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Based on record review and interview, the facility failed to ensure a patient presenting to the emergency department for treatment was identified on the central log and failed to provide a medical screening exam to a patient who presented to the emergency department.

See A2405 and A2406

Based on record review and interview, the facility failed to ensure every patient who presented to the Emergency Department (ED) for treatment was listed on the central log. The affected one (Patient #1) of 20 patients reviewed. The facility had an average of monthly visits to the ED of over two thousand patients.

Findings include:

Review of a police report, dated 09/29/22, revealed the police department was dispatched to a safety check at fast food restaurant in Toledo, Ohio, as the patient exhibited behaviors of agitation. The decision was made to take the patient to the complaint hospital for treatment. Patient #1 stated he was not allowed at the complaint hospital due to a restraining order. Once in the ED, escorted by police, the hospital stated they would not treat Patient #1 due to previous threats to the hospital staff. Patient #1 was taken to another area hospital by police and treated there.

Review of the ED log and hospital admission log dated 09/29/22 revealed Patient #1 was not listed on either log. There was no medical record for Patient #1 related to the ED visit on 09/29/22.

During interview on 11/28/22 at 10:45 AM, Staff C, Staff D, Staff E, and Staff F confirmed Patient #1 did arrive at the hospital on 09/29/22 for treatment. He was not listed on the ED's central log.

Based on record review and interview, the facility failed to provide a medical screening exam to all patients who presented to the emergency department (ED) for treatment. The affected one (Patient #1) of 20 patients reviewed. The facility had an average of monthly visits to the ED of over two thousand patients.

Findings include:

Review of Patient #1's medical record revealed the most recent admission was on 04/26/22. The patient was escorted to the ED by the police and arrived at 10:34 AM. Patient #1 was agitated and a psychiatric evaluation was requested. Patient #1 refused vital signs, but was seen by the physician at 10:57 AM. Patient #1 refused ordered tests and medications, and was released from the facility in police custody.

Review of a court order, dated 04/27/22, documented the facility was not to initiate any contact with Patient #1 and Patient #1 was to stay away from the facility.

Review of a police report, dated 09/29/22, revealed the police department was dispatched to a safety check at fast food restaurant in Toledo, Ohio, as the patient exhibited behaviors of agitation. The decision was made to take the patient to the complaint hospital for treatment. Patient #1 stated he was not allowed at the complaint hospital due to a restraining order. Once in the ED, escorted by police, the hospital stated they would not take Patient #1 due to previous threats to the hospital staff. Patient #1 was taken to another area hospital by police and treated there.

There was no evidence a medical screening exam was performed on arrival to the ED.

During interview on 11/28/22 at 10:45 AM with Staff C, Staff D, Staff E, and Staff F confirmed Patient #1 was not treated at the time of his arrival to the hospital on 09/29/22.