ASMH Social History/Assessment of Social Service Needs/Plan: “Assess CD issues…Contact pt’s wife…make appropriate referrals.”

versus:

a. Characterizing me as being “rather demanding” re CD assessment (see Discharge Report)

b. Telling me Friday for the first time that along with DC it was my responsibility to do.

P. Individual Goal Plan: deferred

Q. Problem/Needs List/Discharge Criteria: “Safe with Self”

versus:

a. So confused, afraid, unable to decide anything, upset, distraught at DC that, once he heard Security walkie-talkies, didn’t dare talk or move…total passivity/total vulnerability/left self completely to whims of others/would have let Security just drop me on street/think I would have just laid there ‘til picked up by someone else…not sure since it never came to that…just feels like what my brain would have said to do to “standstill, stay safe, risk nothing” I was anything but “safe with self”

R. Progress Notes 6/8 CD Eval: “I am recommending [OP CD tx] at F.V.S.D. when insurance (Bx out state?) is approved.”

Yup, this is what we discussed; the need to make sure of ins coverage prior to DC; L_E_ said he’d do it

S. Progress Notes 6/9 RN Reassessment: 11:00 Assessment 1350: DC Quote “…somewhat argumentative re DC planning CM set up.” versus I simply noted that there was no detail on the DC paperwork & when RN handed to me for a ‘closer look’ (nothing changed because it was in my hand instead of hers) said the same thing…RN said that that was all she had…at my request she said she would go check with CM…or as she puts it – “referred pt back to CM” and then it says, “DC’d to home (to wife) via taxi…” [ all I know is I was letting her know that the CD tx plan needed to be in place before DC…RN appeared quite perturbed at the very 1^st instance of questioning the lack of detail re the “CD tx at West” note on DC paperwork]…her attitude simply got worse and worse as we went back & forth between being told it was time to go and responding with the question of whether the CD tx was set up yet

T. CMT Case Manager Note 14:15: …”patient was angry at staff because there was not a date set for an OP CD tx program” versus I was very calm until RN kept coming back time after time without doing anything relative to the OP CD tx…I didn’t get angry for quite awhile and I didn’t get any angrier than the RN except when she threatened Security and I told her “I can’t talk to you anymore. All you do is stress me out!” also versus the problem was much more than just no date set; there was no assurance that BCBS-GA would cover the tx as described.

Also, “The referral has been made to the program, but pt was told that it had to go through the referral process before a date could be set.” versus, again…it wasn’t just the date; and again…I wasn’t told anything about it needing to go through a referral process until she said it that Friday (if she really did – I don’t remember hearing her say it) Also, note when it was theoretically written – after they knew I was in E.R. – falsified to buttress their story?…timing of note vs the intern entering a ‘real time’ note suspicious but no way to prove it…Also, “Pt had been in this specific program before and did not complete it.” versus – hmmm… interesting….since I’VE NEVER BEEN IN ANY CD TREATMENT EVER UNTIL JUNE 2006!

And, “Pt was sarcastic and irritable with staff.” When I turned in the DC paperwork & Patient Feedback Form I had also highlighted their brochure re how they were not living up to their own stated responsibilities. If that’s sarcastic & irritable, letting someone know calmly & assertively (not aggressively) that they aren’t doing what they are supposed to do, then, yes, I was sarcastic & irritable. Personally I think I was fairly calm and firm with all the irritation being pretty much held in.

Wife said to be sure to add that there is no documenting of what they did/said to her, and how they said it; but that they were very rude to her when she called to try to be of help to them and her husband and when she called after DC and they lied about everything that had happened.

And this beauty, “The CMT in charge of case went over details with Pt yesterday also.” This simply did not happen. When I was being “rather demanding” per the CMT/’MD’ meeting about having a CD assessment done it was left at that alone…let’s see what happens and go from there if anything is needed – essentially I felt like I had to talk them into even doing the CD assessment – there was no discussion of “details” at that time (Thu am consult with CMT/’MD’); they were barely able to discuss the assessment. Question: How would the Intern know what was discussed in a meeting she wasn’t even in…K_B_ had left before the CD evaluation was done late Thursday and was out for the day…I don’t recall seeing any such reference in the chart (but it could be there if I look closer)…I doubt they called K_B_ at home! (but who knows?!) This whole line of documentation smacks of cover-up and victim blaming versus taking responsibility for what they didn’t do.

And finally, “The covering CMT [Intern] asked if anything else needed to be done and he said, “no.”

This did not happen. I was very firm all day long with every singe encounter that the OP CD tx plan needed to be set up with ins coverage taken care of by Riverside as I was told it would and should be.

Within the context of asking if there was anything else that needed to be done besides setting up the OP CD tx it is possible that I said no to that. That would even make sense…I sort of even remember it, but I am truly not sure. I do know for sure that I didn’t just say there was nothing else to do ‘globally’ as if the OP CD tx plan was no longer an issue, just nothing other than that.

U. Progress Notes 6/9 13:50 – Quote [circled D] “Pt refusing to leave unit since ok to go home @ 1100. Continually stating needing CM’s to coordinate…outpt services with his insurance. [circled I] CM’s Kim & Laura discussed outpt instructions with pt repeatedly. [circled A] Pt still unsatisfied. Laid down on sofa refusing to prep for DC. [circled P] R_K_, ? informed, as was Niki Gere, acting supervisor.” versus we didn’t really ‘discuss outpt tx’; it was really just a matter of me noting at the beginning that it wasn’t done, then multiple times asking if it was done and multiple times stating that L_E_ said he would take care of it or K_B_ would, in response to RN simply saying it was time to go, and finally with me stating I had talked with K_K_, the OP CD tx contact and that she said they were supposed to do it and that I should ask to speak to someone’s [supervisor], which I did, and then when RN said who the supervisor was and that she was aware of the situation I asked to speak to the supervisor’s supervisor – which resulted in the response of no discussion, and Security being called to drop-kick me outta there, etc. Also, there were not any [discussions of] “outpt instructions with pt repeatedly] – there was one discussion, with the Intern, who essentially focused on her thinking I seemed “perfectly capable of handling it myself”…interesting contradiction, given that they said I was told that they had made the referral and I just needed to wait for them to call. Can’t have it both ways…

And the coup de grace…”Pt escorted off unit in w/c…did not resist or verbalize…[No] incident reported by security personnel.” You have to be kidding!!! Can this be real?!

No one from Security or E.R. called the Unit?! Believability Factor: 0 Oh, I get it, maybe the incident was reported by the E.R….funny they didn’t reference that here.

Finally, there is no patient medical record/entry regarding my June 9^th experience in the E.R.

[This is an area deserving of review for State & Federal law. Anyone who enters an ER, other than the healthy family or friends helping someone to the ER obviously, should have a medical file created and everything should be documented. If they had to document that they didn’t do a psych eval maybe they would have actually chosen to do one, as so obviously indicated by my state, as recognized by none other than security of all people.]

Stonewalling Evidence Requests: Riverside Security Report & Video Surveillance

Mike and the original attorney representing Mike against 385.380 Trespass Charge (Misdemeanor) / Tab Charged by Arresting Officer have made multiple requests beginning with my first requests in July at Riverside to L_F_, Head of Security and J_M_, Patient Relations, among others to Riverside, to release Riverside security incidence reports and video surveillance probably showing me being wheelchaired around non-responsive, abused by the police, and dragged out of the ER like a dead animal. They refused all requests for 5 months. My current attorney has recently subpoenaed this data and is ‘in talks’ trying to get it released. They finally released security report only. (FYI – apprx 11/21 City prosecutor’s office changed this from a City Ordinance violation to a STATE Statute violation; CITY POLICE guidelines forbid Trespassing arrest’s per my situation; nice work-around (mho))

Linda, John, and I also had an extensive discussion that day regarding my complaint about what Riverside staff had done to me on June 9^th, how it ran counter to common sense, standards of care and Patients’ Bill of Rights law. John said he would look into it and get back to me. I never heard from him or anyone else.

Per a recommendation of a representative of the Medical Board, I made a written request on October 27^th for all “patient related data” and spelled out the detail to Riverside’s Privacy Director, Lois Dahl. In theory, the Board representative thought that the reference to all “patient related data” would break through the Riverside argument that security incident reports and/or video were not part of my “medical record” and their associated argument that they didn’t have to release this data. Lois Dahl replied back arguing that they again did not have to provide the data requested because it did not fit the definition of what had to be provided per my request under HIPAA and that Riverside was not governed by STATE Data Practices and therefore did not have to provide it under those laws either. Maybe if Riverside finds this data so embarrassing they shouldn’t have behaved in such a manner so as to bring this data into being.

Security Report Subpoenaed (Finally Retrieved!)

[This was finally received by me on 1/12/07 – 5 days before trial, after 5 months of requests)]

Riverside Security Incident Report (6/9/06 - 1:32 pm)

Responding Supervisor, R_B_

Report by: L_R_

Category: Patient out of control

On the above date and time, I, Officer L_R_, along with Officers M_______, K_____ and W_____ responded to Unit 12 in the North Building for a discharged patient refusing to leave. Upon arriving at Unit 12, we spoke with the charge nurse who said they had a patient identified as Michael Mike, DOB 8-16-55, who they had just discharged and who now didn’t want to leave. I, along with the other Officers and Psych Associate M_____, approached Mike who was lying down on one of the couches in the lounge with his eyes closed. I advised Mike that he had been discharged by the nurse from the unit and that he would need to leave with us. Mike replied “I’m not leaving. I didn’t get the care I need. I want to talk to a different doctor.” I again advised Mike that he was no longer a patient on the floor and that if he wasn’t going to walk off the unit, security would physically assist him off the unit. He again said something to the effect that he needed additional care and that he wasn’t leaving. We both took hold of Mike’s arms and sat him in a wheelchair. Once he was successfully placed in the wheelchair, all officers began the escort off of the unit.

We wheeled Mike down to the north circle and I advised Mike that he needed to leave the property. Mike sat unresponsive in the wheelchair with his eyes closed. I again stated to Mike that he was discharged and that he needed to leave the hospital’s property. He continued to be unresponsive. Because of the fact that the patient was unresponsive and his earlier claims of needing additional care, I decided to escort the patient to the Emergency Room.

After arriving at the Emergency Room, RN G_____ has us place Mike into room #10. G_____ attempted to get the patient to respond, be he remained unresponsive. I gave G_____ a report of everything I knew about Mike. I helped G_____ get Mike onto a bed. Once this was completed, I stood by for further direction from the ER staff. Dr. L_______ and Charge Nurse C_S_ tried talking to Mike, but he continued to be unresponsive. After Mike’s vital signs were checked, Dr. L_______ and C_S_ decided to have us call the City Police to have him removed. I then asked Dispatcher K_____ to call CITY POLICE for assistance.

I stood by room #10 until City Squad #112 arrived. The officer was told of the situation by C_S_. He then went to Mike’s room and told him to get up. Mike was again unresponsive. The Officer advised Mike that if he didn’t leave he would be placed under arrest. Mike then stated that he didn’t get proper care here. The Officer then asked him if he was refusing to leave. Mike again stated that he didn’t get proper care. The Officer then advised Mike that he was placing him under arrest. I helped secure the patient’s left arm as he was placed in handcuffs. I then helped the Officer carry Mike out to the Officer’s squad car. Once the Officer was clear of the West Circle, I cleared.

Security officer L_R_ states that I replied to him twice. I actually didn’t say a word to security. Not one. Exactly as described in the detailed chronology I wrote shortly after this whole horrible day (above). When I read his report I was very upset by the words he put into my mouth. Twice. They didn’t happen. Also, if I had said anything, it wouldn’t have been that “I didn’t get the care I need” or “I want to talk to a different doctor.” Those were not my concerns. Any statement I made would have been about the single topic of the whole day – that the staff hadn’t completed the after-care outpatient CD tx plan they said they would before I was discharged. Security neglects to describe that they literally lifted me, arms and legs, completely up off the couch. I was pure dead weight. Outside, security stated that I was off the property; that it was over. Security talked among themselves and decided on the ER. His report does confirm that it was quite a long wheelchair ride to the ER. Helping me onto a bed was again an arms and legs dead lift. Security is correct in that I was unresponsive to ER staff. There was only a female voice that asked me questions; no male voice spoke directly to me. Per this report, C_S_’s report to Officer L_F_ included no mention of having come directly from locked mental health Unit 12. I can hardly imagine that the ER didn’t discuss anything with unit 12. This would be a horrible dereliction of duty relative to the safety of one of their severely mentally ill patients. My best guess is that they did; but decided not to tell Officer L_F_ – or they did tell him, but chose not to report it in the security report as Officer L_F_ didn’t in his report. Straight from locked mental health unit, virtually non-responsive, with no one saying a thing about it or factoring that into any decisions. It does not add up. I did not say anything to Officer L_F_ regarding not getting proper care. Not once. Not twice. I had an outburst when Officer L_F_ said he referenced arresting me. (paraphrased) “Arresting me?! Aren’t you supposed to do some investigation before you arrest someone?! Go check my medical record! Aren’t you supposed to do your job before you arrest someone?!” I had one other outburst, when the ER female voice said, “He has a history of violence.” I replied, and this is exact, “I was drunk!” I’ve never hurt anybody when I wasn’t drunk!” Why are such striking responses not in the security report? Why are words not said put into my mouth? My best guess is that those are the words that justify the action taken. If they say that I literally said that I refused to leave it’s a better fit than that I was totally non-responsive (to security) or that I told the Officer to do his job before arresting someone or that I barked back to defend myself from someone telling the Officer I had a history of violence, scared to death about what that little statement might trigger the Officer to do to me. And why were the words of the female ER staff not reported. (paraphrased) “What do you mean he didn’t want to leave the locked mental health unit?! This is ridiculous!” Nobody doesn’t want to leave a locked unit! This doesn’t make any sense!” Again, those words don’t fit too well with professional protocol. It doesn’t reflect well on them (like when Officer L_F_ jammed his knuckle into my ear/jaw; like in the unit when I calmly asked to talk to the unit supervisor, and then her supervisor; or when Wife called at 2:15 and they said, “He’s not here!” and hung up on her), so it isn’t reported. Security did help carry me out, not as benignly as it’s stated in the report given that they literally dragged me out like a dead animal for quite a long ways, lifted me roughly enough for significant bruises at both armpit/ shoulders areas, but at least it’s not a complete fabrication like other stuff.