The information below comes from the statement of deficiencies compiled by health inspectors and provided to AHCJ by the Centers for Medicare and Medicaid Services. It does not include the steps the hospital plans to take to fix the problem, known as a plan of correction. For that information, you should contact the hospital, your state health department or CMS. Accessing the document may require you to file a Freedom of Information Request. Information on doing so is available here.

NORTHWEST HOSPITAL CENTER 5401 OLD COURT ROAD RANDALLSTOWN, MD 21133 Aug. 30, 2018
VIOLATION: PATIENT RIGHTS: RESTRAINT OR SECLUSION Tag No: A0178
Based on the review of 4 open and 8 closed medical records. It was determined that the hospital failed to ensure that all patients placed in violent restraints received a face to face evaluation within 1 hour of restraint initiation. This is true of 2 out of 2 violent restraint medical records reviewed.

Patient #4 and #5 were placed in violent restraints, seclusion, and physical hold to administer medication and the Face to Face was not conducted within one hour of the order.

Patient # 4 is a 20+ year old young adult brought to the ED by Crisis team on an Emergency Petition. Family attempted to bring patient to the hospital and the patient jumped out of a moving car window. The family then called 911. Patient had been agressive and threatening toward staff and family in the ED. An order for violent 4 point restraints was obtained from the psychiatry attending on the day of admission at 22:21. No face to face evaluation was documented for this patient.

Patient #4 was admitted to inpatient behavioral unit. On the following day at 20:31 an order for a physical hold and seclusion was recorded. The face to face was documented the same day at 22:18 almost 2 hours later.

Patient #5 is a 40+ year old adult admitted on an involuntary basis to the behavioral health unit after arriving by ambulance. On the third day of admission patient disrupted milieu by grabing a nurses arm, hit another patient in face and arm and activated the panic button. This event lead to orders for IM medication and restraints at 20:21. Face to face occured at 23:04, almost 3 hours late.

Patient #5 at 05:18 on the forth day of admission was placed in seclusion for being intrusive and violent with other patients and staff. Face to face was conducted at 07:13 on 5/30/2018 making it 2 hours late.