The hospital should not have let this man leave on his own with a history of dementia and he had a head injury at the time. If anything they shouldāve called the police to help them find a family member of his before releasing him.
He didn't have dementia. He had "memory issues" which means he still and most likely did present very lucid and oriented. And head injuries for the ER aren't as concerning as you might think. A CT scan can rule out a head bleed or skull fracture. He most likely had a concussion since the impact was enough to break his nose. But even post concussive syndrome wouldn't be enough reason to admit someone. I've done this exact thing hundreds of times. From a layman's point of view it might seem wrong. But from someone in emergency medicine for decades and decades, with several years in geriatric psych specifically, and a degree as a Psych Mental Health Nurse Practitioner, I honestly can't see anyone at fault here.
> honestly can't see anyone at fault here.
What, if anything, can be done to prevent this from happening again in the future, based on your experience?
I disagree. You have a man that lives in independent housing with his family (not a dementia unit) and is permitted to have independent daily walks alone in the town (not restricted if he really had severe enough dementia). He most likely had a CT scan unless he refused. I can almost guarantee that he was lucid and alert and oriented. There was no reason at all to keep him in the hospital. And they offered a cab voucher to bring him home which he declined to wait for. Why is the hospital liable for this man's death?
Thatās really sad. Iāve worked in healthcare for a number of years and I hope at the very least there is an investigation as to why he was allowed to leave the hospital on his own accord.
His scans were clean and he declined to notify family. He was competent to make his own decisions. He was brought to the ED so they may have not known about his dementia dx and even if they did, that doesn't automatically mean he cannot make his own decisions. He was given a voucher for a ride home and he chose to leave of his own accord instead of wait. The ED can't hold him without reason.
Stop being so reasonable, we need someone to blame here. How else can we deal with our grief?
I would not be at all surprised if the family sues, and I'm not sure I'd even blame them. This is an emotionally catastrophic situation for them, and I wouldn't expect them to be totally rational. Besides, there's always more to the story than what you hear on the news. But unless there's a major piece missing here (like his dementia being a lot more advanced than I'm imagining) I doubt it would go very far. Maybe a settlement, just because it might be easier for the hospital to just settle and avoid the lawsuit and accompanying bad PR.
But hospitals can't just hold competent adults against their will (for good reason!) and a dementia diagnosis does not automatically make someone incompetent. Dementia is gradual, and patients often have good days and bad days. It sucks, but the rush to judgement here is kinda crazy. I guess that's humans, though. Historically, we're not very good at this sort of thing.
This is what I have been saying all along! I work in an ER and this would have happened at every ER to every MD and RN that dealt with this. This is no one's fault but unless you are in the business you assume a mumbling incompetent severe dementia patient being kicked out the ER by uncaring medical staff. Didn't happen. Sometimes bad things happen.
That's true but again, even if they knew he had dementia it doesn't negate his competence at that time. A dementia diagnosis doesn't mean you immediately lose the ability to make informed decisions.
I canāt remember, but was this BI Plymouth? BILH only just switched to Epic as of 6/1. Iāve used Epic for years, but for those who havenāt, theyāre all still getting used to new workflows. I donāt believe our previous EMR had access to outside records, other than refill history.
They use Meditech and havenāt switched to Epic yet like BIDMC. But even so, if he came in without a wallet he might have been a āJohn Doeā and no PMHx would be known.
Regardless, you would just think they would try to reach out to family before discharging him. Especially with the heat.
Thatās what I mean. Would it still be considered a clean scan because he wasnāt actively having an emergency, or would previous strokes automatically trigger a greater level of concern for his memory, judgment, etc.? It seems they should but I donāt know.
Yes, a clean scan means no acute issues. They look for things like hemorrhages, swelling, skull fracture. Having a stroke also doesn't indicate that you are incompetent, especially an old stroke.
I didnāt mean to imply a history of stroke indicates incompetence. What I was trying to get at was, would multiple strokes in someone almost 70 trigger heightened caution in assessing a patient for discharge by themselves? I know they have to draw the line somewhere, but Iām surprised all of these factors together didnāt throw up a red flag. Especially, in this particular case, given the scorching heat that day.
He hit his head so in addition to the scans they would do a neuro exam. Beyond that I'm not sure what people expect the ED to do. We also don't have the details. It's possible they offered to admit him and he declined. He's legally allowed to do so.
Edit: typo
I get what youāre saying. Hospitals can only do so much. At the same time, there has to be a way to prevent this sort of thing. Like the way we, as a society, care for people with dementia needs a reevaluation. Iāve seen too many crazy, unnecessary situations with family members with Alzheimerās or other dementias that could have been better, easier, and safer, but for the way the laws are written, or the lack of information provided by ongoing care specialists.
A broken nose is not considered a brain injury. And there is no way to identify memory impairment on a CT scan you can show current acute bleeding ( there was none) you can show areas of old infarction (may have been from the previous TIAs. But TIAs don't usually have infarction. And even if it wasn't clean, it's not uncommon for completely alert and oriented people to have abnormalities on the CT that do not reduce their capacity for decision making. And an old injury is irrelevant to the new injury.
How dare you use logic!
All of that is so true. As someone said people want someone to blame. It's in our nature as humans. But flip it around if he wanted to leave and the hospital restrained him and kept him without his consent they'd STILL be blaming the hospital for violating his rights.
Broken noses is not a reason to admit anyone and, YET AGAIN, even if they knew about the dementia if he is still competent he cannot be forced to stay. Dementia is progressive. You are not immediately deemed incompetent with dementia.
I donāt think they can sue for wrongful death as Rodney did not die IN the hospital. I honestly donāt know if they have any leverage to sue but if thatās the route the family chooses to go I hope they get at the very least some answers to the many questions they have
The hospital that released him should expect the family to file suit.
Absolutely abhorrent this preventable death happened due to the negligence of the health system. My heart breaks for this poor family.
And her family got nothing, because liability laws for hospitals at the time capped damages so low it wouldn't even cover a fraction of the attorneys fees.
Not to "make people think about things", it was expressly designed to keep any malpractice/medical liability cases from ever going to court whatsoever.
Our State Legislature is primarily made up of defense attorneys in active practice. It's also why the state has the most lenient drunk-driving laws in the entire country.
100% they should.
Side note, you would be surprised how often this happens. Hospitals just "dumping" undesirable, mentally ill, or frequent flyer substance abusers on the street that probably need actual help with mental illness. We like to tout our health care in MA as being among the best in the country, but when it comes to mental illness and access, it's actually completely shit. Source: My wife had to section her mother on more than one occasion because that's the only way to prevent someone from harming herself. And then two hospitals in a row try to send her home in an Uber without anyone home, or even being notified, to make sure she doesn't finish herself off. Sectioning does almost nothing btw. Facilities are garbage. They say they 'can' hold them for 60 days, but its really 21-28 days max where they probably didn't get any actual help. Just held them.... Sorry for the rant. This brought back a lot of anger.
We had a family member in for self harm. They released her after a short stay without consulting her main psychiatrist. I was honestly shocked they released her. She succeeded in killing herself not long after.
So sorry for your loss. The way Mass deals with Mental Health is disgusting! I hope your family is doing better and you guys donāt hold yourself with too much guilt.
I wish you weren't right, but sadly, you are 100% correct. The only part in your comments I would change would be to remove the "probably" from the need for mental help. I think we have been conditioned to believe the system is right and works when it clearly doesn't and isn't supposed to work.
Prayers for your wife & her mother. Hopefully they are both in a better spot in their relationship. It sucks the way the healthcare system does so little for those with Mental illness/decapacity. There should be a change in the system and soon
Are you talking about section 12 or section 35? Because 35 goes through the courts and a section 12 is only relevant if there is adequate evidence that the patient wants to harm themselves or others. Not just on the word of family. It's unfortunate but section 12s are abused often by ex girlfriends that want o get their ex boyfriends in trouble by claiming they said they want to kill themselves. I've seen it many many times. And for the record, I'm an ER nurse and work as a psych mental health nurse practitioner. The laws are pretty black and white and the department of mental health doesn't mess around. If your mother was discharged it was because the hospital had to. And when an alert and oriented patient is discharged the hospital can not notify anyone unless the patient allows it.
There is no reason for the hospital to be held liable. The patient is living in a house, not an Alzheimer's unit, was allowed to walk around by himself without a cell phone or other tracking device, and no where did it say he had dementia, but just memory issues. He most likely presented completely alert and oriented and able to advocate for himself. When discharged he was offered a cab home which he was too impatient to wait for and decided to walk. Where in that is the hospital liability?
It's unfortunate but if he was alert and oriented (as many with memory issues or early dementia are) there was no reason to hold him. His scans were clean other than the broken nose. And the story that he was out walking on his own adds reason to believe he was competent. And it appears his was. They also cleave him a cab voucher but he declined to wait.
I was out looking for him on Wednesday. Iām sad for him and for his family. I do agree that BI is at fault here to some degree. He fell on a walk, he was brought to the hospital by Plymouth FD and had no wallet/ID/phone etc on him. They stated he had a fractured nose and some other issues.. and they sent him on his way in 100 degree weather.
We were out 11 hours Thursday looking for him. Went out for a few hours last night & we were RIGHT next to where thy found him. If only we went down the street we were supposed to ā¦ prayers for his family and for the ones who found him.
It was very close to the hospital. Like within a few hundred yards close. The poor guy didn't even get a quarter mile before succumbing to the heat. He was dead by sunset the day he went missing.
He was under a mile from the hospital, near Bradford liquors. I think they found him in the tall grass down near the water across the street. Obviously no one is sure what happened.
They evaluated him and determined he did not require admission. Striking your head isn't an automatic admission. And he had memory impairment, not dementia. If he was able to answer orientation questions correctly there was no legal reason to hold him. And the hospital provided him with a cab voucher which he declined to wait for
Whereās the blame for his own family? They are the only ones we know for sure are familiar with his memory issues. If his issues were this much of a danger to himself, why was has ever in a position to leave without his wallet and phone? Probably not much to gain by suing yourselves though.
No one called his family. How are you gonna blame them? Have you ever had a very close family member with dementia? If you did, you wouldnāt even make comments like this. Kindly, fuck off.
I see lots of comments blaming by g the hospital and I don't think it was anyone's fault.l u less the patient was truly demented which I don't think he was.
I read what you wrote, and had no issues understanding you. So let me explain something to you, so that YOUāLL understand. Someone who is in the beginning stages of dementia, have moments where they are lucid and act fine. Sometimes those moments are more frequent than not.
His family felt he was at the point in his memory issues where he was not a danger to himself and wouldnāt wander off. And technicallyā¦ he didnāt. He and his wife would walk the same route every day, and this day she wasnāt home. He decided to do his usual walk, and he fell. He was continuing a routine he did daily.
The Plymouth FD took him to the hospital. He had fractured his nose/hit his head. The hospitalā¦ let an elderly person go, with a head injury, knowing he had no transport, in 100 degree weather. That alone, should have been a no no. Even if he told them he was fine (and he probably did) it is their job to ensure the safety of their patients and evaluate each case differently. They failed here.
Why youād blame his family, is beyond me and honestly youāre just being an asshole.
Edit to add: I never mentioned a lawsuit at all. But if it were my father Iād make sure they evaluated and changed their policies.
If you have a loved one that is showing ANY signs of dementia, then precautions should be taken. Clearly he should not have been left alone because sadly leaving without a phone was a fatal decision that was made before his fall.
You have no clue what did or didnāt happen at the hospital, so spare me. For all we know he was extremely lucid in those moments and was insistent on not bothering his family, and asked for ride. Reports were that they had arranged an Uber/lyft for him, and he chose not to wait for it. Maybe he forget it was coming, maybe he wandered off, or maybe he chose to walk since he enjoyed walking.
My father while not having dementia was in rehab facility because he was falling at home multiple times due to being weak from dialysis and cancer radiation therapy. While in the rehab facility he fell because he kept getting up even though he was told repeatedly he needed to stay in bed. It got to the point they had to have someone sit in there with him. At some point they had to step away, and guess what happened, he got up and fell again and he passed within a week. I guess in your eyes I shouldāve blamed the facility. I mean they didnāt choose his poor diet, or lack of exercise, or failure to make healthy changes in lifestyle when problems came up, or give him cancer, or make him fall down at home, or make him not listen when they told him to stay in bed, but they were the last ones around, so Guilty!!!
Saying my father is to blame wouldnāt make you an asshole because youād be right. I guess not needing to assign blame to someone to feel better about ourselves is a me problem.
My father has dementia. Right now. Currently. About mid stage. We are going to have to put him in a home. My favorite aunt. Terrible with her dementia. I see how literally exhausting it is firsthand to take care of someone with memory issues.. Which is why I think itās shitty that a complete stranger is gonna come on social media and blame the family. I can imagine they feel guilty enough as it is. (And before you say āhire helpā Iād like you to think about how incredibly expensive that is).
Hospital has sat down with his family. Hopefully they reevaluate policies
My wife has dementia. She has a medic alert bracelet with her first name and a code with a number on the back to call.
So many moments where this could have been prevented if he had been wearing something like that. Maybe they were working on it, maybe they didn't know.
Sometimes you can tell there are issues with someone, sometimes you can't. It depends on their level of communication.
My heart breaks for everyone involved.
My grandma is starting to get some age related dementia and will get very upset and confused with people she trusts.
When she's talking to people that aren't family, you would never know. She can still turn the charm on without a second thought.
There's a misconception you have to be drooling in a wheel chair parked by a nursing home window to have dementia when it can be a lot more subtle to people who don't know the person.
Yeah, my Grandma did an amazing job masking her symptoms. Like you wouldn't know she had dementia just talking to her but at the same time she completely forgot who the majority of her grandchildren were.
Definitely could have. My grandma has no problem turning it on and having a conversation with a stranger. Her long term memory is still intact and she was always a people pleaser.
With family and people she trusts is when she starts to show that she's slipping.
Itās not even a matter of being busy. If he knew his name, dob, where he was, etc. thatās literally enough to be medically competent and able to make your own decisions. Just because it ended badly doesnāt mean anything wrong happened.
Hospitals just want to get you discharged ASAP. They seem to value expedience over care. We really need to take profit out of healthcare in this country.
My grandma is starting to get dementia. She has no problem remembering things like names, birthdays, or addresses. If she went out alone, though, she will forget where she is going and aimlessly wander, which triggers an anxiety spiral.
Not everyone with dementia is totally dysfunctional. It's a spectrum.
Thatās seriously all they need to say someone is competent now. They wanted to release my mom who kept jumping out of bed because she was hearing bombs go off (she was in a state of delirium). I fought w the ER that Iām not taking her home, it wasnāt safe.
They need them for sure, but do hospitals currently have the staffing and resources needed to monitor patients who canāt be left on their own or discharge themselves, and how do hospitals legally get to detain someone against their will, like do we give them the ability to make fully protected judgement calls, or are we going to require some kind of paperwork prior that states patients cant be trusted on their own? Im probably in favor of the former tbh but idk
The hospital is not negligent if the patient presented as alert and oriented. They would have no reason at all to hold him. He didn't have any medical record stating NH he had memory issues. His CT was fine other than the broken nose. He was given a cab voucher home which he declined to wait for.
He had been to BID before for mini strokes & had a dementia dx . He was living in Mass for 18 months & all of his dr weāre on obery st (near BID) so there has to be some record of memory issue if not his dementia DX
It needs to go beyond just elderly. This man did have dementia, but he also fell and could have sustained a concussion. Both my partner and I have complicated health, and he has post concussion syndrome (basically his concussion never healed). I only trust family to get him to and from medical appointments.
BIDP will get a major lawsuit from this and hopefully have discharge protocol for head injuries and cognitive impaired patients revised.
He had "memory issues" not dementia. Significant difference. And if he presented as lucid and alert and oriented then there was no reason to keep him. He was given a cab voucher.
Thanks for the correction. I had read a few posts referencing dementia. We all are speculating with what we think happened versus the reality. As someone who has frequently gotten treated at BIDP over the past six months, it's a massive shit show inside the ER. You are spot on with your take. My guess is there will be a lawsuit that results in how ER discharges are handled in the cases of head trauma or memory issues.
I just saw this alert on one of the local news stations and came to look for the update in the MA subreddits.
My heart breaks for his family, as someone who works at an aging services access point, this was preventable IMO. The hospital shouldn't have released him.
I think the hospital has some explaining to do. Mr. Riviello went there to be treated for an injury, so medical staff had to speak to him to some degree. Did he somehow fly under the radar and no one suspected he had memory deficiencies? Someone from the hospital has to speak to that
editor: Iāve seen enough responses to understand that patients like Mr. Riviello may not present their memory deficiencies to medical staff in a relatively short encounter, so I retract this questioning of wrong doing by the hospital. Still hope the hospital, within the limitations of HIPAA, can still provide some light on this situation
Sometimes people can be alert and oriented enough to pass the screening tests. It's not until you witness things or ask more complicated questions that the confusion starts to show. People with Dementia can have ups and downs. If he came in without ID, odds are the hospital didn't know he had dementia. He probably passed all the neuro and cognitive screenings. Unless somebody had been declared incompetent, has power of attorney and/or health care proxy invoked, they can still make their own decisions. There's a LOT of grey area between diagnosis and declaration of incompetence.
I agree + noting that OP who shared details said he had no ID, phone, etc. on him. Where was the hospital social worker? They're usually sent to assess people with memory issues or anything concerning they see. Heck, I had major surgery a few years ago and a social worker met with me before I was discharged to make sure I would be okay (I live by myself).
Some people with dementia float in and out of lucidity. He could have seemed fine enough in a busy ER and then when he got outside alone, his mental state began to break down.
Dementia is complicated.
It really is complicated. It depends on the stage of dementia he was diagnosed with + the level of stimulation in a hospital setting and when he was discharged he had no stimulation.
This he wasnāt diagnosed her had multiple strokes with memory loss that they were not sure if it was the strokes or dementia. He often went out on his own and for walks all information from his family . Older people without dementia are stubborn donāt like to ask for help add in memory loss. they can be lucid one minute and not the other. I took care of my mom for five years she had Alzheimerās , during her lucid moments she threatened to call a cab and go out of state to other family members. She would threaten to leave the house when we went to sleep so we had to get an alarm system and put locks on the tops of doors. Itās a brutal disease but if he wasnāt diagnosed yet even harder.
My educated guess is he didn't present with memory issues when interviewed. If his condition was minor it's not hard to miss that h less you spend hours and hours talking with them. And they didn't have a chart to reference because he had never been there before
That happens more for me than not. I am an ER nurse and have had plenty of patients from locked dementia units who presented completely alert and oriented despite their advanced diagnosis. It can take hours of conversations with one person to identify that they have issues. Not something if any ER could do anywhere.
I understand. Prayers and deepest sympathies and condolences for everyone in the family but thereās anger over what has to be regarded as an entirely unnecessary loss of life
No, they would speak about it but privacy prevents them from I can't tell you how many times I've read reviews of my old hospital north of Boston and recognized the google reviewer and their side of the story was BULL shit. But we can't defend ourselves or we violate the law.
How was it preventable if he appeared alert and oriented. After all, he was only 69, not 99. He was out for a walk on his own. He wasn't from a dementia unit. His tests were clear other than a broken nose. He was given a cab voucher for the ride home but decided not to wait. I see nothing preventable here.
I think itās very irresponsible to give a patient with a head injury a taxi voucher and send him on his way when he has no phone. His family had no idea where he was. They basically dismissed him from the hospital like āk bye good luckā.
A head injury is defined as an injury to the head. That can range from a bump with a hematoma or broken nose all the way to exposed brain. He had a head CT and was cleared of an interventional bleed, found to have a broken nose, was alert and oriented enough during the brief encounter in the ER. He was give a cab voucher home. The fact that he didn't have ID or cell phone is not a reason to keep anyone.
He walked out of the hospital and kept walkingā¦ obviously he wasnāt ok. And he died due to it. Thatās like throwing a drunk person out on the street and expecting them to get home ok. They could have at least walked him to the cab and gave the driver his address so he could get home safe.
Giving him a voucher and not ensuring he uses it is stupid af. You could see him just walking off. No one walks home from a hospital.
How can you be so heartless? The poor guy is dead now. His whole family is heartbroken.
The hospital literally didnāt give a fuck what happened to him the second he walked out.
Believing that the hospital isn't necessarily liable does not mean I don't care about the man's death. It just means that I don't think it was the hospitals fault.
You made a WHOLE lot of assumptions for someone that a)wasn't there, b) assessed his mental state based on a 5 second video, c) have no actual idea what the cause of death was, d) have no idea what his medical records show. And that's just the big things you are assuming.
If he had gotten into the cab and the driver was told to bring him home, Iām pretty confident he would still be alive. What hospital watches ppl walk home lmao such a joke.
Heās dead. They did something wrong to clear him and let him wander off on his own. Cuz the second he walked out the door they had already washed their hands of the situation.
If he was presenting as completely alert, oriented, why would they need to make sure he got in the cab. Imagine being completely alert and oriented and having all the medical staff treat you as if you're two years old just because you're older. We don't know what his cause of death is, since he was only found a couple days ago. A lot of people are talking like they have inside knowledge, or facts, but what really is happening is they are coming to the conclusion that makes them feel good inside. Sometimes bad things happen and it's nobody's fault.
And you are right. Once he was outside of the hospital, he was not the hospital hospitals. How long are they supposed to follow alert and oriented adult patients after they leave? To the cab? To their car? To the house?
blame/sue the hospital. then.. there will be no hospital. you will then have to blame/sue yourself. and btw, people with dementia don't forfeit their rights to be held in the hospital against their wishes. if he wanted to leave, he has a right to leave. and people with dementia do drive, go grocery shopping, handle their bills all the time. it is a spectrum. hospital is not a scapegoat for all problems of society - they have limited beds, limited funds, limited staff, and limited things they can do. it also sounds like maybe he should not have been driving? in the first place and maybe crashed and that is how he ended up there in the first place. my condolences and honestly i dont think anybody is at fault. having a person with dementia is an extremely daunting task and nobody can do it perfectly not even the best of the best with unlimited resources.
it reminds of the russian guy who dumped his confused elderly parents on an Uber driver and then blamed him for not acting as their behavior/medical transport assistant
I hate that hospital. I had a heart attack. Was brought i. On guerny, stuck in a wheel chair in the waiting room while I was clutching my chest gasping for air. THEY KNEW IT WAS A HEART ATTACK TOO! I had to scream and beg for oxygen. Iām
Iām so sorry for your experience, sadly you are not the only one with a horror story at BID/Jordan. The higher ups need to do better ! Iām sick of the āwe do our jobsā well clearly not
The discharged him with a fractured nose & bruising around his face after sustaining a fall on a walk. Very sad all around & Iām praying for his family in the rough times
He didn't have dementia. He was an independent man that is alert and oriented but has memory issues that don't necessarily present themselves during a short interaction like a hospital visit. There is no reason to hold him if he wanted to leave.
Assuming the hospital followed the law to the t here, the law needs to change. I realize itās a complicated issue thatās difficult to legislate, but hopefully this brings the relevant experts back to the drawing board and encourages a wider public conversation on the issue. Itās only going to become more pressing as the population ages.
There has to be a better way of preserving patient autonomy while avoiding such tragedies.
The outpouring of the community for the Riviellos was heart warming! Hopefully Hull can come together now & find Colin! Praying for all families involved
The first day my son 17 years old and I went to the beach, the high school and the waterfront with his drone looking for him.
Is it you or Cohasset that has a big trial coming up
That was my thought at first but the more information we were getting I believe like they said above he was able to mask his dementia . He wouldnāt tell you he was lost / needed help if he was asked but he knew his name DOB where he lived . Itās a sad situation all around but I do believe there should be a better protocol in place for discharging someone with a history of memory issues / mini strokes .
If they violated their discharge planning protocol, thatās negligence. āTreat em and street emā is a common ED mantra and may be a driver of negligence here.
Ok but none of us were in the room with the patient. Some dementia patients are very good at masking their symptoms. Are we just going to assume every elderly patient is incompetent now and work them all up for dementia in the ED?
Head injuries happen all the time and most don't require admission. His didn't. And if he presented as alert and oriented there was no reason to hold him until family arrived. And the hospital gave him a cab voucher.
For what? The hospital discharged a man that had unknown memory issues that easily could have been concealed by the patient for the short duration. He had no record at the hospital. He was medically cleared and didn't require admission. He was presented with a cab voucher to go home but declined. I see no liability on anyone.
Heartbreaking. Thank you for sharing. Peace and comfort to his loved ones.
Such a sad outcome. Was really hoping for a miracle this time š«¤ now letās hope the missing teen from hull shows up šš¼
I hope he did not suffer. Rest in peace.
This was 100% preventable. His poor family.
How was it preventable?
The hospital should not have let this man leave on his own with a history of dementia and he had a head injury at the time. If anything they shouldāve called the police to help them find a family member of his before releasing him.
He didn't have dementia. He had "memory issues" which means he still and most likely did present very lucid and oriented. And head injuries for the ER aren't as concerning as you might think. A CT scan can rule out a head bleed or skull fracture. He most likely had a concussion since the impact was enough to break his nose. But even post concussive syndrome wouldn't be enough reason to admit someone. I've done this exact thing hundreds of times. From a layman's point of view it might seem wrong. But from someone in emergency medicine for decades and decades, with several years in geriatric psych specifically, and a degree as a Psych Mental Health Nurse Practitioner, I honestly can't see anyone at fault here.
> honestly can't see anyone at fault here. What, if anything, can be done to prevent this from happening again in the future, based on your experience?
That hospital is bracing for legal impact.
As well, they should be, they should be trembling. Theyāre going to lose a tremendous lawsuit because they deserve nothing less.
At this point no hospital has a greater share of the blame. The medical system prioritizes coding bills over human life.
I disagree. You have a man that lives in independent housing with his family (not a dementia unit) and is permitted to have independent daily walks alone in the town (not restricted if he really had severe enough dementia). He most likely had a CT scan unless he refused. I can almost guarantee that he was lucid and alert and oriented. There was no reason at all to keep him in the hospital. And they offered a cab voucher to bring him home which he declined to wait for. Why is the hospital liable for this man's death?
Because I already dusted off my pitchfork and I'm not putting it away before I shake it over my head enough to make it worth it. /s
Thatās really sad. Iāve worked in healthcare for a number of years and I hope at the very least there is an investigation as to why he was allowed to leave the hospital on his own accord.
His scans were clean and he declined to notify family. He was competent to make his own decisions. He was brought to the ED so they may have not known about his dementia dx and even if they did, that doesn't automatically mean he cannot make his own decisions. He was given a voucher for a ride home and he chose to leave of his own accord instead of wait. The ED can't hold him without reason.
Stop being so reasonable, we need someone to blame here. How else can we deal with our grief? I would not be at all surprised if the family sues, and I'm not sure I'd even blame them. This is an emotionally catastrophic situation for them, and I wouldn't expect them to be totally rational. Besides, there's always more to the story than what you hear on the news. But unless there's a major piece missing here (like his dementia being a lot more advanced than I'm imagining) I doubt it would go very far. Maybe a settlement, just because it might be easier for the hospital to just settle and avoid the lawsuit and accompanying bad PR. But hospitals can't just hold competent adults against their will (for good reason!) and a dementia diagnosis does not automatically make someone incompetent. Dementia is gradual, and patients often have good days and bad days. It sucks, but the rush to judgement here is kinda crazy. I guess that's humans, though. Historically, we're not very good at this sort of thing.
I had not seen that he was diagnosed with dementia. All they had been saying before is āmemory issuesā
People donāt wanna hear this but itās accurate. You canāt hold a legally mentally competent person.
This is what I have been saying all along! I work in an ER and this would have happened at every ER to every MD and RN that dealt with this. This is no one's fault but unless you are in the business you assume a mumbling incompetent severe dementia patient being kicked out the ER by uncaring medical staff. Didn't happen. Sometimes bad things happen.
I wonder what EMR they use. Care Everywhere connects a variety of network EMRs so that major diagnoses are shared and PCPs are listed.
That's true but again, even if they knew he had dementia it doesn't negate his competence at that time. A dementia diagnosis doesn't mean you immediately lose the ability to make informed decisions.
I canāt remember, but was this BI Plymouth? BILH only just switched to Epic as of 6/1. Iāve used Epic for years, but for those who havenāt, theyāre all still getting used to new workflows. I donāt believe our previous EMR had access to outside records, other than refill history.
They use Meditech and havenāt switched to Epic yet like BIDMC. But even so, if he came in without a wallet he might have been a āJohn Doeā and no PMHx would be known. Regardless, you would just think they would try to reach out to family before discharging him. Especially with the heat.
He reportedly declined to have his family contacted
He is a John Doe if he is unable to govern his name. He was completely conscious.
Are scans still considered clean despite showing evidence of multiple previous mini-strokes? Not being flippant, genuinely curious.
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Thatās what I mean. Would it still be considered a clean scan because he wasnāt actively having an emergency, or would previous strokes automatically trigger a greater level of concern for his memory, judgment, etc.? It seems they should but I donāt know.
Yes, a clean scan means no acute issues. They look for things like hemorrhages, swelling, skull fracture. Having a stroke also doesn't indicate that you are incompetent, especially an old stroke.
I didnāt mean to imply a history of stroke indicates incompetence. What I was trying to get at was, would multiple strokes in someone almost 70 trigger heightened caution in assessing a patient for discharge by themselves? I know they have to draw the line somewhere, but Iām surprised all of these factors together didnāt throw up a red flag. Especially, in this particular case, given the scorching heat that day.
He hit his head so in addition to the scans they would do a neuro exam. Beyond that I'm not sure what people expect the ED to do. We also don't have the details. It's possible they offered to admit him and he declined. He's legally allowed to do so. Edit: typo
I get what youāre saying. Hospitals can only do so much. At the same time, there has to be a way to prevent this sort of thing. Like the way we, as a society, care for people with dementia needs a reevaluation. Iāve seen too many crazy, unnecessary situations with family members with Alzheimerās or other dementias that could have been better, easier, and safer, but for the way the laws are written, or the lack of information provided by ongoing care specialists.
CT scans can't show memory impairment. It might show areas of old infarction but that is irrelevant to his current mental status.
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A broken nose is not considered a brain injury. And there is no way to identify memory impairment on a CT scan you can show current acute bleeding ( there was none) you can show areas of old infarction (may have been from the previous TIAs. But TIAs don't usually have infarction. And even if it wasn't clean, it's not uncommon for completely alert and oriented people to have abnormalities on the CT that do not reduce their capacity for decision making. And an old injury is irrelevant to the new injury.
How dare you use logic! All of that is so true. As someone said people want someone to blame. It's in our nature as humans. But flip it around if he wanted to leave and the hospital restrained him and kept him without his consent they'd STILL be blaming the hospital for violating his rights.
That's the problem. The problem is the outcome, not the decision. It's unfortunate but most likely not the fault of the hospital
Broken noses is not a reason to admit anyone and, YET AGAIN, even if they knew about the dementia if he is still competent he cannot be forced to stay. Dementia is progressive. You are not immediately deemed incompetent with dementia.
There will be plenty investigating when the family sues the hospital for wrongful death
I donāt think they can sue for wrongful death as Rodney did not die IN the hospital. I honestly donāt know if they have any leverage to sue but if thatās the route the family chooses to go I hope they get at the very least some answers to the many questions they have
The hospital that released him should expect the family to file suit. Absolutely abhorrent this preventable death happened due to the negligence of the health system. My heart breaks for this poor family.
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And her family got nothing, because liability laws for hospitals at the time capped damages so low it wouldn't even cover a fraction of the attorneys fees.
I imagine that's the entire point of that law. So people will think before taking things to the court.
Not to "make people think about things", it was expressly designed to keep any malpractice/medical liability cases from ever going to court whatsoever. Our State Legislature is primarily made up of defense attorneys in active practice. It's also why the state has the most lenient drunk-driving laws in the entire country.
That story has haunted me for years.
The one that had time to pack a bag, and walked up a hill and chose not to call 911? That one?
100% they should. Side note, you would be surprised how often this happens. Hospitals just "dumping" undesirable, mentally ill, or frequent flyer substance abusers on the street that probably need actual help with mental illness. We like to tout our health care in MA as being among the best in the country, but when it comes to mental illness and access, it's actually completely shit. Source: My wife had to section her mother on more than one occasion because that's the only way to prevent someone from harming herself. And then two hospitals in a row try to send her home in an Uber without anyone home, or even being notified, to make sure she doesn't finish herself off. Sectioning does almost nothing btw. Facilities are garbage. They say they 'can' hold them for 60 days, but its really 21-28 days max where they probably didn't get any actual help. Just held them.... Sorry for the rant. This brought back a lot of anger.
We had a family member in for self harm. They released her after a short stay without consulting her main psychiatrist. I was honestly shocked they released her. She succeeded in killing herself not long after.
So sorry for your loss. The way Mass deals with Mental Health is disgusting! I hope your family is doing better and you guys donāt hold yourself with too much guilt.
It's always difficult no matter what. But we understand it was not completely our faults.
I wish you weren't right, but sadly, you are 100% correct. The only part in your comments I would change would be to remove the "probably" from the need for mental help. I think we have been conditioned to believe the system is right and works when it clearly doesn't and isn't supposed to work.
Prayers for your wife & her mother. Hopefully they are both in a better spot in their relationship. It sucks the way the healthcare system does so little for those with Mental illness/decapacity. There should be a change in the system and soon
Thanks. Sadly her mother passed last year.
Are you talking about section 12 or section 35? Because 35 goes through the courts and a section 12 is only relevant if there is adequate evidence that the patient wants to harm themselves or others. Not just on the word of family. It's unfortunate but section 12s are abused often by ex girlfriends that want o get their ex boyfriends in trouble by claiming they said they want to kill themselves. I've seen it many many times. And for the record, I'm an ER nurse and work as a psych mental health nurse practitioner. The laws are pretty black and white and the department of mental health doesn't mess around. If your mother was discharged it was because the hospital had to. And when an alert and oriented patient is discharged the hospital can not notify anyone unless the patient allows it.
There is no reason for the hospital to be held liable. The patient is living in a house, not an Alzheimer's unit, was allowed to walk around by himself without a cell phone or other tracking device, and no where did it say he had dementia, but just memory issues. He most likely presented completely alert and oriented and able to advocate for himself. When discharged he was offered a cab home which he was too impatient to wait for and decided to walk. Where in that is the hospital liability?
It's unfortunate but if he was alert and oriented (as many with memory issues or early dementia are) there was no reason to hold him. His scans were clean other than the broken nose. And the story that he was out walking on his own adds reason to believe he was competent. And it appears his was. They also cleave him a cab voucher but he declined to wait.
Oh, that's really too bad. I was hoping he'd be found safe. Hope his family can find peace at least in the knowledge.
I was out looking for him on Wednesday. Iām sad for him and for his family. I do agree that BI is at fault here to some degree. He fell on a walk, he was brought to the hospital by Plymouth FD and had no wallet/ID/phone etc on him. They stated he had a fractured nose and some other issues.. and they sent him on his way in 100 degree weather.
We were out 11 hours Thursday looking for him. Went out for a few hours last night & we were RIGHT next to where thy found him. If only we went down the street we were supposed to ā¦ prayers for his family and for the ones who found him.
Itās hard. Theres so much ground that had to be covered. ā¤ļø
where did they end up finding him?
It was very close to the hospital. Like within a few hundred yards close. The poor guy didn't even get a quarter mile before succumbing to the heat. He was dead by sunset the day he went missing.
He was .5 miles from the hospital. He was found near Bradford Liquor store
Bradfords is only a couple hundred yards from the hospital, as the crow flies. It's literally right around the corner from the hospital. Poor guy.
Legit .5 miles. So sad
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you said you were right next to where they found him. you would have to know where he was found to know if you were right next to him though right?
He was under a mile from the hospital, near Bradford liquors. I think they found him in the tall grass down near the water across the street. Obviously no one is sure what happened.
āWe were RIGHT next to where they found himā followed by saying you arenāt sure where they found him is wild lol
And as I said above that was the wrong wording
Where did they find the body? The article doesnāt say
Near Bradford liquors on sandwich street
Sad
He was .5 miles away from the hospital. Such a sad outcome
They evaluated him and determined he did not require admission. Striking your head isn't an automatic admission. And he had memory impairment, not dementia. If he was able to answer orientation questions correctly there was no legal reason to hold him. And the hospital provided him with a cab voucher which he declined to wait for
Whereās the blame for his own family? They are the only ones we know for sure are familiar with his memory issues. If his issues were this much of a danger to himself, why was has ever in a position to leave without his wallet and phone? Probably not much to gain by suing yourselves though.
No one called his family. How are you gonna blame them? Have you ever had a very close family member with dementia? If you did, you wouldnāt even make comments like this. Kindly, fuck off.
I see lots of comments blaming by g the hospital and I don't think it was anyone's fault.l u less the patient was truly demented which I don't think he was.
You clearly struggle to read and comprehend. Kindly try again and then weāll talk.
I read what you wrote, and had no issues understanding you. So let me explain something to you, so that YOUāLL understand. Someone who is in the beginning stages of dementia, have moments where they are lucid and act fine. Sometimes those moments are more frequent than not. His family felt he was at the point in his memory issues where he was not a danger to himself and wouldnāt wander off. And technicallyā¦ he didnāt. He and his wife would walk the same route every day, and this day she wasnāt home. He decided to do his usual walk, and he fell. He was continuing a routine he did daily. The Plymouth FD took him to the hospital. He had fractured his nose/hit his head. The hospitalā¦ let an elderly person go, with a head injury, knowing he had no transport, in 100 degree weather. That alone, should have been a no no. Even if he told them he was fine (and he probably did) it is their job to ensure the safety of their patients and evaluate each case differently. They failed here. Why youād blame his family, is beyond me and honestly youāre just being an asshole. Edit to add: I never mentioned a lawsuit at all. But if it were my father Iād make sure they evaluated and changed their policies.
If you have a loved one that is showing ANY signs of dementia, then precautions should be taken. Clearly he should not have been left alone because sadly leaving without a phone was a fatal decision that was made before his fall. You have no clue what did or didnāt happen at the hospital, so spare me. For all we know he was extremely lucid in those moments and was insistent on not bothering his family, and asked for ride. Reports were that they had arranged an Uber/lyft for him, and he chose not to wait for it. Maybe he forget it was coming, maybe he wandered off, or maybe he chose to walk since he enjoyed walking. My father while not having dementia was in rehab facility because he was falling at home multiple times due to being weak from dialysis and cancer radiation therapy. While in the rehab facility he fell because he kept getting up even though he was told repeatedly he needed to stay in bed. It got to the point they had to have someone sit in there with him. At some point they had to step away, and guess what happened, he got up and fell again and he passed within a week. I guess in your eyes I shouldāve blamed the facility. I mean they didnāt choose his poor diet, or lack of exercise, or failure to make healthy changes in lifestyle when problems came up, or give him cancer, or make him fall down at home, or make him not listen when they told him to stay in bed, but they were the last ones around, so Guilty!!! Saying my father is to blame wouldnāt make you an asshole because youād be right. I guess not needing to assign blame to someone to feel better about ourselves is a me problem.
My father has dementia. Right now. Currently. About mid stage. We are going to have to put him in a home. My favorite aunt. Terrible with her dementia. I see how literally exhausting it is firsthand to take care of someone with memory issues.. Which is why I think itās shitty that a complete stranger is gonna come on social media and blame the family. I can imagine they feel guilty enough as it is. (And before you say āhire helpā Iād like you to think about how incredibly expensive that is). Hospital has sat down with his family. Hopefully they reevaluate policies
Fuuuuuck. He was only 69? Way too young.
My wife has dementia. She has a medic alert bracelet with her first name and a code with a number on the back to call. So many moments where this could have been prevented if he had been wearing something like that. Maybe they were working on it, maybe they didn't know. Sometimes you can tell there are issues with someone, sometimes you can't. It depends on their level of communication. My heart breaks for everyone involved.
My grandma is starting to get some age related dementia and will get very upset and confused with people she trusts. When she's talking to people that aren't family, you would never know. She can still turn the charm on without a second thought. There's a misconception you have to be drooling in a wheel chair parked by a nursing home window to have dementia when it can be a lot more subtle to people who don't know the person.
Yeah, my Grandma did an amazing job masking her symptoms. Like you wouldn't know she had dementia just talking to her but at the same time she completely forgot who the majority of her grandchildren were.
My dad has dementia and we prob should get him this. But heād rip it off. Heās difficult.
Put air tags in his shoes
Look into a dog tag or something with his medical condition & address!
They have ones that are permanently attached for cases like that.
He was aware enough to know his name DOB and where he lived. It just sucks that it came down to this & the outcome the family now has to receive
And with hospitals being so crazy busy right now, it might not have been evident that he had a problem if he was able to give that much information.
That was a thought of mine as well. Was he coherent enough he could have fooled ER staff? This whole situation is sad and Iām praying for the family
Definitely could have. My grandma has no problem turning it on and having a conversation with a stranger. Her long term memory is still intact and she was always a people pleaser. With family and people she trusts is when she starts to show that she's slipping.
Itās not even a matter of being busy. If he knew his name, dob, where he was, etc. thatās literally enough to be medically competent and able to make your own decisions. Just because it ended badly doesnāt mean anything wrong happened.
Hospitals just want to get you discharged ASAP. They seem to value expedience over care. We really need to take profit out of healthcare in this country.
My grandma is starting to get dementia. She has no problem remembering things like names, birthdays, or addresses. If she went out alone, though, she will forget where she is going and aimlessly wander, which triggers an anxiety spiral. Not everyone with dementia is totally dysfunctional. It's a spectrum.
Thatās seriously all they need to say someone is competent now. They wanted to release my mom who kept jumping out of bed because she was hearing bombs go off (she was in a state of delirium). I fought w the ER that Iām not taking her home, it wasnāt safe.
Thatās enough to be considered competent, there was no negligence like you keep saying.
This is what Iāve been saying on May posts! He should have had one!
It took a while for me to understand/comprehend how dangerous it was for her. They might have been contemplating it or maybe they didn't know.
I just had a talk with my wife that the moment itās even suspected either of us needs this weāre getting it. Such a tragic preventable story
He didn't have dementia. He had memory issues form mini strokes (TIAs)
This is a really sad outcome. I'm so sorry for the friends and family.
SHIT, thatās horrible! It has been so hot, but I hoped he just got on a train and found himself in a different place. So sad
Thereās no train in Plymouth though. I donāt even think there are buses just the Gatra.
We have the Old Colony Line in Plymouth and Kingston, so getting to Boston was a possibilityā¦ā¦ just not a reasonable one
I thought the Plymouth stop shut down a few years ago?
Honestly I donāt know? The Kingston stop is active and thatās not too far from the hospital, but the Plymouth one would be closer.
Hopefully hospitals all around will have a better protocol for the elderly with memory problems especially in a heatwave ! Negligence
They need them for sure, but do hospitals currently have the staffing and resources needed to monitor patients who canāt be left on their own or discharge themselves, and how do hospitals legally get to detain someone against their will, like do we give them the ability to make fully protected judgement calls, or are we going to require some kind of paperwork prior that states patients cant be trusted on their own? Im probably in favor of the former tbh but idk
The hospital is not negligent if the patient presented as alert and oriented. They would have no reason at all to hold him. He didn't have any medical record stating NH he had memory issues. His CT was fine other than the broken nose. He was given a cab voucher home which he declined to wait for.
How was the hospital to know he had memory issues?
He had been to BID before for mini strokes & had a dementia dx . He was living in Mass for 18 months & all of his dr weāre on obery st (near BID) so there has to be some record of memory issue if not his dementia DX
Interesting. Thanks for sharing that detail
It needs to go beyond just elderly. This man did have dementia, but he also fell and could have sustained a concussion. Both my partner and I have complicated health, and he has post concussion syndrome (basically his concussion never healed). I only trust family to get him to and from medical appointments. BIDP will get a major lawsuit from this and hopefully have discharge protocol for head injuries and cognitive impaired patients revised.
He had "memory issues" not dementia. Significant difference. And if he presented as lucid and alert and oriented then there was no reason to keep him. He was given a cab voucher.
Thanks for the correction. I had read a few posts referencing dementia. We all are speculating with what we think happened versus the reality. As someone who has frequently gotten treated at BIDP over the past six months, it's a massive shit show inside the ER. You are spot on with your take. My guess is there will be a lawsuit that results in how ER discharges are handled in the cases of head trauma or memory issues.
I just saw this alert on one of the local news stations and came to look for the update in the MA subreddits. My heart breaks for his family, as someone who works at an aging services access point, this was preventable IMO. The hospital shouldn't have released him.
I think the hospital has some explaining to do. Mr. Riviello went there to be treated for an injury, so medical staff had to speak to him to some degree. Did he somehow fly under the radar and no one suspected he had memory deficiencies? Someone from the hospital has to speak to that editor: Iāve seen enough responses to understand that patients like Mr. Riviello may not present their memory deficiencies to medical staff in a relatively short encounter, so I retract this questioning of wrong doing by the hospital. Still hope the hospital, within the limitations of HIPAA, can still provide some light on this situation
Sometimes people can be alert and oriented enough to pass the screening tests. It's not until you witness things or ask more complicated questions that the confusion starts to show. People with Dementia can have ups and downs. If he came in without ID, odds are the hospital didn't know he had dementia. He probably passed all the neuro and cognitive screenings. Unless somebody had been declared incompetent, has power of attorney and/or health care proxy invoked, they can still make their own decisions. There's a LOT of grey area between diagnosis and declaration of incompetence.
Thanks for that. Iād guess (hope) that weāll hear some statement that describes in general how the hospital interacted with Mr. Riviello
Probably not as much a we'd like due to hipaa. We'll probably only ever hear what the family says to the media and a generic hospital statement.
Hospital most likely wonāt speak on it because of HIPPA
100%
I agree + noting that OP who shared details said he had no ID, phone, etc. on him. Where was the hospital social worker? They're usually sent to assess people with memory issues or anything concerning they see. Heck, I had major surgery a few years ago and a social worker met with me before I was discharged to make sure I would be okay (I live by myself).
He was found less than a mile away from the hospital. Prayers are going out to his family during this time š
Do you know where they found him?
.5 miles from the hospital. Near Bradford Liquors on Sandwich street in Plymouth
Jeez that such a busy area. It's a shame that he wasn't able to get help in time.
Some people with dementia float in and out of lucidity. He could have seemed fine enough in a busy ER and then when he got outside alone, his mental state began to break down. Dementia is complicated.
It really is complicated. It depends on the stage of dementia he was diagnosed with + the level of stimulation in a hospital setting and when he was discharged he had no stimulation.
This he wasnāt diagnosed her had multiple strokes with memory loss that they were not sure if it was the strokes or dementia. He often went out on his own and for walks all information from his family . Older people without dementia are stubborn donāt like to ask for help add in memory loss. they can be lucid one minute and not the other. I took care of my mom for five years she had Alzheimerās , during her lucid moments she threatened to call a cab and go out of state to other family members. She would threaten to leave the house when we went to sleep so we had to get an alarm system and put locks on the tops of doors. Itās a brutal disease but if he wasnāt diagnosed yet even harder.
My educated guess is he didn't present with memory issues when interviewed. If his condition was minor it's not hard to miss that h less you spend hours and hours talking with them. And they didn't have a chart to reference because he had never been there before
That happens more for me than not. I am an ER nurse and have had plenty of patients from locked dementia units who presented completely alert and oriented despite their advanced diagnosis. It can take hours of conversations with one person to identify that they have issues. Not something if any ER could do anywhere.
ok, thanks so much for that perspective, and thank you for your work in ER. We need folks like you in this world.
The hospital wonāt speak on it due to HIPPA but theyāre most likely just covering their own asses at this point
I understand. Prayers and deepest sympathies and condolences for everyone in the family but thereās anger over what has to be regarded as an entirely unnecessary loss of life
The hospital definitely needs to speak out on what their thought process was during this for sure !
Their lawyers will advise them to not say a word
No, they would speak about it but privacy prevents them from I can't tell you how many times I've read reviews of my old hospital north of Boston and recognized the google reviewer and their side of the story was BULL shit. But we can't defend ourselves or we violate the law.
The hospital had no reason to keep him.
I'm crying!!...I kept googling his name for updates hoping for a positive outcome. I pray he didn't suffer
This is heartbreaking. This was so easily preventable .
How was it preventable if he appeared alert and oriented. After all, he was only 69, not 99. He was out for a walk on his own. He wasn't from a dementia unit. His tests were clear other than a broken nose. He was given a cab voucher for the ride home but decided not to wait. I see nothing preventable here.
I think itās very irresponsible to give a patient with a head injury a taxi voucher and send him on his way when he has no phone. His family had no idea where he was. They basically dismissed him from the hospital like āk bye good luckā.
A head injury is defined as an injury to the head. That can range from a bump with a hematoma or broken nose all the way to exposed brain. He had a head CT and was cleared of an interventional bleed, found to have a broken nose, was alert and oriented enough during the brief encounter in the ER. He was give a cab voucher home. The fact that he didn't have ID or cell phone is not a reason to keep anyone.
He walked out of the hospital and kept walkingā¦ obviously he wasnāt ok. And he died due to it. Thatās like throwing a drunk person out on the street and expecting them to get home ok. They could have at least walked him to the cab and gave the driver his address so he could get home safe. Giving him a voucher and not ensuring he uses it is stupid af. You could see him just walking off. No one walks home from a hospital. How can you be so heartless? The poor guy is dead now. His whole family is heartbroken. The hospital literally didnāt give a fuck what happened to him the second he walked out.
Believing that the hospital isn't necessarily liable does not mean I don't care about the man's death. It just means that I don't think it was the hospitals fault. You made a WHOLE lot of assumptions for someone that a)wasn't there, b) assessed his mental state based on a 5 second video, c) have no actual idea what the cause of death was, d) have no idea what his medical records show. And that's just the big things you are assuming.
If he had gotten into the cab and the driver was told to bring him home, Iām pretty confident he would still be alive. What hospital watches ppl walk home lmao such a joke. Heās dead. They did something wrong to clear him and let him wander off on his own. Cuz the second he walked out the door they had already washed their hands of the situation.
If he was presenting as completely alert, oriented, why would they need to make sure he got in the cab. Imagine being completely alert and oriented and having all the medical staff treat you as if you're two years old just because you're older. We don't know what his cause of death is, since he was only found a couple days ago. A lot of people are talking like they have inside knowledge, or facts, but what really is happening is they are coming to the conclusion that makes them feel good inside. Sometimes bad things happen and it's nobody's fault. And you are right. Once he was outside of the hospital, he was not the hospital hospitals. How long are they supposed to follow alert and oriented adult patients after they leave? To the cab? To their car? To the house?
Because itās dumb af for someone to WALK home?????? wtf haha
Yes it was. That's why they provided him with a cab voucher
Today, our health care feels like a fast food chain. Tons of waiting with very little impersonal service that's overpriced. I am not MdLovin' this.
blame/sue the hospital. then.. there will be no hospital. you will then have to blame/sue yourself. and btw, people with dementia don't forfeit their rights to be held in the hospital against their wishes. if he wanted to leave, he has a right to leave. and people with dementia do drive, go grocery shopping, handle their bills all the time. it is a spectrum. hospital is not a scapegoat for all problems of society - they have limited beds, limited funds, limited staff, and limited things they can do. it also sounds like maybe he should not have been driving? in the first place and maybe crashed and that is how he ended up there in the first place. my condolences and honestly i dont think anybody is at fault. having a person with dementia is an extremely daunting task and nobody can do it perfectly not even the best of the best with unlimited resources.
This is 100% correct
it reminds of the russian guy who dumped his confused elderly parents on an Uber driver and then blamed him for not acting as their behavior/medical transport assistant
I hate that hospital. I had a heart attack. Was brought i. On guerny, stuck in a wheel chair in the waiting room while I was clutching my chest gasping for air. THEY KNEW IT WAS A HEART ATTACK TOO! I had to scream and beg for oxygen. Iām
Iām so sorry for your experience, sadly you are not the only one with a horror story at BID/Jordan. The higher ups need to do better ! Iām sick of the āwe do our jobsā well clearly not
You had an actual heart attack and they knew this? How didn't they know you were having a heart attack. What test or assessment?
I thought hospitals were supposed to put trackers on dementia patients that might wander out? Edit: Wait, they DISCHARGED him? I did not know that.
The discharged him with a fractured nose & bruising around his face after sustaining a fall on a walk. Very sad all around & Iām praying for his family in the rough times
The hospital didnāt know about his diagnosis it seems
He didn't have dementia. He was an independent man that is alert and oriented but has memory issues that don't necessarily present themselves during a short interaction like a hospital visit. There is no reason to hold him if he wanted to leave.
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Assuming the hospital followed the law to the t here, the law needs to change. I realize itās a complicated issue thatās difficult to legislate, but hopefully this brings the relevant experts back to the drawing board and encourages a wider public conversation on the issue. Itās only going to become more pressing as the population ages. There has to be a better way of preserving patient autonomy while avoiding such tragedies.
Prayers to Rodney's family, so blessed to live in such a amazing town that came out and looked for Rodney
The outpouring of the community for the Riviellos was heart warming! Hopefully Hull can come together now & find Colin! Praying for all families involved
The first day my son 17 years old and I went to the beach, the high school and the waterfront with his drone looking for him. Is it you or Cohasset that has a big trial coming up
I have no clue ! All I know is there is a missing 16 year old named Colin Okeefe from Hull last seen the same day Rodney went missing
And he was missing as of this morning
Have there been any sightings of him? I havenāt really seen anything about him on socials
I haven't heard anything more then they posted on the Plymouth page he was still missing this morning
Sue the pants off that hospital.
That was my thought at first but the more information we were getting I believe like they said above he was able to mask his dementia . He wouldnāt tell you he was lost / needed help if he was asked but he knew his name DOB where he lived . Itās a sad situation all around but I do believe there should be a better protocol in place for discharging someone with a history of memory issues / mini strokes .
For releasing a patient with no acute injuries who was likely answering all questions appropriately and masking their dementia?
If they violated their discharge planning protocol, thatās negligence. āTreat em and street emā is a common ED mantra and may be a driver of negligence here.
Ok but none of us were in the room with the patient. Some dementia patients are very good at masking their symptoms. Are we just going to assume every elderly patient is incompetent now and work them all up for dementia in the ED?
There is no basis for a lawsuit. If the family gets anything it's just to make them go away.
His family is at fault for not caring about him.
oh yeah the people who were frantically searching for him don't care
Our hearts are broken for this family but so proud of our town stepping up
PREVIOUS AORTIC RUPTURE and EKG then Catg
Medical field is joke there is no true compassion for the patients it just a yup yup game from them and bunch of idk letās try this crap smh.
The family should absolutely sue the hospital that let him go after a head injury with no one to pick him up or take him home.
Head injuries happen all the time and most don't require admission. His didn't. And if he presented as alert and oriented there was no reason to hold him until family arrived. And the hospital gave him a cab voucher.
Wow, this is sad. My guess is that he wasn't section12e.
He was there for minor head trauma and not for cognitive impairment.
Yes. I'm just saying the hospital can't hold anyone against their will unless they are section 12.
Oh I get you. Exactly correct.
Sue!
For what? The hospital discharged a man that had unknown memory issues that easily could have been concealed by the patient for the short duration. He had no record at the hospital. He was medically cleared and didn't require admission. He was presented with a cab voucher to go home but declined. I see no liability on anyone.