Two Twin Cities hospitals cited after federal investigations

Two Fairview hospitals in the Twin Cities have been cited by the federal government for violating the rights of patients who showed up in emergency rooms with mental health concerns. In one case, staff forcibly stripped a patient of her clothes.

According to federal records obtained by the Fox 9 Investigators, a woman sought help at the emergency department at the University of Minnesota Medical Center at Fairview Riverside Hospital in Minneapolis.

Her medical history includes rape, bouts with anxiety, depression, drug abuse and post-traumatic stress. She was acting paranoid, sounding delusional, but there was no evidence she was a danger to herself or others.

Staff took her to an exam room and asked her to put on rust-colored scrubs. The patient sat calmly in a chair but refused to change out of what she was wearing.  

A dozen staff members entered the room, wrestled her to the floor, stripped her clothes off and forced her into the scrubs.

When she began to fight back, staff gave her a shot, which sedated her. The entire incident was recorded on video by the hospital.

Roberta Opheim is the state of Minnesota's Mental Health Ombudsman. Her office investigates complaints about mental health care, and she's reviewed the records in this case.

"I can feel the anxiety, the tension just by reading those. It's completely outrageous to the dignity of the person that's there," Opheim said.

The U.S. Centers for Medicare and Medicaid Services investigated Fairview Riverside's handling of this incident.

CMS cited the hospital for violating the patient's rights. Remember, the woman had previously been raped and then was subjected to having her clothes stripped from her by hospital staff because she did not want to change into scrubs.

The same investigation revealed staff used a "show of force" to coerce two other patients to change into so-called "behavioral scrubs" when they initially declined.

CMS found the hospital had an ongoing practice of requiring anyone who came into the E.R. with a mental health issue to wear rust-colored scrubs that distinguished them from other patients.

"Making anyone identify that they're a mental health or chemical dependency patient is a complete abdication of their right to privacy," Opheim said.

SECOND CMS INVESTIGATION AT OTHER HOSPITAL

According to another CMS investigation, staff at Fairview's Southdale Hospital in Edina asked a patient who was brought in by police for a psych evaluation to put on "behavioral scrubs".   

When she declined, three staff and two security guards entered the room and approached her.

Teresa Graham eventually changed out of her street clothes.

"They told me they were going to disrobe me if I didn't put these scrubs on. I became very frightened because they obviously meant it," said Graham.

She was evaluated by a doctor and sent home. She later learned that a camera had secretly recorded everything that happened in the exam room. 

She obtained a copy of the video as part of a federal lawsuit she filed regarding her treatment by police that night.

"I realized that they had been filming the whole time, including when I had to take my clothes off, she said.  "I was just so horrified.” 

CMS cited Fairview Southdale for violating Graham’s rights as a patient by recording her without her consent.

The hospital had cameras installed in three psychiatric evaluation rooms with no signs alerting patients they were being recorded.

FAIRVIEW’S RESPONSE

In a statement to the Fox 9 Investigators, Fairview said "our goal is to provide safe and compassionate care to every patient while also ensuring the safety of our staff, providers and other patients. Our pledge to this community is to continually learn and improve our care processes in order to best support the health and well-being of our community members" (see complete statement below).

Fairview said the use of identifiable scrubs is a common practice in health care as a way to identify patients who pose a safety risk to themselves or others. However, it's now making the use of them voluntary.

Fairview continues to use cameras in some of its emergency exam rooms. The company said it allows staff to continually observe a person to prevent harm to themselves or others.

However, there are now signs posted and patients are verbally informed of the cameras. They also must give consent to being recorded.

Fairview’s full statement:

Fairview is the largest behavioral health provider in Minnesota, caring for thousands of individuals and families who are managing serious behavioral health and substance abuse issues that are growing in complexity.  Every day in our emergency rooms, we see families, police officers, EMTs and others who are seeking care for people who are in a crisis state. Our goal is to provide safe and compassionate care to every patient while also ensuring the safety of our staff, providers and other patients. Our pledge to this community is to continually learn and improve our care processes in order to best support the health and well-being of our community members.