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Friday, November 1, 2013

Lynne Spalding: Death BY Hospital Negligence

     On September 19, 2013, Lynne Spalding, suffering from a bladder infection, checked herself into the San Francisco General Hospital. The 57-year-old native of Peterlee, England worked in San Francisco's tourist industry. The thin, frail divorced mother of two seemed confused and disoriented, perhaps from the effects of  her medication. Members of the hospital staff assigned to her care were under orders to look in on Spalding every fifteen minutes.

     When one of Spalding's friends showed up at the hospital on September 21 for a visit, Spalding was not in her room. Hospital employees searched the immediate area and couldn't find her. Maybe she had checked herself out. The friend went to Spalding's apartment and found it vacant. When Spalding didn't return to her dwelling, the friend filed a missing persons report with the police.

     Over the next few days, the missing woman's friends and members of her family looked for her at various places in the city. They posted missing persons flyers around as well. One of her friends created a "Find Lynne" Facebook page. Deputies with the sheriff's office, the agency in charge of hospital security, conducted a search of the giant medical complex. It seemed this woman had vanished into thin air.

     At ten in the morning of October 8, 2013, seventeen days after Lynne Spalding went missing from her hospital room, a hospital employee discovered the body of a middle-aged woman lying dead in a stairwell used as a fire escape. Todd May, the chief hospital medical officer tentatively identified the dead woman as Lynne Spalding. (I presume she was wearing a hospital identification bracelet.)

     The job of determining when, where, and exactly how this woman had died rested in the hands of the San Francisco Medical Examiner's Office. The principal determination involved Spalding's manner of death. While it was not unreasonable to presume that this hospital patient's death occurred naturally, the forensic pathologist looked for signs of physical trauma that suggested a struggle. The pathologist who performed the autopsy also looked for physical evidence of a sexual assault.

     Assuming the absence of foul play in this unusual death, the Spalding case presented the obvious question as to how this sick woman had gotten from her room to the stairwell without being observed by hospital staff. Unless the stairwell where Spalding's body was found was located in an extremely remote section of the hospital, someone should have detected the odor of decomposition.

     San Francisco General Hospital spokesperson Todd May, at a press conference held on October 8, 2013, said, "What happened at our hospital is horrible. We are here to take care of patients, to heal them, to keep them safe. This has shaken us to our core. Our staff is devastated."

     David Perry, Lynne Spalding's friend and the family spokesperson told reporters that "We need to know what Lynne's condition was. We need to know what she was being treated for and frankly we need to know what medications she was on and what state of mind she was in. We're not trying to place blame. We're trying to find answers."

     On Thursday, October 10, San Francisco General Hospital Chief Operating Officer Roland Pickens announced that pursuant to the medical examiner's office report, the corpse in the stairwell was Lynne Spalding's body. A second hospital spokesperson revealed that the stairwell in question was located several hundred feet from the unit where Spalding was being treated. According to this spokesperson, Spalding was being treated in a unit where patients are not watched closely. This contradicted previous information regarding the fifteen minute patient check-ups.

     In a private ceremony held on October 21, Spalding's body was cremated. (This meant, of course, that there would be no second autopsy if one became necessary.)

     On October 22, 2013, the San Francisco Chronicle reported that four days before sheriff's deputies responded to the dead woman found in the city-owned hospital's stairwell, an orderly had twice stepped over her body thinking she was a homeless person. To reporters, Haig Harris, the attorney representing Spalding's children, said, "This is a hospital. Why didn't somebody put their hand on the body to see if there was a pulse?"

     David Perry, a Spalding family spokesperson said this to reporters: "The family is angry and frustrated and out of patience. While we understand the need for a thorough investigation, it has now been one month and three days since Lynne Spalding went missing....The time for answers and real solutions that will protect lives of future patients is long past due."

     A woman who had been visiting her son at the hospital in June 2013 said she had been locked in the same stairwell. She had taken the stairs instead of the elevator, entering the fifth-floor stairwell without realizing it was an emergency exit. The woman walked down to the ground level, but the door sounded an alarm when she opened it. She slammed the door shut and went back upstairs where she pounded on the door window to attract attention. A nurse who happened by let her back inside. No one had responded to the exit alarm.

     Investigators and hospital authorities did not reveal if Spalding had changed into her street clothes before leaving her room. (The fact the orderly presumed she was a homeless person suggests that she had.) While the coroner still had not revealed Spalding's cause of death, the family was assured she had not been the victim of foul play.

     Dan Cunningham with the San Francisco Police homicide unit announced on October 28, 2013 that four days before Spalding's body was discovered, an Asian man in his thirties wearing a hospital name tag told a hospital supervisor that he had seen a person lying in the stairwell. The supervisor checked out the stairwell but didn't see anyone there. Homicide investigators were trying to identify this man for questioning. (It's not clear if the Asian man was the orderly who stepped over the body on October 4, 2013.)

     On December 15, 2013, the medical examiner's office released the results of Spalding's autopsy. According to the San Francisco medical examiner, Spalding had died of "probable electrolyte imbalance with delirium clinical sepsis." In other words, she had died from a chemical imbalance related to chronic alcoholism. According to Dr. Thomas Shaughnessey, the electrolyte imbalances, in combination with a liver that is unable to compensate form the imbalance, resulted in a collapse of Spalding's heart or brain resulting in her death. The forensic pathologist who performed the autopsy was not able to say exactly when she died.

     Members of Spalding's family immediately disputed the allegation that she was an alcoholic. They were therefore outraged by the contents of the medical examiner's report.

     In February 2014, the Centers For Medicare and Medicaid Services, a federal agency that decides whether hospitals meet minimum standards to be eligible for Medicare payments, announced the results of its extensive investigation into the Spalding tragedy. According to the report, hospital nurses failed to act on a doctor's order that this patient be watched around the clock. Federal investigators also blamed the sheriff's department for not having an emergency plan worked out with hospital staff. Investigators concluded that the hospital's "chaotic and poorly coordinated response had contributed to patient Spalding's death."

     The sheriff, in the wake of the hospital scandal, fired one member of the agency's hospital staff and suspended two others. Five more deputies were disciplined administratively. No hospital employees were punished for the Spalding fiasco.

     The Spalding family has filed a wrongful death suit against San Francisco General Hospital.

     

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