Department of Veterans Affairs hospital staff dismissed a suicidal patient who died six days after a visit in which a doctor shouted that the patient "can go shoot (themself). I do not care,” a new report finds.
The patient in their 60s had a history of panic attacks and addiction to opioids and tranquilizers and sought treatment at the VA Medical Center in Washington, D.C., but was released before being given required suicide prevention planning, the department's inspector general said in the report released Tuesday. The patient, who isn't identified by name or gender, later died from a self-inflicted gunshot.
In a statement, the medical center's director, Mike Heimall, called the instance an isolated incident that "does not represent the quality health care tens of thousands of D.C.-area veterans have come to expect from our facilities." He said the center "grieves the loss of this veteran."
The hospital, Heimall said, 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.
The patient had gone to the hospital's emergency room seeking admission after having trouble sleeping because of withdrawal from prescription drugs, the report states. An outpatient psychiatrist assessed the patient as being a "moderate" risk for suicide.
But after handing the patient off to emergency room staff, another psychiatrist rated suicide risk as "mild." The patient denied thoughts of suicide, and home care instead of hospitalization was recommended.
After being told of the plan, the patient refused to leave. A doctor working in the emergency room, identified only as "physician 2" in the report, wrote that the patient was ranting and "clearly malingering." VA police officers were called to escort the patient out of the emergency room.
When told the patient wanted to return for treatment of knee pain, the doctor exclaimed the patient "can go shoot (themself). I do not care." The statement was heard by at least three other staff members though it was unclear whether it was heard by the patient, the IG states.
Though considered effective in patient outcomes, the doctor had an attitude problem, the chief of staff told the inspector general's office. Last fall, the chief of staff said the doctor would have practice privileges suspended if another complaint was received. Yet no formal fact-finding or administrative investigation was conducted against the doctor as required by the VA because of a "pattern of misconduct."
At about the same time of year, another complaint was lodged against the doctor, who later resigned.
The doctor who dismissed the veteran's suicide warnings was a contract worker "who is no longer welcome at the facility," Heimall said in his statement. The doctor's conduct "was unacceptable and does not represent the dedication and compassion our employees exhibit daily. "
The inspector general found that the hospital's emergency department and its mental health staff didn't coordinate. It also bungled trying to arrange for a followup post-release appointment for the patient before the suicide, the report said.
This article originally appeared on USA TODAY: VA doctor dismissed suicidal patient saying, 'I don't care'