Hospital Must Release Policies After Deadly Fall

     (CN) – A Virginia hospital must produce its bed alarm policies and the incident report related to the death of a patient who tried to make his way to a bathroom alone because his bed alarm was turned off, a federal judge ruled.



     Paul Fleming was admitted to Russell County Medical Center, in Lebanon, Virginia in January 2010 to be treated for pneumonia. According to hospital records, he was rated a fall risk of 16 at the time of his admission.
     Despite this rating, on Fleming’s first night in the hospital, his bed sensor was turned off. Unable to summons assistance, Fleming attempted to make his way to the bathroom unattended. While doing so, he slipped and fell in the bathroom, hitting the back of his head.
     He died later that day of a brain hemorrhage.
     Sharon Fleming, the administrator of his estate, sued the hospital in federal court and requested that the hospital produce all policies and training manuals regarding bed alarms. The hospital objected to the request on the ground that such polices are privileged under the “quality assurance privilege.”
     But U.S. Magistrate Judge Pamela Sargent sided with Fleming and ordered the hospital to produce the information.
     “The Virginia General Assembly, in enacting this quality assurance privilege, intended to promote open and frank discussion during the peer review process among health care providers with the ultimate goal of improving the quality of health care… I find that ‘the ultimate end results of such critiques, which might find their way into depersonalized manuals of procedure and which have been shorn of individual criticisms, do not merit the same concern for protection from public scrutiny,'” Sargent said, quoting precedent.
     The judge found that “the hospital’s policies, procedures and protocols regarding what measures should have been implemented for a patient with a fall risk of 16 and should be done when ‘Fall Protocol I’ is initiated certainly is relevant to determining whether the defendant acted with the requisite ‘degree of skill and diligence practiced by a reasonably prudent practitioner.'”
     Sargent also ruled that the incident report following Fleming’s fall was discoverable. Quoting a Virginia circuit court, she said it would be an “impermissible reading of the statute to extend the privilege to cover all factual reports or incident reports of accidents that happen at a hospital simply because they are sent to a quality assurance committee.”

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