Medical staff in the psychiatric unit of Grand Falls-Windsor's hospital showed "flagrant disregard" for the wishes of a patient by not arranging for her discharge when she requested one, according to a judge.
According to a ruling released Friday by the Supreme Court of Newfoundland and Labrador, staff at the Central Newfoundland Regional Health Centre did not discharge a 56-year-old patient from the psychiatric ward, even after she filed a court application arguing she was "being held against her will and unlawfully."
'Alarm bells should have been ringing.' - Justice David Peddle
Justice David Peddle found that the extended hospital stay constituted an unlawful detainment.
"Alarm bells should have been ringing at this point," Peddle wrote in his decision. "The lack of immediate action to address the situation is a flagrant disregard for [the patient's] legislated right to liberty."
Should have been no doubt
The patient, identified by the court ruling as E.D., was brought to hospital by the RCMP in April 2016. Although she had no history of psychiatric hospital admissions, she was found to meet the criteria for an involuntary admission, and kept in hospital.
To be admitted against her will, E.D. had to be assessed by two people and had to be, "likely to cause harm to himself or herself or to others or to suffer substantial mental or physical deterioration or serious physical impairment" if she was not held, according to the standards of Newfoundland and Labrador's Mental Health Care and Treatment Act.
Almost two weeks later, E.D. was reassessed and found to be no longer "certifiable," meaning she no longer met that criteria and had the right to leave the hospital.
'How could there be any doubt … whether Ms. D. wanted to stay on the unit or go home?' - Justice David Peddle
She was released on May 2, 2016, four days after her status was changed.
Peddle ruled there was "no evidence" that E.D. was told she had the right to leave the psychiatric unit, and testimony from one nurse on the ward indicated that E.D. never signed a consent form to remain as a voluntary patient.
According to the written judgment, a doctor and three nurses gave affidavits or testimony in the case. Three of them indicated that they were aware E.D. wanted to leave the hospital, although two said E.D. agreed following their conversations to wait for more treatment or for more assessment.
Peddle wrote that it should have been clear to everyone working in the unit that E.D. wanted to leave, especially when she filed a court application for her release the day after her status was switched to a voluntary patient.
"How could there be any doubt after service of this notice as to whether Ms. D. wanted to stay on the unit or go home?" Peddle wrote. "I cannot accept the argument that notwithstanding this notice and application Ms. D. agreed to stay voluntarily."
The court hearing did not take place until May 2017, a year after the woman was released from hospital.
But Peddle wrote it was still appropriate for him to make a ruling on the matter, saying it was important to do so for future similiar cases.
E.D.'s lawyer declined to comment on the decision. A spokesperson for Central Health did not respond.