14577Re: [infoguys-list] Psychiatric case
- Apr 1, 2009
>>> Diagnostic films do not show additional injury to brain >>>What diagnostic tests were performed on this young man?
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Sent: Wednesday, April 01, 2009 5:17 PM
Subject: [infoguys-list] Psychiatric case
$10 per opinion donated to March of Dimes. I am in a time crunch here. (sigh)
Please help me with your valuable opinions. This is an interesting case.
Wonder how y'all feel about the unpredictability of mental illness as well.
If you find the psychiatrist/hospital at fault what are the damages, if any?
Amy singer, Ph.D.
A 20 yr. old mildly retarded, epileptic (seizure) patient is living with his
father, younger sister and grandfather. His mild retardation and epilepsy came
about because of a head injury suffered as a young child. His seizure
disorder also caused a psychiatric disorder, which would, at times, cause him to
act violently towards others. He had been living with his father, who was his
legal guardian, as he had been previously found legally incompetent. He was
admitted to Defendant hospital on two occasions in November and December, 2003
as a Medicaid patient. He had been having seizures. The Defendant hospital is
aware of all of his medical conditions. In early December, he allegedly
strikes a nurse while in the Defendant hospital. There is little supporting
documentation that this event took place other than 1 note in the record as well
as testimony from Defendant hospital employees. Critical documents that the
hospital requires to be kept for violent incidents are unable to be produced by
the Defendant hospital. The defendant hospital cannot identify any of the
people that would have responded to such an incident. Accordingly, surveillance
is not found. The Defendant hospital tried to directly transfer him to
hospital #2, but was unable to do so. The Defendant hospital then had a police
officer working for the Defendant hospital deliver him to hospital #2 as an
involuntary Baker Act patient. This is in violation of the Baker Act. Hospital #2
accepted him as an involuntary Baker Act patient as they did not know he came
from Defendant hospital and discharged him the following day.
Approximately one week after the alleged incident, the patient becomes
violent towards his family. The father calls the police, as he is unable to stop
him. The police Baker Act him to the Defendant hospital. This is the third
visit to the Defendant hospital since November. He is found to be hallucinating,
delusional, and a threat to himself and others. The Defendant hospital, by
law, is a “receiving facility” under the Baker Act. The Defendant hospital
admits him as a Baker Act patient. As a Baker Act patient, he is entitled to
certain rights, including not to be released unless in a stable condition, until
he is no longer a threat to himself or others and until a face-to-face
evaluation is performed by a psychiatrist. The Defendant psychiatrist testified
that he was planning on keeping him at the Defendant hospital for up to 8 days.
The Defendant hospital denies him these rights and he is released into police
custody the following day and charged with battery for allegedly striking the
nurse at the previous visit the week before. The psychiatrist never performed
a face-to-face evaluation to determine if he was stable prior to releasing
him. The medical records indicate that approximately one hour before his
release into police custody, he had a seizure and was delusional. This was not
reported to the psychiatrist by the nurses employed by the Defendant hospital.
The only reason we know about his condition is because a 15 minute tech recorded
his findings. Upon his release, there are no instructions to continue
administering psychotropic drugs. It is well known that abrupt withdrawal of
psychotropic drugs can cause an increase in seizures. It is the Plaintiff’s
contention that the hospital and its employees grew tired of dealing with this
problematic patient and orchestrated his arrest to get him out of the hospital.
The 20 year old mentally retarded young man was taken to jail in an unstable
condition where he was placed in the prison population. He was beaten
(although on direct proof) and found with a black eye and orbital fractures and in a
state of constant seizure, requiring immediate medical attention. It is well
known that being found in a state of constant seizure can cause brain damage.
IQ testing performed months after this incident show a drop in IQ from 61 to
48. This demotes him from the mildly retarded category into the moderately
retarded category. A combination of his head injury and seizures is alleged to
have caused the decrease in IQ. The medical records, by themselves, do not
show a significant change, but the people (and doctors) who know and care for
him the most notice a significant difference. There are records prior to this
incident indicating that he would be able to work in a supervised setting.
Plaintiff alleges that he will now require round-the-clock care.
Problem areas for Plaintiff:
They will have a diificult time proving that he "is worse off" than he was
before (the medical records, by themselves, do not show a significant change);
They will have a diificult time proving that the decrease in IQ was not a
Defense will argue that he is better off in a live-in facility anyway
(records seem to indicate this);
Defense will argue that police made a unilateral arrest and they could not
Diagnostic films do not show additional injury to brain
Hospital will argue they did not harm him, it is the police department’s
He has a violent past
Hospital claiming psychiatrist not an agent of hospital
Problem areas for the defense:
Father makes a very sympathetic witness
Psychiatrist was required to perform a face-to-face evaluation and did not
Hospital released him into police custody in a highly unstable state knowing
that he was aggressive
Hospital and agents violated Baker Act
His medical providers (several of them) will testify that he was much worse
now than before (slower, worsened gait, decreased cognition);
IQ testing shows decrease
IQ testing trends shows decrease after significant events occur. This is a
Inflaming jury by how a mentally retarded young man was treated
Absence of findings on diagnostic films do not mean no injury – witnesses
testified that IQ testing is the best indicator of injury
Glaring absence of proof regarding incident where he struck nurse (at least
that it was as bad as hospital says it was)
**************Feeling the pinch at the grocery store? Make dinner for $10 or
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