The Washington, D.C. VA is under fire after dismissing a suicidal patient, only to have that patient commit suicide 6 days later.
A lawsuit was recently filed over claims that the Department of Veterans Affairs hospital staff dismissed a suicidal patient, only for that patient to die soon after he visited a VA doctor. During that visit, the doctor allegedly “shouted that the patient ‘can go shoot themselves. I don’t care.’” The patient was in their 60s and had a history of panic attacks. Additionally, he was also addicted to opioids and tranquilizers, something he was seeking treatment for at the VA Medical Center in Washington, D.C. According to a report from the department’s inspector general, the patient was released from the VA “before being given required suicide prevention planning.” Tragically, he was later found dead from a self-inflicted gunshot wound.
When asked about the incident, the director of the D.C. medical center, Mike Heimall, said it was an isolated incident. He added that it “does not represent the quality health care tens of thousands of D.C.-area veterans have come to expect from our facilities.” He also added that the center “grieves the loss of this veteran.” He went on to explain that the hospital has “made improvements that include random audits of 20% of suicide-related emergency room visits to make sure staff followed policy and checking that staff monitors emergency-room patients who express suicidal thoughts.”
What happened, exactly? How was the patient brushed aside the way he was, and why? For starters, the patient went to the hospital’s emergency room for admission “after having trouble sleeping because of withdrawal from prescription drugs,” according to the report from the inspector general. While there, the patient was assessed by an outpatient psychiatrist who labeled him as being a “moderate risk for suicide.” The patient was then handed off to emergency room staff, where another psychiatrist rated his suicide risk as mild. Because the patient denied having thoughts of suicide, home care instead of hospitalization was recommended.
However, the patient refused to leave. According to the report, another doctor “working in the emergency room, identified only as ‘physician 2’ in the report, wrote that the patient was ranting and ‘clearly malingering.’” Eventually, VA police were summoned and escorted the patient from the emergency room. When the patient protested and said he “wanted to return for treatment of knee pain, the doctor exclaimed the patient ‘can go shoot (themself). I do not care.’” According to the report, the statement was “heard by at least three other staff members, though it was unclear whether it was heard by the patient.”
The chief of staff later reported that the particular doctor had a history of attitude problems. For example, last fall the doctor “would have had his practice privileges suspended if another complaint was received.” Despite numerous complaints against the doctor, a formal fact-finding or administrative investigation was never conducted as required by the VA because of a “pattern of misconduct.”
In a statement, Heimall said, “The doctor who dismissed the veteran’s suicide warnings was a contract worker who is no longer welcome at the facility…The doctor’s conduct was unacceptable and does not represent the dedication and compassion our employees exhibit daily. “
Despite the statement, the inspector general determined there was a failure to communicate between the hospital’s mental health staff and the emergency department. Additionally, it also failed to arrange a “followup post-release appointment for the patient before the suicide,” the report noted.