Dazed, Confused and… Medically Cleared?
Jones is arrested for misdemeanor battery and brought to the jail. As officers begin booking him, Jones is confused and unable to answer basic questions. He is also breathing heavily and sweating profusely. The officers decide to transport him to the hospital for evaluation, but he refuses care. The hospital says Jones is “fine” and “probably just on something.” Jones is sent back to the jail without paperwork, where his condition gets worse.
Get hospital records: don’t take “NO” for an answer
The purpose of sending a detainee offsite to the ER is to have medical testing done to rule out emergencies such as delirium, organ failure, and/or infection. Testing such as lab work or CT scans can help explain bizarre behaviors in someone who appears to be mentally ill. Copies of these medical records should be obtained at discharge from the hospital to be included in the medical chart at the jail.
Sometimes, a hospital thinks it is a violation of patient rights to provide medical information to the jail. This is incorrect. If the hospital is refusing to provide records, ask if they will call the jail practitioner who oversees the detainee’s care directly. If this doesn’t work, escalate the issue up your chain of command to get hospital records: don’t take NO for an answer.
Notify medical upon return to jail
The jail’s medical provider should be notified of a detainee’s return to jail. This call should include information like what testing was completed at the hospital and the diagnosis. This information can help a practitioner determine if a detainee is fit for confinement. Hospital records can be released to the jail on behalf of the medical practitioner for continuity of care. Medical clearance from the hospital without input from the practitioner does not mean the detainee is fit for confinement – notify medical upon return to jail.
Document, document, document
Document when a detainee is sent off site for care and what tests were done to determine if the detainee is fit for confinement. The law only permits a person to refuse hospital evaluation if they are medically competent. Competency can be determined by asking basic questions such as, “What is your name?”, “Where are you right now?” and “How did you get here?” In Jones’ case, he could not answer those questions during intake. If a detainee cannot answer appropriately, document their responses to help inform medical staff.
The use of emergency room treatment and referral forms can help ensure the appropriate tests are completed at the hospital and that the results of the evaluation are provided to the jail. Document, document, document.
For more information, please contact training@sparktraining.us.
Disclaimer
All materials have been prepared for general information purposes only. The information presented should be treated as guidelines, not rules. The information presented is not intended to establish a standard of medical care and is not a substitute for common sense. The information presented is not legal advice, is not to be acted on as such, may not be current, and is subject to change without notice. Each situation should be addressed on a case-by-case basis. When in doubt, send them out!®