HospitalInspections.org

Based on document review and interview, it was determined that for 1 of 3 (Pt. #1) clinical records reviewed for allegation of abuse, the hospital failed to follow-up on patient allegation of assault while in the emergency room, as required.

Findings include:

1. On 01/16/2024 at approximately 10:30 AM, the clinical record of Pt. #1 was reviewed. Pt. #1 presented to the ED (Emergency Department) with a chief complaint of chest pain on 12/17/2023, at 12:33 AM. Pt. #1's clinical record included the following:

-The ED Resident Physician (MD #1) medical decision-making note dated 12/17/2023 at 3:53 AM, included, " ...During attending evaluation, patient was responding to internal stimuli...patient also had ideations regarding possible assault in the ER by staff despite, ER room doors and windows being completely open for the duration of (Pt. #1) stay in the ER room ..."

-The ED Physician (MD #2) addendum to Pt. #1's clinical record, dated 01/17/2024 at 10:49 AM, included, " ... When I discussed this with (Pt. #1), the patient was evasive in answering the details of what took place and failed to provide any detail of the events and had no medical concerns following this (Pt. #1's) thought process during my interview did seem scattered and tangential like there could be some underlying psychiatric component. (Pt. #1) did file a police report and spoke with CPD [Chicago Police Department] while in the department (ED)."

2. On 1/17/2024, the hospital's policy titled, "Event Reporting" dated 06/2022, was reviewed and included, " ...It is the policy ...that all medical staff members and employees shall notify the Risk Management and Patient Safety Department of any ...sexual abuse/assault of any patient while receiving care, treatment, and services while on site at the organization/facility or while under the supervision/care of the organization ...events to be reported to the Risk Management and Patient Safety Department ...accusation of abuse by a hospital employee, agent, or medical staff member on a patient of the hospital and should be reported immediately to the Risk Manager ...team will notify the regulatory compliance team ...with involved employee (s) interviews ..."

3. On 1/17/2024, the hospital's policy titled, "Staff Interaction with Law Enforcement" dated 07/31/2023, was reviewed and included, " ...This policy defines a cooperative process for maintaining patient centered care while assisting law enforcement officials perform their duties associated with the ...investigation of a patient ...B. Check in process: 1. Regardless of point of entry, all law enforcement will check in with security and be escorted to a unit or bay ...3. Law enforcement can follow ...into bays with medical staff approval ...5. If the patient consents to speak with law enforcement agents, access will be granted ...public safety will escort law enforcement to the appropriate unit/bay ..."

4. On 01/17/2024 at 9:10 AM, the UCPD [University of Chicago Police Department] report dated 12/17/2023 at 3:03 AM, that was a read-out by Deputy Chief (Z #1) included, " ...Patient [Pt. #1] from ER [emergency room] ...911 call ...CAD [computer aided dispatch] Report ...Officer (Name of Officer) ...spoke with patient [Pt. #1] in ED Room #27 ...ER Technician [E #2] touched [Pt. #1's] leg inappropriately ...while raising the guard rails moved the legs and nothing happened ...There was no crime or inappropriate touching during the moment."

5. On 01/17/2024 at approximately 9:15 AM, the Deputy Chief of The University of Chicago Police Department (UCPD) (Z #1), was interviewed. Z #1 stated that there was a 911 call from the patient (Pt. #1) on 12/17/2023 at 3:03 AM, that was automatically responded by the UCPD. Z #1 stated that there was no crime that had occurred at that moment, and the allegation was not true, since the officer spoke with the ER Technician while in the ED. Z #1 stated that she does not have any documentation from the officer, indicating this allegation from Pt. #1 was reported to the ED Manager or to the Director of Risk Management. Z #1 stated that it was mentioned to the ED Charge Nurse (E #5) on-duty in the ED on 12/17/2023.

6. On 01/17/2024 at approximately 10:15 AM, the ED Charge RN (E #5) was interviewed. E #5 stated that she faintly remembers Pt. #1. E #5 stated that she (E #5) does not recall the details of the incident, but remembers the CPD (Chicago police department) talking with Pt. #1 as Pt. #1 was getting discharged and was leaving the ED.

7. On 01/17/2024 at approximately 1:30 PM, the Director of Regulatory Compliance (E #11) was interviewed. E #11 stated that the abuse or assault allegations are reviewed and reported on a weekly basis, but this incident regarding Pt. #1 was not brought to E #11's attention since the UCPD took the 911-call and addressed it with Pt. #1.

8. On 01/17/2024 at approximately 1:40 PM, the Director of Risk Management (E #6), was interviewed. E #6 stated that as per the hospital's policy titled, "Staff Interaction with Law Enforcement" the UCPD should have stopped by the public safety desk to report to the hospital's public safety, documenting in the log, the specific reasons why they were in ED to see Pt. #1. E #6 stated that the UCPD and public safety staff failed to follow the policy and Pt. #1's allegation of assault was not reviewed.