HospitalInspections.org

Based on document reviews and interviews, the hospital failed to ensure that all patients are free from abuse or harassment in one of five surgical records reviewed (Record A).

Finding:

On October 18, 2017, the hospital notified the Division of Licensing and Certification (DLC) of the following allegation of abuse: On October 12, 2017, Patient A was sedated in the operating room. The Registered Nurse (RN), who was caring for the patient, took the patient's hand and hit a Certified Surgical Technician's (CST) breast and then used the patient's arm to wave at the CST as she walked away. A CST student reported her observation to her instructor, who in turn reported it to the Operating Room Manager on October 13, 2017.

On October 25, 2017 at 1:22 PM, the hospital provided the surveyor with the Human Resources investigative report that verified the above described incident. The report stated 'In this case the action constitutes an example of..."Conduct considered an abuse of the patient".'

During an interview with the Operating Room Manager, on October 24, 2017 at 2:02 PM, she revealed that she became aware of the incident on October 13, 2017, when the CST Instructor from a local college notified her of the incident, which she immediately reported. The hospital's Human Resources Department immediately started its investigation. The Manager reported that the RN was immediately suspended. When the RN was interviewed, he reported that he did it to "lighten the mood" in the operating room, and denied hitting the CST's breast with the patient's hand.

During an interview with the CST, on October 24, 2017 at 2:35 PM, she verified that the RN had taken the anesthetized patient's hand and used it to wave at her and then hit her chest with it.

During an interview with the Chief Nursing Officer (CNO), on October 25, 2017 at 1:00 PM, she reported that when she interviewed the RN, he denied the allegations. He only admitted to lifting the patient's hand and asking "Who's having surgery?" and saying "I am, I am". He did not admit to touching the CST's breast with the patient's hand. She disclosed that the RN voluntarily terminated his employment on October 16, 2017.

During a telephone interview with the alleged perpetrator (RN), on October 26, 2017 at 9:30 AM, he reported that "it was taken completely out of context". He reported that he jokingly said "who needs surgery?" and then raised the patient's hand, waved it , and said "I do, I do". He stated, "it was not my intention to be disrespectful... I know it wasn't right...didn't intend to embarrass or humiliate...[abuse was] not my intention..." He denied hitting the CST's breast.

Maine statute 22 MRSA §3477 states, "Persons mandated to report suspected abuse, neglect or exploitation ... The following persons immediately shall shall report to the department when the person knows or has reasonable cause to suspect that an incapacitated or dependent adult has been or is likely to be abused, neglected or exploited: A. While acting in a professional capacity: ... A registered or licensed practical nurse .... Unlicensed assistive personnel ... Any person who has assumed full, intermittent or occasional responsibility for the care or custody of the incapacitated or dependent adult, regardless of whether the person receives compensation. .."

On October 24, 2017, a review of the hospital "Abuse, Neglect or Exploitation - Adults" policy was conducted. The policy stated, "Any provider who knows or has reasonably cause to suspect that an incapacitated adult (patient) or dependent adult (patient) has been or is likely to be Abused, Neglected, or Exploited is required to report this information immediately. Reports are made to the Maine Department of Health & Human Services (DHHS). Reports must be made immediately by telephone and must be followed by a written report within 48 hours, if requested by DHHS."

During an interview with the Compliance Officer, on October 25, 2017 at 8:57 AM, she confirmed that she failed to inform the State of the incident prior to October 18, 2017, when she faxed the incident report to DLC. She revealed that it was her responsibility to report incidents "to the State".

During an interview with the CNO, on October 25, 2017 at approximately 1:39 PM, she confirmed that she is a mandated reporter; however, she left it up to the Compliance Officer to make the report.

Based on the above interviews, the hospital failed to immediately report the suspicion of abuse to the Department as required by state law and facility policy.