Temple Hospital Cited in ER Fire

By Walter F. Roche Jr.

Security personnel at Temple University Hospital"s Episcopal campus gave a cigarette lighter back to a bahavioral patient who subsequently lit a mattress on fire using that same lighter, according a state Health Department report.
The May 23 incident which triggered an emergency evacuation order at the facility was detailed in a June 9 report just made public.
The report concludes that the hospital "failed to provide care in a safe setting and put patients and staff "at risk for serious physical and emotional impairment."
According to the report the psychiatric patient was uncooperative, hallucinating and had a history of polysubstance abuse.
During a safety search, security personnel found a lighter, but it was given back to him by security. An employee told state inspectors that emergency department patients were allowed to have lighters and matches.
Hospital officials did not respond to a request for comment and the state report notes that the hospital had not filed an acceptable plan of correction. The hospital did however file a response to a state of "immediate jeopardy" declared when the surveyors first arrived on May 30.
The "immediate jeopardy" was lifted a day later when the hospital filed an interim plan to assess behavioral patients upon arrival, use of a metal detector and staff education.
After passing through security the patient, according to the surveyors, was placed in an examination room on a gurney which had an oxygen tank attached. A review of videotapes showed the patient was next seen manipulating the oxygen tank and then set the mattress on the gurney on fire with his lighter.
The unidentified patient already had barricaded the door to the examination room.
Surveyors found that ER personnel, despite the patient's hallucinations, substance abuse history and displayed abnormal psychiatric behavior did not order a one-to-one watch.
One ER employee told the state surveyors she was trying to transfer a Covid-19 patient and "I did not have time" to see that a one-to-one watcher was assigned" to the behavioral patient.
The hospital did not have a specific policy on how to handle patients suffering from hallcinations, the report states.
The report also questions why oxygen tanks were routinely attached to gurneys when oxygen already was piped into the examination rooms.
"In this incident, having the oxygen tank underneath the stretcher in exam room eight with this patient did create a potential hazard to the patient and to all in the emergency department," a Temple employee told the surveyors. Security personnel broke a window to the room to gain access while the patient came out of the room and at one point threw a chair into the nurses station. A Code Red was declared and patient evacuation initiated.
Police and fire personnel responded and the patient was placed under arrest and the fire extinguished.
The state surveyors weren't done. They inspected the emergency department and found numerous ligature risks, door knobs and other fixtures that could be utilized for suicide attempts. Records showed the department had not been assessed for suicide risks since Jan. 31, 2019.
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