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Inappropriate discharge and lack of respect for dignity

Health and Disability Commissioner Anthony Hill today released a report finding Canterbury District Health Board in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for failures in the care provided to a man with alcoholic hepatitis.

The man was admitted to the gastroenterology ward at the hospital and treated for alcoholic hepatitis. Around three weeks later he was discharged, despite his continuing to be unwell, requiring ongoing medications, and having no suitable accommodation arrangements in place. The man was considered to be deliberately engaging in behaviour intended to prevent his discharge.

The man was escorted from the hospital by security staff and taken to a nearby bus stop while wearing hospital pyjamas. He remained at the bus stop for many hours. During that time, members of the public and security staff raised concerns about his condition, but he was not assessed by hospital staff. Later in the day, the Police were called to remove the man. He was issued a trespass notice and taken to a social service agency. While there his condition deteriorated further and he was returned to the hospital, where sadly he died two days later.

The Commissioner was concerned about a lack of effective response to the man’s need for help, and commented on the need for staff to think critically and recognise when a patient’s condition indicates that they need to speak up and advocate for the patient.

He found the DHB in breach of Right 4(1) of the Code for discharging the man while he had unresolved medical and accommodation issues, and for failing to reassess him, issuing him with a trespass notice, and requesting the Police remove him from the hospital. He also found the DHB breached Right 3 of the Code for failing to respect the man’s dignity, and commented that "there was a striking lack of compassion" in failing to take seriously the concerns raised by security staff and members of the public.

Mr Hill recommended that Canterbury DHB apologise to the man’s family, audit the operation of its new trespass policy, ascertain whether staff in the Gastroenterology Department feel free to raise their concerns and escalate these if necessary, review the Gastroenterology Department staff’s ability to access test results, and develop a protocol for the re-admission of patients who re-present following discharge.

The full report for case 17HDC00497 is available on the HDC website.

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