Escape from the Mayo Clinic: Teen accuses world-famous hospital of 'medical kidnapping' (1 Viewer)

[Saint_Ward]

https://www.cnn.com/2018/08/13/health/mayo-clinic-escape-1-eprise/index.html

Sherburn, Minnesota (CNN)In a jaw-dropping moment caught on video, an 18-year-old high school senior rushes to escape from the hospital that saved her life and then, she says, held her captive.
At the entrance to the world-renowned Mayo Clinic, the young woman's stepfather helps her out of a wheelchair and into the family car.
Staff members come running toward him, yelling "No! No!" One of them grabs the young woman's arm.
"Get your hands off my daughter!" her stepfather yells.
The car speeds away, the stepfather and the patient inside, her mother at the wheel.
Mayo security calls 911.
"We have had a patient abduction," the security officer tells police, according to a transcript of the call.
'A cautionary tale'
The patient's name is Alyssa Gilderhus.
She and her family say she wasn't abducted from the Mayo Clinic in February 2017; rather, she escaped. They say the hospital was keeping her there against her will -- that Mayo "medically kidnapped" her.
Unhappy with the care she was receiving at Mayo, they say, they repeatedly asked for her to be transferred to another hospital. They say Mayo refused.
According to police, Mayo officials had a different plan for Alyssa: They had asked the county for assistance in "gaining guardianship of Alyssa," who was an adult.

Now, this entire story (in two parts) is from mostly the Family's perspective, so it may be slanted, but this sounds crazy.

As someone who's spent their fair share in hospitals being an advocate for a family member, I'm not shocked the family felt like they had to speak up to get things done. It's common. I think too many patients are alone, and unable to get good care, because of the snap shots of time you get to have with the doctor (sometimes not even awake!). Nurses can only do what they're ordered to do. We had a medication that my wife was supposed to get every 4 hours. But, the nurses couldn't even get her medication to her within 6 hours. They just didn't have the staff to follow the doctor's orders. It's stupid. So, why write the order that way?!?!?! I've had to complain to get medications changed, to get a status on where we are with testing? We spent at least one extra day in the hospital, just because the doctors found a result, we could have easily explained, but no, they ran a confirmation test to realize it wasn't an issue, when we could have just told them that ahead of time. I finally had to complain to talk to whatever doctor was in charge about what's going on,what's the plan, what are they still trying to figure out? When you can't answer the basic question, "why am I here and what are we trying to figure out?" then you have a big problem.

It's akin to "we need to make sure you're not pregnant before we allow you to get an X-ray". "I don't have a uterus.. and I told the nurse and doctor that". "oh, nevermind, let's get that x-ray".

Hospitals get so bogged down in protocol that they often forget to just listen to the patient. I"m sure many lie too, or are confused, but I've experienced it enough times, that if you don't have a healthy patient advocate, you're going to be less comfortable, or even potentially miserable.

 

[superchuck500]

More detail:

Alyssa Gilderhus was rushed to Mayo Clinic on Christmas morning, 2016, after suffering a ruptured brain aneurysm.

Though her prognosis was grim, the then-18-year-old survived several surgeries and moved into rehab to recover from her brain injury. That’s when Alyssa’s parents, Amber and Duane Engebretson, began having conflicts with hospital staff.

According to interviews the family gave with CNN, there were several incidents in which they disagreed about the medical care their daughter recieved. They asked to have several health workers on their daughter’s care team removed; they asked to have their daughter transferred to a new rehab facility; they even got a lawyer to write a letter to make a formal transfer request. The hospital refused.

After several heated arguments with hospital administrators, Alyssa’s mother Amber was banned from the hospital.

What the family didn’t know then, but would later learn, was that administrators had begun proceedings with local adult protection agencies to request a guardian be appointed to take over Alyssa’s medical decisions.

They allege the hospital soon began isolating Alyssa. Staffers took away her phone, laptop and tablet, they told CNN, and visitors were banned from bringing devices into the hospital or from attending her rehab sessions.

In late February, 2017 -- two months after the Mayo Clinic had helped save their daughter’s life – Alyssa’s family decided they needed to help her escape.

They came up with a plan to trick the nurses who had been assigned to watch over Alyssa.

They told them that Alyssa’s grandmother was in the lobby to visit her but was too frail to come upstairs. When they arrived in the lobby with the two nurses following, they told them her grandmother was still in the parking area outside and headed for a minivan.

Then, as family members captured on video, they lifted Alyssa out of her wheelchair into the van. The nurses yell, "No!" and one appears to try to grab Alyssa’s arm.

"Get your hands off my daughter!" Duane Engebretson yells back.

After the van sped away, security guards at the hospital called 911 to report “a patient abduction.”

Police soon began an investigation. They learned that while hospital officials had concerns about Alyssa’s mother’s ability to make decisions for her daughter, Alyssa was technically an adult and, as other doctors would later corroborate, able to make decisions for herself. That included the decision to leave the hospital against medical advice.

Police determined there was no abduction and no charges were ever laid.

In a statement to CNN, the Mayo Clinic said it would not discuss specifics of Alyssa’s case but said it stands by the decisions it made regarding her care.

"Our internal review determined that the care team's actions were true to Mayo Clinic's primary value that the patient's needs come first. We acted in a manner that honoured that value for this patient and that also took into account the safety and wellbeing of the team caring for the patient,” the statement reads.

Now, more than a year after leaving hospital, Alyssa is able to walk on her own and finished speech therapy in the spring. She graduated high school and was selected as prom queen. And this September, the now-20-year-old Alyssa is set to enter Southwest Minnesota State University.

Family captures moment they help daughter 'escape' Mayo clinic

 

[Taurus]

One wonders if the family had God's Own Insurance and Alyssa was a (not yet) walking cash cow for the clinic. That's the only reason I can come up with as to why they'd flip out like that. If it was about the patient's health, they might argue a little because of course they'd think they were the best, but if she was just being transferred to a different rehab center, they wouldn't put up that much of a fight.

 

[Saint_Ward]

One wonders if the family had God's Own Insurance and Alyssa was a (not yet) walking cash cow for the clinic. That's the only reason I can come up with as to why they'd flip out like that. If it was about the patient's health, they might argue a little because of course they'd think they were the best, but if she was just being transferred to a different rehab center, they wouldn't put up that much of a fight.

I'd like to give Mayo a bit of the benefit of the doubt based on maybe a far earlier interaction.

Then being told the hospital doesn't have a patient advocate? I dunno.

Looks like once the (I'm assuming chief resident?) doctor who ran the floor seemingly disliked them, it looks like their options were limited.

I get them not wanting to comment in public, but the patient signed the release. This is going to murder their PR.

 

[Outbackjack]

There’s a pretty freaky movie called Unsane.

It’s fictional but I left it thinking.....could that happen?

Basically a similar story about a routine visit to a psychologist (located at a hospital), and the generic signing of initial papers included , unknowingly, consent to be committed until “doctor clearance”
Turns out it was fully due to the type of insurance, which was a cash grab for the hospital. Then how a mental hospital stay against your will can mess with your brain.

Unsane (2018) - IMDb

Very thought provoking picture

 

[livefromDC]

Mayo is a world renowned facility. This is isn't a case of the for pay neighborhood hospital trying to rack up insurance claims so I'm not buying the idea that Mayo was operating in any way outside of what was best for the patient.

To me, and this is just my opinion, the family decided to move her to a place that would yield to their requests instead of do what was in the best interest of their daughter. ...Which sucks for the daughter because she doesnt know any better.

 

[superchuck500]

Mayo is a world renowned facility. This is isn't a case of the for pay neighborhood hospital trying to rack up insurance claims so I'm not buying the idea that Mayo was operating in any way outside of what was best for the patient.

To me, and this is just my opinion, the family decided to move her to a place that would yield to their requests instead of do what was in the best interest of their daughter. ...Which sucks for the daughter because she doesnt know any better.

The doctors aren't always right - the doctor/patient relationship is based on the idea that the patient ultimately controls the treatment. That's what the entire idea of a second opinion is based on and any doctor that refuses to recognize the value of a second opinion and the patient's rights is rogue IMO. It gets complicated when the patient decision-maker is not the patient, but that's where the law comes in. Here the hospital was trying to get an adult-custodian appointed but that hadn't happened yet. But at the same time, the adult patient was conscious and communicative and had never been ruled incompetent. The adult in this case was able to state her desire to leave but the hospital rejected it as incompetent, despite not having legal grounds to do so.

I'm not sure how you can say it sucks for the daughter because she doesn't know any better. She was 18, I don't think you can presume she wasn't forming her own opinion about her treatment. And I also think the proof is in the pudding: "Now, more than a year after leaving hospital, Alyssa is able to walk on her own and finished speech therapy in the spring. She graduated high school and was selected as prom queen. And this September, the now-20-year-old Alyssa is set to enter Southwest Minnesota State University."

Doesn't sound like getting out sucked that badly for her.

 

[Doug B]

This is an auto-lawsuit on the family's part, right? Seems the Mayo Clinic would want to cut a PR-saving check ASAP to make this all go away.

Then again, it's been over a year, and no lawsuit seems to have been filed.

 

[superchuck500]

This is an auto-lawsuit on the family's part, right? Seems the Mayo Clinic would want to cut a PR-saving check ASAP to make this all go away.

Then again, it's been over a year, and no lawsuit seems to have been filed.

Not necessarily. She was an adult with a brain injury. It doesn't appear that her parents ever got legal guardianship over her so their requests to take her home had no legal effect. It's unclear whether she made such requests or whether they would be considered valid/competent under state law. It's possible that they have good legal advice that is telling them it's a long shot and would likely be disruptive and emotional.

 

[Doug B]

It's possible that they have good legal advice that is telling them it's a long shot and would likely be disruptive and emotional.

One might go to court without necessarily caring about winning the case -- but rather, to publicly embarrass the Mayo Clinic. Thus the anticipated summary PR payout.

 

[superchuck500]

One might go to court without necessarily caring about winning the case -- but rather, to publicly embarrass the Mayo Clinic. Thus the anticipated summary PR payout.

If you presume the facts are embarrassing to Mayo, the story is already out there. The suit wouldn't make it any more embarrassing. I suspect Mayo Clinic gets sued all the time.

 

[livefromDC]

The doctors aren't always right - the doctor/patient relationship is based on the idea that the patient ultimately controls the treatment. That's what the entire idea of a second opinion is based on and any doctor that refuses to recognize the value of a second opinion and the patient's rights is rogue IMO. It gets complicated when the patient decision-maker is not the patient, but that's where the law comes in. Here the hospital was trying to get an adult-custodian appointed but that hadn't happened yet. But at the same time, the adult patient was conscious and communicative and had never been ruled incompetent. The adult in this case was able to state her desire to leave but the hospital rejected it as incompetent, despite not having legal grounds to do so.

I'm not sure how you can say it sucks for the daughter because she doesn't know any better. She was 18, I don't think you can presume she wasn't forming her own opinion about her treatment. And I also think the proof is in the pudding: "Now, more than a year after leaving hospital, Alyssa is able to walk on her own and finished speech therapy in the spring. She graduated high school and was selected as prom queen. And this September, the now-20-year-old Alyssa is set to enter Southwest Minnesota State University."

Doesn't sound like getting out sucked that badly for her.

Just because she's able to walk now and "finished" speech therapy, we still dont know to what degree her quality of life has resturned to normal or if there are some long term neural ramifications that Mayo was monitoring. Of course, we can't gauge what could have happened, but Mayo felt strongly enough that Im wondering if her "progress" is actually slower than it could have been. The appearance of normality doesnt mean normality ESPECIALLY when we're talking brain trauma. Unlike a broken arm or an ankle you can't put weight on, brain injuries are incredibly hard for untrained people to comprehend. I wish her well, but I still side with Mayo on this one. They are a world leader in neurological science, I'll defer to their expertise over an 18 year old who says, "I feel fine I want to go home".

 

[livefromDC]

Perhaps Im off base here, but I get the feeling that the responses in this thread are not familiar with Mayo. In medicine, they are the Pats, Yankees, Celtics, and whatever hockey team is the most dominant. Seriously, they are the #1 in several fields of medicine in addition to Neurology. Based on their reputation, I have a hard time buying this story. Like I would have a hard time believing that Sean Payton purposely stole the Browns offensive playbook. It's far fetched.

Your 7 year old kid ask if he can go play in a busy intersection. You say no because he'll likely get killed. You tell him no but he goes anyway. When he comes back, he only has a bruise on his leg. Thats not really proof that he knew what he was talking about.

And again...it's the Mayo Clinic, not some random hospital. That means something in the medical community.

 

[dgrant]

Like I would have a hard time believing that Sean Payton purposely stole the Browns offensive playbook. It's far fetched.

I am not saying you're wrong, but given this recent article I had to post it.

The Saints are always looking for 'inspiration' for new plays, and they aren't afraid to steal what they like

 

[superchuck500]

Just because she's able to walk now and "finished" speech therapy, we still dont know to what degree her quality of life has resturned to normal or if there are some long term neural ramifications that Mayo was monitoring. Of course, we can't gauge what could have happened, but Mayo felt strongly enough that Im wondering if her "progress" is actually slower than it could have been. The appearance of normality doesnt mean normality ESPECIALLY when we're talking brain trauma. Unlike a broken arm or an ankle you can't put weight on, brain injuries are incredibly hard for untrained people to comprehend. I wish her well, but I still side with Mayo on this one. They are a world leader in neurological science, I'll defer to their expertise over an 18 year old who says, "I feel fine I want to go home".

Medically, yes - you're entirely correct. It's the Mayo Clinic, the gold standard of care. Yes, the Mayo neurologists know more about her condition than she does. But whether the Mayo Clinic can hold an adult patient against her will is a legal question, not a medical one. Yes, the medicine informs the legal result but it doesn't necessarily drive it. We don't have standard rule in American law that provides medical providers with the final say in a patient's care. Rather, we rely on informed consent: the idea that the medical provider's job is fully inform the patient of the diagnosis, prognosis, treatment options, and treatment risks . . . but the final decision is the patient's.

This is because American law is based on a fundamental rule of individual liberty and self-determination, we don't freely transfer that right of determination to a third party - it requires substantial burdens of proof. An adult is presumed competent to decide her own treatment unless and until it has been determined, legally, that she is not competent - and in such cases, a guardian is appointed. This is why everyone should have medical powers of attorney (sometimes called a healthcare proxy) appointing a trusted family member or friend to serve in this capacity (and, indeed, any competent wills and estates lawyer that prepares a will is going to include a medical power of attorney in the package).

Like I said earlier, this fact pattern presents challenges. With an adult patient (with no medical power of attorney), the desires of the parents are effectively advisory - they have no legal effect. The patient suffered a brain injury, indeed, but it also says she was communicating, reading, using smart phones, etc. This was not a vegetative-state patient. I think your characterization of "I feel fine I want to go home" is a bit flip, the story says that the patient and her family had determined a different treatment center for her to transfer to - but Mayo declined to allow her to transfer. Of course during all of this, Mayo was supposedly trying to have an adult-patient guardian appointment (presumably by the court) but it doesn't say how far along that process was.

So the patient here was in a bit of limbo. The hospital may have been on good medical grounds to refuse her requests, but they lacked genuine legal power to keep her. I don't know enough about whether relevant state law may provide hospitals with a temporary right to hold a patient pending judicial review of the patient's competency - so there may be something there. But again, in the American legal system, a medical providers conviction that their treatment is in the patient's best interest doesn't outweigh a competent adult's right to determine his or her own treatment. Only a judge can make that finding.