St. Paul’s Hospital (Vancouver) attempts to play down stabbings committed by their of their discharged patients

VANCOUVER — St. Paul’s Hospital in Vancouver is defending its record for treating psychiatric cases, even though three recently discharged patients have been arrested for violent crimes in the last year.

The downtown hospital released recommendations Thursday from an internal review that was launched after 35-year-old Nicholas Osuteye of Alberta was charged with three counts of attempted murder for his alleged attacks on women aged 63, 79 and 87 last December. He had seen emergency room doctors at St. Paul’s two days earlier after asking police for help.

The latest review follows a more sweeping, independent report prompted by attempted-murder charges against Mohamed Amer, who allegedly stabbed a 71-year-old man in a café on Feb. 21, 2012. The homeless man, 30 at the time, had been taken to St. Paul’s by police for assessment under the Mental Health Act twice that day, but was released both times.

Then in January of this year, a stabbing spree in a West End apartment building resulted in French national Jerome Bonneric, 33, being charged with 12 counts of assault. Bonneric’s lawyer has said his client suffers from mental health problems and had been to St. Paul’s shortly before the attack.

But Dr. Maria Corral, head of psychiatry at St. Paul’s, said the hospital has far more success stories than tragic ones.

“There are many ways to treat psychiatric illness and mental illness problems,” she said in an interview. “By far the most common and effective is to treat them in the community by outpatient means. We had 4,500 psychiatric patients (through the emergency department last year) … the majority of those patients are managing very well in the community as our neighbours, our friends, our brothers, our mothers.”

She emphasized that hospital staff will hold anyone — even against their will — if they are considered a threat to themselves or others. St. Paul’s has 60 beds in its psychiatric ward and a four-bed secure observation unit in the emergency department.

The hospital serves Vancouver’s Downtown Eastside and a larger than average number of people who have mental health problems, drug addiction, low incomes and inadequate housing.

“I want to assure the public that I’m very confident in our treatment team and in the processes we have in place to deliver safe psychiatric care to all the patients who visit St. Paul’s,” Corral insisted.

But Darrell Burnham, executive director of Coast Mental Health, says that St. Paul’s has been trying to cope with a flood of psychiatric patients for years and there aren’t enough places for discharged patients to go.

“I think it’s safe to say their emergency ward is overwhelmed with the number of mental health crises it sees on a daily basis and this has been going on for many years, at least 12. They’re in the unenviable position of deciding who is the most in need today … Every once in a while, despite their best efforts, they’re going to make that call wrong.”

Coast Mental Health is a not-for-profit charity that runs group homes and supported living apartments for about 800 people in Vancouver. While more spaces are being created for mentally ill people to get help from health and support workers outside of hospitals, there still aren’t enough, said Burnham.

“It’s because Vancouver is the end of the road and it’s also because people’s living situations are less supported. There are a lot of folks coming out of SROs (single-room occupancy hotels) and shelters and literally off the street … If you’re discharging someone to a loving family to care for them that’s far better from a hospital point of view rather than discharging them to a shelter or literally to nowhere.”

All of the accused are in custody awaiting trial and no one was killed in any of the incidents.

At least one of the women beaten in December is still in hospital, as is one of the victims from the Jan. 31 stabbings, according to Vancouver police department spokesman, Const. Brian Montague.

Source: Erin Ellis, “St. Paul’s Hospital defends record after three discharged psychiatric patients arrested for violence,” Vancouver Sun, March 1, 2013.

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Mental health clinic director sentenced to 100 months prison for fraud

WASHINGTON – A former clinical director for Biscayne Milieu, a Miami-based mental-health clinic, was sentenced today to 100 months in prison for his participation in a Medicare fraud scheme involving the submission of more than $50 million in fraudulent billings to Medicare, announced Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; Michael B. Steinbach, Acting Special Agent in Charge of the FBI’s Miami Field Office; and Special Agent in Charge Christopher B. Dennis of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Office of Investigations Miami Office.

Rafael Alalu, 47, of Miami, was sentenced today by U.S. District Judge Robert N. Scola Jr. in the Southern District of Florida.  Alalu was convicted on Aug. 24, 2012, of one count of conspiracy to commit health care fraud and two substantive counts of health care fraud, following a two-month jury trial.  The evidence at trial showed that Alalu participated in treating ineligible patients, concealing that fact by falsifying patient files and writing fraudulent group therapy notes, and instructing others to do the same.  In addition to the prison term, Alalu was ordered to pay more than $5.6 million in restitution, jointly and severally with his co-defendants.

Various owners, doctors, managers, therapists, patient brokers and other employees of Biscayne Milieu have also been charged with various health care fraud, kickback, money laundering and other offenses in two indictments unsealed in September 2011 and May 2012.  Biscayne Milieu, its owners, and more than 25 of the individual defendants charged in these cases have pleaded guilty or have been convicted at trial.  Antonio and Jorge Macli and Sandra Huarte – the owners and operators of Biscayne Milieu – and Dr. Gary Kushner – its medical director – were each convicted at trial of various offenses and are scheduled for sentencing in March 2013.

According to the evidence at trial, the defendants and their co-conspirators caused the submission of over $50 million dollars in false and fraudulent claims to Medicare through Biscayne Milieu, which purportedly operated a partial hospitalization program (PHP) – a form of intensive treatment for severe mental illness.  Instead, the defendants devised a scheme in which they paid patient recruiters to refer ineligible Medicare beneficiaries to Biscayne Milieu for services that were never provided.  Many of the patients admitted to Biscayne Milieu were not eligible for PHP because they were chronic substance abusers, suffered from severe dementia and would not benefit from group therapy, or had no mental health diagnosis but were seeking exemptions for their U.S. citizenship applications.  The evidence at trial showed that once these ineligible patients were admitted to Biscayne Milieu, Alalu and others concealed the fraud by falsifying patients’ group therapy notes to reflect legitimate PHP treatment that was never provided, and directed others to do so.

The case is being prosecuted by Assistant U.S. Attorneys Michael Davis and Marlene Rodriguez of the U.S. Attorney’s Office for the Southern District of Florida, and by Trial Attorney James V. Hayes of the Fraud Section of the Justice Department’s Criminal Division.  The case was investigated by the FBI with the assistance of HHS-OIG, and was brought by the U.S. Attorney’s Office for the Southern District of Florida in coordination with the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

Source: “Clinical Director for Miami-based Health Care Clinic Sentenced to Prison for Role in $50 Million Medicare Fraud Scheme,” Department of Justice Office of Public Affairs press release, December 20, 2012.

Psych nurse admits sexual assault; patient wants judgment against mental hospital

A McArthur woman who is suing a former nurse/supervisor at a local mental hospital has asked a judge to grant her partial summary judgment in the case.

The woman, who has asked for damages of more than $2 million, claimed in her suit, filed last December, that Ryan E. Blaine, a former employee of the Appalachian Behavioral Health Center, had inappropriate sexual contact with her in January and February 2011 when she was a patient there.

After the Ohio State Highway Patrol investigated the woman’s allegations, Blaine pleaded guilty to attempted patient abuse, a fifth-degree felony. He was ordered to relinquish his nursing certificate, and placed on three years’ probation.

In addition to Blaine, the lawsuit named five “John Doe” defendants who were working for the Ohio Department of Mental Health, alleging that when the plaintiff complained about Blaine’s actions, the other employees “drugged (her) and subjected her to isolation, telling her that she fabricated the… events of which she complained.”

In asking Athens County Common Pleas Judge Michael Ward to grant partial summary judgment, the woman’s attorneys, Richard V. Zurz and Martin S. Delahunty, cite a number of facts they say are not in dispute, because Blaine has failed to respond to a set of questions filed by the plaintiff, asking for admissions of fact.

These include the fact that Blaine has admitted he was a supervisor at ABH when the woman was there; that he had access to her medical chart; that she was a patient under his care; that he engaged in improper sexual conduct with her; and that he pled guilty to a felony charge stemming from this conduct.

“The foregoing admitted facts constitute violations of Ohio law and constitute an assault and abuse of a patient under Ohio law,” the motion alleges.

The plaintiff has alleged among other claims that Blaine committed assault and patient abuse, and that he violated her constitutional right to be “secure in her person.” Each claim, her attorneys maintain, is supported by the undisputed facts they have cited.

“The defendant’s admissions in conjunction with the laws of the state of Ohio clearly provide that the plaintiff has proven the elements necessary to allow summary judgment” on the first six claims in her lawsuit, the motion argues.

Therefore, Zurz and Delahunty have asked Ward to rule in their client’s favor, and to schedule a hearing on how much she deserves in damages.

When The Athens NEWS sought comment in December 2011 on the lawsuit, a spokesperson for the ODMH said she could not comment on pending litigation involving one of the agency’s facilities. The lawsuit does not name ODMH itself as a defendant.

Source: “Woman wants judgment in mental hospital lawsuit,” The Athens News, July 18, 2012.

Mother to sue psych hospital over sexual assault: “They failed to protect my daughter.”

A teenage girl interned in a psychiatric ward was sexually abused by an 11-year-old patient and kept in the same unit with him for weeks after the attack, authorities said.

Patricia Watson, the 15-year-old girl’s mother, told how her daughter had been placed in Manhattan’s Metropolitan Hospital’s child psychiatric ward in February.

Then on a visit to the hospital on March 9, Mrs Watson was told by her daughter how she had been attacked by the boy, who sat on her as she slept, before pulling her pants and underwear down and sodomising her.

Speaking to the New York Daily News, Mrs Watson said: ‘When my daughter told me what happened, I felt like a knife had pierced me in my heart.

‘The hospital failed to protect her. They failed to protect my daughter.’

When Mrs Watson approached authorities,she was told  they were aware of the attack, but it took another two weeks before the boy was removed from the ward.

Mrs Watson added: ‘She has panic attacks when she’s in her room, when she’s in the shower.

‘I feel heartbroken my daughter is still there. She should have been moved within hours.’

Mrs Watson now plans to sue the city for $20 million.

Speaking to the paper, Mrs Watson described how she coaxed the story of the attack out of her daughter.

After she noticed her daughters ‘vacant’ stare she asked: ‘Baby, what’s wrong.’

The girl then described the attack, telling her mother the boy crept into her room the night before while she was sleeping.

He straddled her back, holding her down, while he started to feel her breasts.

As he began to pull down her trousers and underwear she struggled to throw him off, but couldn’t.

She said: ‘I tried to push him off, but I couldn’t.

‘I told him to stop a lot of times, but he didn’t. He told me to shut up,’ she told prosecutors.’

Tragedy: The boy was kept on the same ward as his victim for two weeks, reports said.

Mrs Watson says her daughter is still reeling from the affects of the attack.

She said: ‘Her smile used to brighten up a room.

‘Now, I have to ask her to smile for me, and when she smiles, I can still see the pain, the hurt, the anger, the sadness.’

Mrs Watson said she did not remove her daughter from the facility because it would delay her placement in a state hospital for long term treatment.

The boy pleaded guilty to sexual misconduct on March 29 and is awaiting sentencing.

A Metropolitan Hospital spokesman said: ‘We take all such allegations seriously and the matter is under police investigation.

Source: “Girl, 15, sodomised by 11-year-old boy in psychiatric hospital and kept in same ward as attacker for TWO weeks,” Daily Mail (UK), April 25, 2011.