Parliamentary Ombudsman Petri Jääskeläinen issued a reprimand to two doctors on call and two nurses for breaches of law and negligence related to restraining and caring for a patient.
Restraining of the patient
The doctor on call had given a nurse permission to restrain a patient over the telephone because of the patient's threatening behaviour. The Ombudsman found that the doctor on call should have personally examined the patient as soon as possible after this. However, the doctor did not examine the patient at all during the shift. The Ombudsman also noted that the doctor on call should have assessed the need to keep the patient restrained at the end of the shift at the very latest to ensure that the patient could be cared for safely.
After the change of shift, another doctor only met the patient after he had been released from the limb restraints. However, the doctor had given the permission in advance to restrain the patient again if necessary. The Parliamentary Ombudsman does not consider an advance permission of this type legal or appropriate. Restraining a patient is an exceptional, last-resort measure, a decision on which can only be made by a doctor after personally examining the patient.
Inadequate entries in patient records
The Ombudsman found that the Central Hospital of Lapland had neglected to make the necessary and sufficiently entries concerning the restraining and care of the patient in the patient records. The responsibility for making the entries rested with the doctors on call and two nurses.
The reason and justification for restraining the patient, the start and end time of restraint use, the names of the persons who restrained the patient and the type of limb restraints that were used should have been noted in the patient records. Inadequacies in the entries hampered the assessment of the case. It is possible that the patient had been kept in restraints for up to 12 hours.
In the absence of entries in the patient records it was, for example, impossible for the Ombudsman to assess if the patient had been kept in restraints for longer than justified by the emergency. The Parliamentary Ombudsman considered this a serious neglect.
Further information is available from Principal Legal Adviser Kaija Tanttinen-Laakkonen, tel. +358 (0)9 432 3377