Inadequate Supervision Leads to Sexual Assault of Vulnerable Patient
A young individual in a psychiatric unit faces a serious incident due to alleged inadequate supervision, raising concerns about care standards and provider liability.
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Case Overview
This case involves a young individual on the autism spectrum who was admitted to a psychiatric unit for support during a challenging period. The individual, who has severe developmental delays and cognitive impairments, was placed under a protocol requiring checks every 15 minutes. However, these checks were allegedly not conducted as mandated. During the admission, the individual was sexually assaulted by a roommate under circumstances that raise serious questions about the adequacy of supervision and care provided by the psychiatric staff. Surveillance footage revealed that a nurse briefly peered into the room during the assault but did not intervene. Following the incident, both individuals were separated, and a rape kit was utilized, which confirmed the presence of semen collected from the victim's rectum. This case seeks to evaluate the standards of care within the psychiatric setting and the potential liability of the healthcare providers involved.
Questions to the Forensic Psychiatry expert and their responses
What are the most pertinent measures that healthcare providers in the inpatient psychiatry unit can perform to minimize the incidence of resident-on-resident assault?
Private rooms have become a standard of care in child and adolescent psychiatry to prevent these kinds of issues. Standard of care also calls for screening for a history of sexual perpetrating behavior upon admission. If an individual has such and is accepted for admission, they need to be maintained on continuous visual observation throughout their hospital stay. For patients that are more vulnerable - due to size, age, or cognitive ability - I often increase the level of observation to have 1:1 staffing or continuous visual observation.
What are the most pertinent measures that healthcare providers in the inpatient psychiatry unit can perform to minimize the incidence of resident-on-resident assault?
Private rooms have become a standard of care in child and adolescent psychiatry to prevent these kinds of issues. Standard of care also calls for screening for a history of sexual perpetrating behavior upon admission. If an individual has such and is accepted for admission, they need to be maintained on continuous visual observation throughout their hospital stay. For patients that are more vulnerable - due to size, age, or cognitive ability - I often increase the level of observation to have 1:1 staffing or continuous visual observation.
About the expert
This expert has 10 years of experience in the field of general psychiatry, specializing in adolescent and forensic psychiatry. She earned her BA in French and her BS in zoology from Louisiana State University, followed by her MD from Louisiana State Health Sciences Center. She completed three residencies in pediatrics, child psychiatry, and psychiatry as well as a fellowship in forensic psychiatry, all at the University of Cincinnati. Today, this expert is board certified in psychiatry, forensic psychiatry, and child and adolescent psychiatry. She is an active member of the American Psychiatric Association, the American Psychoanalytic Association, and the American Academy of Child and Adolescent Psychiatry. Previously, she was a psychiatrist at Veteran’s Affairs Medical Center Ohio and at Children's Home of Cincinnati and an attending psychiatrist at Summit Behavioral Healthcare and New Orleans Justice Center. She also served as the medical director of the Alabama Department of Mental Health and as an assistant professor of child and adolescent psychiatry at the University of Alabama at Birmingham. Currently, she is an assistant professor of child and adolescent psychiatry and the associate director of the forensic psychiatry fellowship program at a well-known university in Louisiana. Additionally, she is the medical director of the behavioral health service line and an attending psychiatrist at a pediatric hospital in Louisiana.
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