Patient Elopement and Wandering in Hospitals

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Prevention, Consequences, and Legal Recourse

In the complex environment of a hospital, patient safety is paramount. Yet, a critical concern that often gets overlooked is the issue of patients eloping or wandering from the facility, leading to serious injury or even death. At Lupetin & Unatin, we have seen the devastating outcomes that can arise when a patient is allowed to elope or wander from a hospital or nursing home.

older man walking away, using a cane

Understanding Elopement and Wandering in Hospitals

Elopement refers to a patient leaving a medical facility unsupervised and unnoticed, especially when they are unable to make safe decisions on their own due to medical conditions. Wandering involves a patient moving about the facility in a confused or disoriented state, potentially leading to them exiting the premises or entering unsafe areas.

Elopement is a National Issue According to the Joint Commission

The Joint Commission, a significant accrediting body for healthcare organizations in the United States, takes the issue of patient elopements very seriously. Patient elopement, which refers to situations where a patient leaves a healthcare facility without authorization or appropriate discharge, can lead to significant safety risks for the patient and potential liability issues for the healthcare provider.

Here are key perspectives and guidelines from The Joint Commission regarding patient elopements:

  1. Patient Safety: The Joint Commission emphasizes that patient safety is a top priority. Elopement poses a direct risk to patient safety, particularly in cases involving vulnerable populations such as the elderly, those with mental health conditions, or individuals with cognitive impairments.
  2. Risk Assessment: The Joint Commission advocates for thorough and regular risk assessments to identify patients who may be prone to elopement. This includes evaluating patients for confusion, agitation, a history of wandering, or other risk factors.
  3. Preventive Measures: The organization stresses the importance of preventive strategies to reduce the risk of elopement. This might include environmental modifications, adequate staffing, use of surveillance and alarm systems, and patient-specific interventions.
  4. Staff Training: Ensuring that staff are properly trained to recognize and respond to potential elopement situations is another crucial point. This training helps staff to understand the signs that a patient may be at risk of eloping and the appropriate actions to take in response.
  5. Policies and Procedures: The Joint Commission requires healthcare facilities to have clear policies and procedures in place to prevent elopements. These policies should include steps for immediate response if an elopement does occur, as well as strategies for communication with family members and law enforcement if necessary.
  6. Reporting and Analysis: In the event of an elopement, The Joint Commission emphasizes the need for prompt reporting and thorough analysis of the incident. This helps in understanding the root causes and implementing changes to prevent future occurrences.
  7. Accreditation Standards: Compliance with standards related to patient safety and care, including those that pertain to the prevention of elopement, is a part of The Joint Commission’s accreditation process for healthcare organizations.

The Joint Commission views patient elopement as a critical issue related to patient safety and the quality of care. Accredited healthcare facilities are expected to have effective measures in place to prevent elopement and to respond appropriately if it does occur. The focus is on proactive risk management and creating a safe environment for all patients.

man with his hands covering his eyes, looking concerned

The Incidence of Patient Elopement and Wandering Events

The incidence of patients eloping (or absconding) from hospitals, while not extremely common, is a significant concern, especially in certain patient populations and healthcare settings. The exact prevalence is difficult to quantify universally due to varying reporting standards, healthcare systems, and definitions of elopement across different regions and institutions. However, some insights can be provided:

  1. High-Risk Groups: The likelihood of elopement is higher in certain patient groups. This includes individuals with mental health disorders, dementia, or cognitive impairments, as well as patients under the influence of drugs or alcohol, or those experiencing delirium. Pediatric patients, especially in emergency or unfamiliar settings, may also be at risk.
  2. Psychiatric Units: Elopement is more frequently reported in psychiatric units or hospitals. Patients with psychiatric conditions, particularly those who are involuntarily admitted, may attempt to leave the facility without proper discharge or medical approval.
  3. Emergency Departments: Emergency departments (EDs) often see higher rates of elopement, attributed to longer wait times, the stress of the environment, or confusion and disorientation in patients.
  4. Underreporting: Incidents of elopement are often underreported. This could be due to the stigma associated with such events, fears of legal repercussions, or institutional policies.
  5. Data Variability: Research and data on patient elopement vary significantly. Some studies focus on specific settings like psychiatric facilities, while others consider broader hospital environments.

The Harm from Elopement and Wandering

The consequences of elopement or wandering can be grave, particularly for vulnerable patients such as those with dementia, mental health issues, or critical medical conditions. Potential harms include:

  • Exposure to Hazardous Conditions: Patients may wander into traffic, encounter environmental hazards, or suffer from exposure due to weather conditions.
  • Medical Complications: Wandering or eloping patients may miss critical treatments, medications, or suffer injuries leading to complications.
  • Psychological Trauma: The experience can be traumatizing for both the patient and their family.
  • Fatal Outcomes: In severe cases, such incidents can lead to the death of the patient.

Hospital’s Duty to Prevent Elopement and Wandering

Hospitals are obligated to implement comprehensive measures to prevent such incidents:

  1. Risk Assessment: Regularly assess patients for elopement and wandering risks, especially those with known cognitive impairments or psychiatric conditions.
  2. Monitoring and Surveillance: Use of CCTV, alarm systems, and electronic monitoring bracelets can help keep track of high-risk patients.
  3. Staff Training: Ensure staff are trained to recognize and manage patients at risk of wandering or eloping.
  4. Safe Environment: Implement secure ward designs, locked doors, and safe wandering paths within the facility.
  5. Regular Checks and Communication: Frequent patient checks and effective communication among staff members are crucial.

When hospitals who are paid to care for and monitor patients violate these duties they may be held accountable for medical malpractice and the cost of the harm suffered by the patient.

Legal Rights of Families

Families of patients who have suffered injury or death due to hospital elopement or wandering may have legal recourse. They can potentially claim that the hospital failed in its duty of care, leading to negligence. Key considerations include:

  • Breach of Standard Care: Demonstrating that the hospital did not follow standard procedures to prevent such incidents.
  • Direct Causation: Linking the hospital’s negligence directly to the harm or death of the patient.
  • Damages: Quantifying the damages, including medical expenses, emotional distress, and, in fatal cases, wrongful death.

Elopement and Wandering Malpractice Settlement and Verdicts

$10.8 Million Verdict: The Washington Appellate Court upheld a $10.8 million verdict in a case involving a mental health professional’s alleged negligence in failing to involuntarily monitor and detain a man who had suffered a serious brain injury. The man had behavioral issues and repeatedly eloped from the hospital, eventually falling down a construction site staircase, resulting in severe injuries. Washington’s Involuntary Treatment Act sets criteria for involuntary commitment based on imminent harm or grave disability due to a mental disorder. In this case, the County Designated Mental Health Professional did not evaluate the man for involuntary detention, believing he wasn’t gravely disabled as he was still under hospital care. The jury found the county 40% at fault and the hospital 60% at fault, awarding $10.8 million to the plaintiffs.

$900,000 Settlement: An 88-year-old woman was initially found confused outside her son’s home and was taken to a hospital. She later transferred to a nursing facility due to altered consciousness and inability to perform daily activities. After a series of events, including the use of restraints, she went missing from the hospital and was tragically found dead on the roof due to hypothermia. Her son sued the hospital, alleging wrongful death, claiming that the hospital failed to address her elopement risk and had numerous care violations. The case was settled for $900,000 before going to trial.

$2 Million Settlement: A $2-million settlement was reached for the family of an elderly woman with Alzheimer’s who passed away after eloping from Brookfield Assisted Living and Memory Care in Bella Vista, Arkansas. The woman, Barbara Doyle, had Alzheimer’s and required constant supervision due to her elopement risks. She managed to leave the facility unnoticed, and a staff member who saw her exit failed to intervene or notify others. Barbara’s remains were found after 13 days, and the cause of death was determined to be “environmental heat stress.” This case highlighted severe staff negligence, leading to the substantial settlement.

How Lupetin & Unatin Can Assist

Lupetin & Unatin, specialists in medical malpractice law, provide essential services for families affected by hospital elopement or wandering.  Here is what you can expect when you contact our firm:

  • Case Evaluation: We assess the case details to establish the viability of a malpractice claim.  This detailed evaluation is 100% free.
  • Expert Collaboration: We work with medical experts to determine the breach in standard care and its impact.
  • Legal Advocacy: Our experienced attorneys navigate the complex legal system, ensuring the rights of our clients are vigorously defended.
  • Pursuing Justice: We are committed to pursuing fair compensation for the damages suffered due to the hospital’s negligence.

The elopement and wandering of patients in hospitals are serious issues that can lead to tragic consequences. Hospitals must take proactive steps to prevent such incidents, and families affected by such negligence have the right to seek legal recourse. Lupetin & Unatin stand ready to assist, providing expertise and compassionate legal support to ensure that families receive the justice and compensation they deserve.  If your loved one has suffered a serious injury or died after eloping or wandering from a hospital or nursing home, please consider contacting Lupetin & Unatin, LLC.

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