Discharge disaster: Shoeless patient abandoned out in the cold and dark

A woman was found wandering outside a Baltimore hospital wearing only a hospital gown and socks. The person who found her recorded the scene in a shocking video, which has gone viral. This video can be a training tool to review expectations for dealing with difficult cases at your facility’s emergency department.

After a video of the woman standing at a bus stop, dazed and barely able to walk, went viral on social media—one news report said it was viewed more than 2.3 million times on Facebook—University of Maryland Medical Center Midtown Campus’ CEO Mohan Suntha promised a full investigation into what he termed “a failure of basic compassion and empathy.”

The video was taken by a man who said he witnessed hospital security guards bring the woman in a wheelchair to the bus stop. The man confronted the guards, who said the woman had been medically discharged.

Other than the statement from Suntha saying that the hospital was still “trying to understand the points of failure that led to what we witnessed on that video,” the hospital released no details of what brought the woman to the hospital, what her condition was, or any treatment she received, citing patient confidentiality.

The man who recorded the video called the police, who had an ambulance take the woman back to the hospital. From there she was sent to a homeless shelter and finally picked up by family members. The Washington Post later talked to the woman’s mother, who said the patient had a history of mental illness.

While there are a lot of what-ifs about the incident, “we technically don’t know what happened during the encounter,” notes Frank Ruelas, MBA, a patient safety professional and HIPAA consultant who founded HIPAA College in Arizona. “However, there is enough information for us to consider asking questions on how we may have managed this patient if she had presented at our respective ED within our respective hospitals.”

Regulatory considerations with such a patient would fall under the Emergency Medical Treatment and Active Labor Act (EMTALA) as well as discharge planning expectations, says Ruelas.

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