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As a HIPAA issue, the Mayo cannot defend itself here - it has no right to disclose any information on this patient’s stay or condition. Key quote, >“You’re on

As a HIPAA issue, the Mayo cannot defend itself here - it has no right to disclose any information on this patient’s stay or condition. Key quote, >“You’re only hearing one side,” cautioned Dr. Chris Feudtner, a professor of pediatrics, medical ethics and health policy at the University of Pennsylvania Perelman School of Medicine. They “broke her out” while she still had a feeding tube in place, and had only just “The video shows Duane pushing Alyssa in her wheelchair down the hospital hallway. She has a bandage on her neck where her breathing tube had been removed a few days before.” If you’re getting a feeding tube and a trache, you’re likely sick as shit. Even if one thinks the Mayo docs were wrong, that course of treatment suggests they earnestly thought she was extremely ill. Which makes their actions less evil than the article implies.

lylecubed 8y ago
> Which makes their actions less evil than the article implies. And accusing the mother of having a history of mental illness in an attempt to get conservatorship when no such history exists? Sounds pretty damned evil to me. The road to hell is paved with good intentions. Even if they had their patient's best interests at heart, that doesn't excuse what they did.
- JoeAltmaier 8y ago
  We don't have any information on the parents at all. I know its good to give parents the benefit of the doubt, but these people could have been ignorant, suspicious and contrary. Or 100 other things, that make a trained physician wary of trusting them with anything as important as a critically ill patient.
  - ars 8y ago
    > We don't have any information on the parents at all. I'm not sure what you read, but there is plenty of information about the parents. They are quoted, they have videos, they have facebook posts. There is no reason to see them as mentally incompetent. > could have been ignorant, suspicious and contrary. Makes no difference. They have the right to stop medical treatment whenever they want. They have the right to leave the hospital and take their daughter whenever they want. Not to mention the patient was over 18 and wanted to leave, and the hospital didn't let them. > wary of trusting them with anything as important as a critically ill patient. Too bad. Then you explain to them how to help her. The hospital has no legal right to hold someone prisoner.
  - lylecubed 8y ago
    > these people could have been ignorant, suspicious and contrary So if they were "suspicious" the hospital is justified in committing kidnapping, even after being turned down for conservatorship by two judges?
  - jessaustin 8y ago
    This episode didn't happen yesterday. The patient has since recovered, attended and graduated from high school, and enrolled in college. She is as competent to make health care decisions as any other 20yo. She is glad that her parents helped her escape, because she got better care that led to her recovery at a different hospital. She was clearly not critically ill, because she arrived at that hospital in a different state in fine shape. We consider the medical judgments of trained physicians (the untrained ones, not so much...) but only until they are clearly contradicted by reality. Properly understood, the duty of physicians is also to serve those patients who are "ignorant, suspicious and contrary". They are also humans with dignity and autonomy.
ars 8y ago
> has no right to disclose any information on this patient’s stay or condition Except that according to the article the Mayo said they would if the patient signed a release form. So the patient did so (called their bluff basically), and they still refused to discuss it. > they earnestly thought she was extremely ill. Which makes their actions less evil than the article implies. Make no difference whatsoever. People have the right to stop medical treatment whenever they like. They have zero right to force anything on anyone. On top of that a different set of Dr's said she was just fine to go home. So on top of everything else they were also wrong medically.
- lsaferite 8y ago
  I'm sure their lawyer put the kibosh on that. How could they square their claim that she was not capable of making decisions with honoring a release also signed by her?
  - jtbayly 8y ago
    Exactly the same way they squared having her make her own medical decisions while claiming she couldn’t.
  - ars 8y ago
    Since when do hospitals have the ability to unilaterally decide someone is not capable of making their own decisions? If they believe that is the case they get a judge to give that person a guardian, they don't just make decisions for them.
    - koboll 8y ago
      That's literally what they were trying to do; read the article.
larkeith 8y ago
> A spokeswoman for the Mayo Clinic said hospital officials would be willing to answer CNN's questions if Alyssa signed a privacy release form giving them permission to discuss her case publicly with CNN. The spokeswoman, Ginger Plumbo, supplied that form to CNN. > Alyssa signed the form, but Plumbo declined to answer CNN's questions on the record. https://www.cnn.com/2018/08/13/health/mayo-clinic-escape-1-eprise/index.html https://www.cnn.com/2018/08/13/health/mayo-clinic-escape-1-e...
paxy 8y ago
Except on the same day another world-class hospital decided that she was healthy enough to go home..
- Para2016 8y ago
  You mean an ER physician who had no history of the previous hospitalization? The family had no discharge paperwork because they left AMA. I don't think they provided an adequate history including recommendations from neurosurgery, Pulm crit, GI, physical therapy, and speech therapy. Also I don't think the ER physician was going to admit a patient for an ultimate disposition for inpatient therapy either. What I think is kind of funny is that there is a general pediatrician who was probably coordinating care and never really needed to get consent for treatment. I'm sure the neurosurgeon who did the clip got consent, GI/surgery got consent for the PEG, Pulm crit for the trach. Now this sad primary care/peds doctor is going down for not getting consent. And one last thing, primary team pediatricians/hospitalists and their assisting case managers/social workers are not excited about long and protracted patient dispositions. No one likes to have a patient sitting on their list forever, especially one who really wants to leave and is aggressive about it. This story is incomplete without Mayo's side. I don't trust any of those comments from the medical ethicists when they don't have access to the full EMR at Mayo. I suppose they were enamored with the idea of providing a comment to the journalist.
spydum 8y ago
I have personally witnessed doctors order surgically implanted feeding tubes (aka gtube) for literally no sound reasoning other than “just incase”. I would not put it past an overworked, egotistical doc who spent all of 15minutes involved in the case and got his or her feelings hurt by a parent or relative who dared to question their medical treatment. It’s nuts but I have seen this play out in my personal life and people around me: people have no idea that they are in charge of their own medical care, and on occasion accept terrible advice. Wish I had solutions other than “be informed and willing to assert your rights” - because in the situation, that is damned difficult.
pvaldes 8y ago
> If you’re getting a feeding tube and a trache, you’re likely sick as shit. Or maybe you are being strongly sedated for some reason and are unable to breath and feed correctly by yourself. Sedation is a famous infamous way to restrain and dominate a conflictive patient. Can be used for good reasons but opens a door to some abuses also. Being sedated when is not really necessary increases the probability of death by accidental suffocation.

lylecubed 8y ago

> Which makes their actions less evil than the article implies. And accusing the mother of having a history of mental illness in an attempt to get conservatorship when no such history exists? Sounds pretty damned evil to me. The road to hell is paved with good intentions. Even if they had their patient's best interests at heart, that doesn't excuse what they did.

JoeAltmaier 8y ago
We don't have any information on the parents at all. I know its good to give parents the benefit of the doubt, but these people could have been ignorant, suspicious and contrary. Or 100 other things, that make a trained physician wary of trusting them with anything as important as a critically ill patient.
- ars 8y ago
  > We don't have any information on the parents at all. I'm not sure what you read, but there is plenty of information about the parents. They are quoted, they have videos, they have facebook posts. There is no reason to see them as mentally incompetent. > could have been ignorant, suspicious and contrary. Makes no difference. They have the right to stop medical treatment whenever they want. They have the right to leave the hospital and take their daughter whenever they want. Not to mention the patient was over 18 and wanted to leave, and the hospital didn't let them. > wary of trusting them with anything as important as a critically ill patient. Too bad. Then you explain to them how to help her. The hospital has no legal right to hold someone prisoner.
- lylecubed 8y ago
  > these people could have been ignorant, suspicious and contrary So if they were "suspicious" the hospital is justified in committing kidnapping, even after being turned down for conservatorship by two judges?
- jessaustin 8y ago
  This episode didn't happen yesterday. The patient has since recovered, attended and graduated from high school, and enrolled in college. She is as competent to make health care decisions as any other 20yo. She is glad that her parents helped her escape, because she got better care that led to her recovery at a different hospital. She was clearly not critically ill, because she arrived at that hospital in a different state in fine shape. We consider the medical judgments of trained physicians (the untrained ones, not so much...) but only until they are clearly contradicted by reality. Properly understood, the duty of physicians is also to serve those patients who are "ignorant, suspicious and contrary". They are also humans with dignity and autonomy.

ars 8y ago

> has no right to disclose any information on this patient’s stay or condition Except that according to the article the Mayo said they would if the patient signed a release form. So the patient did so (called their bluff basically), and they still refused to discuss it. > they earnestly thought she was extremely ill. Which makes their actions less evil than the article implies. Make no difference whatsoever. People have the right to stop medical treatment whenever they like. They have zero right to force anything on anyone. On top of that a different set of Dr's said she was just fine to go home. So on top of everything else they were also wrong medically.

lsaferite 8y ago
I'm sure their lawyer put the kibosh on that. How could they square their claim that she was not capable of making decisions with honoring a release also signed by her?
- jtbayly 8y ago
  Exactly the same way they squared having her make her own medical decisions while claiming she couldn’t.
- ars 8y ago
  Since when do hospitals have the ability to unilaterally decide someone is not capable of making their own decisions? If they believe that is the case they get a judge to give that person a guardian, they don't just make decisions for them.
  - koboll 8y ago
    That's literally what they were trying to do; read the article.

larkeith 8y ago

> A spokeswoman for the Mayo Clinic said hospital officials would be willing to answer CNN's questions if Alyssa signed a privacy release form giving them permission to discuss her case publicly with CNN. The spokeswoman, Ginger Plumbo, supplied that form to CNN. > Alyssa signed the form, but Plumbo declined to answer CNN's questions on the record. https://www.cnn.com/2018/08/13/health/mayo-clinic-escape-1-eprise/index.html https://www.cnn.com/2018/08/13/health/mayo-clinic-escape-1-e...

paxy 8y ago

Except on the same day another world-class hospital decided that she was healthy enough to go home..

Para2016 8y ago
You mean an ER physician who had no history of the previous hospitalization? The family had no discharge paperwork because they left AMA. I don't think they provided an adequate history including recommendations from neurosurgery, Pulm crit, GI, physical therapy, and speech therapy. Also I don't think the ER physician was going to admit a patient for an ultimate disposition for inpatient therapy either. What I think is kind of funny is that there is a general pediatrician who was probably coordinating care and never really needed to get consent for treatment. I'm sure the neurosurgeon who did the clip got consent, GI/surgery got consent for the PEG, Pulm crit for the trach. Now this sad primary care/peds doctor is going down for not getting consent. And one last thing, primary team pediatricians/hospitalists and their assisting case managers/social workers are not excited about long and protracted patient dispositions. No one likes to have a patient sitting on their list forever, especially one who really wants to leave and is aggressive about it. This story is incomplete without Mayo's side. I don't trust any of those comments from the medical ethicists when they don't have access to the full EMR at Mayo. I suppose they were enamored with the idea of providing a comment to the journalist.

spydum 8y ago

I have personally witnessed doctors order surgically implanted feeding tubes (aka gtube) for literally no sound reasoning other than “just incase”. I would not put it past an overworked, egotistical doc who spent all of 15minutes involved in the case and got his or her feelings hurt by a parent or relative who dared to question their medical treatment. It’s nuts but I have seen this play out in my personal life and people around me: people have no idea that they are in charge of their own medical care, and on occasion accept terrible advice. Wish I had solutions other than “be informed and willing to assert your rights” - because in the situation, that is damned difficult.

pvaldes 8y ago

> If you’re getting a feeding tube and a trache, you’re likely sick as shit. Or maybe you are being strongly sedated for some reason and are unable to breath and feed correctly by yourself. Sedation is a famous infamous way to restrain and dominate a conflictive patient. Can be used for good reasons but opens a door to some abuses also. Being sedated when is not really necessary increases the probability of death by accidental suffocation.