Drunk patient lawsuit highlights hospital risk management issues.

A recent court ruling should motivate hospital risk managers to conduct a careful periodic review of their facility's procedures and legal obligations when it comes to treating intoxicated patients.

In a June ruling, the New York State Court of Appeals - the state's highest court - upheld a lower court's dismissal of a 2007 lawsuit that had accused Poughkeepsie-based St. Francis Hospital and Health Centers of medical malpractice and negligence for failing to prevent a patient from leaving the hospital in December 2006 while he was still intoxicated.

The patient, Kevin Kowalski, later wandered onto a nearby highway and was struck by a car, leaving him paralyzed below the neck. Throughout the case, Mr. Kowalski contended that even though he decided on his own to leave the hospital, the hospital should have prevented him from doing so based on his level of inebriation.

The appeals court ultimately rejected the lawsuit under the state's Mental Hygiene Law that, as do similar statutes in most states, neither permits nor requires health care providers to forcibly detain patients admitted voluntarily for treatment unless they pose a threat to themselves or others, or are unable to make informed decisions about their treatment. Still, legal experts say Kowalski highlights many of the legal risks inherent to treating and discharging intoxicated patients.

"The real value of this case for a hospital is that it gives them some guidance and some comfort in knowing what their obligations and duties are when presented with an intoxicated patient who says he wants to leave," said Jeffrey Araten, a New York-based partner at Wilson Elser Moskowitz Edelman & Dicker L.L.P., which represented St. Francis Hospital.

"Barring specific circumstances, hospitals can't lock someone up or restrain them just on the basis of that person being intoxicated," Mr. Araten said. "Intoxication is not in and of itself enough to warrant involuntarily confining a patient."

Perhaps the most salient lesson for risk managers and medical staff from Kowalski is the imperative nature of detailed, real-time record-keeping of all interactions with an intoxicated patient from the time they are admitted to the time they are discharged.

"First and foremost, documentation is the most important thing any doctor or hospital staff can do to protect themselves," said Marshal Endick, Wilson Elser's lead attorney in Kowalski. "Document what was done in terms of treatment, what was told to the patient, how the patient was evaluated and any advice not to leave that was given to the patient."

Dunning, Matt. "Drunk patient lawsuit highlights hospital risk management issues" Business Insurance 25 Aug 2013 WEB. 25 Aug 2013.|338|302#crit=matt