Harborview Treats Epilepsy On Involuntary Psych Ward
By Vonne Worth
Copyright ©, Vonne Worth, 2002. All Rights Reserved.
Last December, I regained consciousness in 5-point restraints. I knew I’d had epileptic seizures and my epileptic seizures had been misdiagnosed as a psychiatric episode for the fourth time in 25 years. I asked the psych aides what day it was. Since they told me it was the same day that my seizures had started, I knew they were lying. My epileptic seizure episodes last at least two days. I had no idea why I was in restraints. To me, it was punishment for something I hadn’t done.
I found out was in the Harborview Psychiatry Intensive Care Unit for treatment of my epileptic seizures.
Two psychiatrists, Maryanne Bolte, M.D., and an unknown male doctor came to see me. I told them epileptic seizures were the problem, although I knew they would not believe me because they had designated me to be a mental patient. I was right. I told them misdiagnosis and improper treatment could be the basis for a lawsuit.
The man said, “Everybody says they’re going to sue me.”
“I’ll bet they do,” I replied.
I later learned they had written in my medical chart: “She blames her behavior on her seizures.”
I also asked why they were not following my Advanced Directive (AD). Turns out they didn’t know I had one even though it had been in my medical records at Harborview since at least 1997 and they are required to read it because they work in a Medicare-Medicaid certified hospital. Also, because of a recent court decision, Hargrave v. State of Vermont, they are required to follow a Mental Health AD in the same way they would follow any other AD. Since they didn’t follow it, they’re now respondents in a federal civil rights complaint based on Hargrave.
The papers with “Rights and Responsibilities of Psychiatric Patients” had been thrown on my bed behind my back while I was lying on my back in 5-point restraints so I could not read them.
They put me back in behavioral restraints because I did not deserve medical treatment for my medical condition. I deserved punishment for my bad behavior, such as escaping from restraints.
A psychiatric worker jerked my right arm down to put me back into tight five-point restraints and I screamed. My bad shoulder hurt and I felt a pop in my elbow. No medical people came to see if I were injured. Nobody looked to see that my previously dislocated and repaired should that had calcium deposits and osteoarthritis had been strained badly. No Harborview medical personnel diagnosed, treated or cared for my strained shoulder or my torn elbow ligament. Because I was designated a mental patient, I couldn’t get medical care in this hospital.
That night, a psychiatric person brought a partial dose of my epilepsy anti-seizure medications. When I asked for the rest of them, he took all the anti-seizure medications away from me. Since I was designated a mental patient, I couldn’t get anti-convulsants when I was having seizures on a mental ward in this hospital. It seems I may have gone without proper anti-seizure medication for three days. I had experienced seizures on at least two of those days and maybe once in a while on this third. I came out of the seizures in spite of Harborview’s treatment. If I had never come out of seizures, I would have been locked up forever, denied anti-seizure meds, given medications that cause seizures and other brain damage (most of it irreversible), and I probably would have died.
I did not receive proper anti-seizure medication in the appropriate doses until I had come out of my seizures and could supervise Harborview’s personnel.
I told them I wanted a phone and my purse.
I finally was able to call the person who has power of attorney (POA) to make decisions for me during health care crisis. I had written a Durable Power of Attorney, an end of life Health Care Directive, a mental health advanced directive (AD), and a crisis prevention plan, all of which Harborview ignored until I told them about it. They ridiculed it in medical records, saying I had written a “novel” of over 30 pages, proving I was self-focused and grandiose. They would have known all the proper medication to give me and they would have known the proper doses if they had read it. Actually, when I first wrote the AD, one of Harborview’s own department heads signed a statement that said I was rational and able to execute the document, which Harborview’s psych personnel now call a “novel”. They had to say the AD was irrational as a result of my so-called mental illness in order to justify their ignoring an AD in a Medicare-Medicaid hospital.
Anyway, after I called my POA and I told him I wanted to sign myself out against medical advise, he called the psychiatrist and found out that I was involuntarily committed for 72 hours, which meant I was locked up for seven days.
I finally got fed for the first time in days. Somebody even figured out how much I love hot chocolate and brought it to me often.
According to my records, I had been in retraints for at least 32 hours for the treatment of epilepsy. I could have died if I had experienced a grand mal seizure. I do have grand mal seizures sometimes during the 2-5 day episodes. Many people have died in behavioral restraints. After they took me out of behavioral restraints for treatment of a medical condition, I could hardly stand up.
After four days of sleep deprivation, I got a little bit of sleep but not until after I was released from restraints. Then I got the first bath in days. Clean hospital gowns, even. Then the nurse told me I could go out and have dinner with the other patients on a “trial basis.” I wondered how this would treat my epilepsy.
One night, a nurse beckoned to me and handed me a post-it note. It had his name, Frank Coleman MHT, on it. He urged me to file an incident report about “excessive use of force” regarding the arm injury.
I did that. I was told that only a professional could file an incident report. I got something to file anyway and did so, but it was not followed up on. Coleman said he would “take care of the professional part of it.”
I also had a newly-chipped tooth.
On the fourth day of my 72-hour detention, I asked a psychiatrist for the generally accepted medical treatment for my disabilities, conditions, and allergies, all of which I had not been receiving. I was in a hospital, not a jail, so I saw no reason for them to withhold medical treatment from me. I am a Medicaid patient, so their refusal of medical treatment for me is fraud. Well, they kept on refusing epilepsy treatment and examination by a neurologist, or by my neurologist, who practices at Harborview. No, I was told, they would not stop using they psychiatric protocol to treat my epilepsy. Maybe this was experimental treatment of epilepsy, I thought.
No, they said they would not allow an orthopedic specialist to treat my arm. At midnight the night before I was released, they x-rayed my elbow.
I was refused treatment by Harborview for my sleep apnea and other sleep disorders, so my friend brought the sleep apnea control equipment and Harborview wouldn’t let me use it! After a day or two, the night crew brought it in to me. They weren’t supposed to, but I thank God they did.
I got most of the allergy treatment. However, I was told that I would have to launder the sheets and bedding and nightgowns myself. I even had to provide my own laundry detergent (the hospital probably charged Medicare and Medicaid for laundry services). I was supposed to do the laundry?
Cathy, a state employee, told me I had to do the laundry. I told her this was a legal issue: it was slavery and it was illegal. She said she didn’t know that. I didn’t know if she whether she meant: 1) She didn’t know slavery was illegal, or 2) she didn’t know forcing involuntarily committed mental patients to work was slavery. So she had to do the laundry. She didn’t launder the nightgowns, so I had to sleep in my day clothes.
I asked for treatment of chronic fatigue. They never got it right.
They never provided pictures of bruises they inflicted on me, they never provided hand cream, chap stick, heat pads and cold pads for my pain, and many other medical things I asked for.
Their medical records said I was overly somatically focused.
I was involuntarily committed so Harborview could deprive me of medical treatment their own doctors prescribed for me. Except for sleep disorders and orthopedic. Swedish provides that. So Harborview also deprived me of care Swedish physicians prescribed for me.
One time I asked my night contact person, Steve, to write down a specific thing in my chart. He said he didn’t chart things like that. I asked him what kinds of things he charted. “Global impressions,” he answered.
Maryanne Bolte, M.D., talked with my neurologist and told her I had a seizure, I was doing well, and that I would be discharged. On that same day, this government official signed a petition to involuntarily commit me fourteen more days on the basis of mental illness: the catch-all of bipolar, mixed, rapid cycling. On that day, a court-appointed mental health professional was supposed to examine me, then make a recommendation to the court about whether the judge should lock me up for fourteen more days. He came in to my room, asked me one question, then handed me the petition, which had been previously filled out and signed by both him and Dr. Bolte. Why did he bother to examine me?
The next day, the court dismissed my case before the Harborview hearings even began. I was free from depriviation of liberty without due process and without treatment for the medical cause that they said they detained me for: epilepsy which was a “grave disability” which “made me a danger to myself and others.”
What is “danger”? Bruce Ennis, American Civil Liberties Union Lawyer, wrote “That’s anybody’s guess,” in his book, The Rights of Mental Patients. He says mental health professionals are wrong about future danger far more often than they are right.
In Baxstrom v. Herold, psychiatrists had examined 1000 patients and locked them up because they were dangerous. After the decision in favor of the patients, only 7 were found to be too dangerous to be released from a this mental hospital.
Harborview deprived me of liberty because they could neither read my descriptions of what I had in my AD, nor could they read my medical records, nor could they tell the difference between epilepsy and whatever “mental illness” is. When they didn’t know, they got a County Designated Mental Health Professional (CDMHP), Lynne Meredith, to make a guess that’s wrong more often that it’s right (7 right, 993 wrong), and on the basis of this guess, she and they deprived me of liberty for seven days, put me in a position where I was at unreasonable risk of harm (injury to my shoulder, no treatment for my medical conditions, risk of lock-up forever), and she put me in a position where my property was damaged (although Harborview has since reimbursed me).
In mid December, I filed a police complaint of assult of my arm while I was on the Harborview Psychiatry Intensive Care Unit, but at press time, neither the police nor the prosecutor has contacted me.
It could have been worse. Twenty-five years ago, policy took me to Western Missouri Mental Health Center, in MO. I regained consciousness from my seizures in a locked room. The door had a small glass window. A guy on the other side made faces, stuck out his tongue, teased and taunted me. The guy said if I wanted out of the room, I had to defecate on the floor, pick up my feces, and write my name on the window in the door. I did it. Then people wrestled me to give me a shot of Thorazine, which causes seizures. They forced me to take Mellaril, which caused me to have two-day seizures every eight to ten days for three and a half years. When I stopped taking Mellaril, I had no personality changes. I had seizures far less frequently, but my seizures began to last five days.
For 43 years I have had “childhood absence seizures in status epilepticus, sometimes secondarily generalized by grand mal seizures.” I have thousands of little blank outs over 2-5 days. I may have convulsions. I walk and talk, but as my mother puts it, “what [I] do and say may not be factual.”
I was involuntarily committed to Harboview’s psychiatry ward. I was deprived of medical care, even though a recent court decision, Rust et al v. Western State et al ruled that persons involuntarily committed in mental wards need timely adequate medical and dental care. Harborview didn’t provide timely medical treatment.
Harborview also ignored my AD. Hargrave v. State of Vermont rules this to be illegal because it is a violation of the Americans with Disabilities Act (ADA).
In Missouri, psychiatrists diagnosed my seizures as “chronic undifferentiated schizophrenia,” while Harborview called the same seizures “bipolar disorder, mixed rapid cycling.”
After an internal review of my hospitalization, Harborview said there was no way they could have known that in December.
How many other epileptics are treated for epilepsy on the psych ward at Harborview, then locked up forever on the back wards of Western? That scares me.
(I called Harborview several times to get their comments on this, but they did not return my calls. – editor)
Source: Different Times, Seattle, Washington
Summer 2002, Volume XII, Number 1