Mayo clinic turning to kidnapping to make cash?

[Daehawk]

18 year old girl had a brain aneurysm. They saved her life but once she was well they wouldn't let her leave. Family got a lawyer to request transfer yet they refused. Finally family had to just drive off with her. Mayo called cops. Seems behind the scenes they had been working to get guardianship of her for 2 weeks without the family even knowing. Mayo says the girl is not mentally able to make her own decisions. When police asked who had been making her medical decisions for the last few months Mayo said the girl had

Make me afraid of the damn places. Sounds like kidnapping for money to me. Girl probably had good insurance.

https://www.cnn.com/2018/08/13/health/m ... index.html

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

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'

[dbt1949]

Just read that article a while back. Looks to me like a doctor or two with an ego problem and the backing of the Mayo Clinic.

[stessier]

Read the article today as well. I really wish we had Mayo's full side. It seems hard to imagine Mayo has anything that would make sense though. Glad to see the cops were reasonable.

[Daehawk]

Yes the police actually being reasonable was a big 'wow!' to me. Glad to see it.

[hepcat]

Read the article today as well. I really wish we had Mayo's full side.

That was my takeaway. There may very well have been a good reason for what they were doing. They certainly don't need the money.

[Blackhawk]

I've heard of doctors not listening to patients, I've heard of patients being kept when they didn't need to be. I've also heard of families who get way out of line and try to force doctors to treat people their way instead of doing what's needed, to which the doctors respond much the way that story describes.

I'll withhold judgment unless I can hear both sides.

[Lorini]

Me too.

[Paingod]

The only thing I can think of is that this is a clash of ignorance vs. bureaucracy on a personal level. I'm interested to see how it plays out.

There's a lot of "Stealing People" that happens on different levels in American society - mostly to seniors, though - utilizing the Guardianship Rules and collecting state benefits (or stealing life savings) once someone is declared incompetent to represent their own interests. It can be insanely hard and expensive to get yourself back once someone arbitrarily decides your fate in a courtroom without you present or even aware that they were doing it.

[El Guapo]

Mayo's rationale is almost certainly that the girl's life remains in danger and that she needs to remain on medical observation in case she has another aneurysm or other predictable issue. It's *possible* that the girl is 100% well, and that Mayo was knowingly keeping her for the money, but that seems incredibly unlikely - that's not what was going on. It's more plausible that the Mayo was being extra conservative in their medical judgment, and were not being sufficiently responsive to the girl's wishes. I think the general practice when you have a patient who you think is in danger if they don't follow your advice, where the patient doesn't want to follow the advice, is to have the patient sign a form acknowledging that they are going against medical advice.

Also seems possible that the stepfather is throwing himself around here where he shouldn't be.

[Jaymann]

Couldn't the girl decide to walk out?

[Paingod]

Couldn't the girl decide to walk out?

That's the heart of the issue. The hospital says "No" because she's possibly mentally impaired from the aneurysm. As an adult, if she's incompetent to make her own health decisions, I imagine the hospital would be liable if they let her. Why the hell they didn't push the parents to get Guardianship so they could make the call for her instead of trying to file for it themselves is beyond me.

[Daehawk]

Story states they claimed she was mentally unfit to decide to leave. yet for the last couple months she had made her own medical decisions according to the same hospital. The family even hired a lawyer and had them tell the hospital to let her go and they ignored the lawyer.

[coopasonic]

The family even hired a lawyer and had them tell the hospital to let her go and they ignored the lawyer.

Lawyers generally don't get to dictate such things. They can make threats or file suit, but hospitals don't listen to lawyers that are not their own.

[Punisher]

Couldn't the girl decide to walk out?

That's the heart of the issue. The hospital says "No" because she's possibly mentally impaired from the aneurysm. As an adult, if she's incompetent to make her own health decisions, I imagine the hospital would be liable if they let her. Why the hell they didn't push the parents to get Guardianship so they could make the call for her instead of trying to file for it themselves is beyond me.

According to the story, they also claimed that the mother was mentally ill...Even though there was no formal diagnosis.
Also, as Daehawk mentioned, teh hospital let the girl make all of her decisions for months, except the decision to leave. Either she is capable of making her own decisions, in which case, let her leave, or she is not capable in which case they should be held liable for letting her make all of her previous decisions.
It's the various little details that keep popping up that makes me side with parents and think this was a money grab or a pure ego thing. Yes, the Mayo clinic has a lot of money, that doesnt mean they dont want more.

[Daehawk]

Perhaps but if it was me as her or the family Id look at it as kidnapping and medical fraud.

[Jaymann]

Hold the Mayo!

[Blackhawk]

According to the story, they also claimed that the mother was mentally ill...Even though there was no formal diagnosis.
Also, as Daehawk mentioned, teh hospital let the girl make all of her decisions for months, except the decision to leave. Either she is capable of making her own decisions, in which case, let her leave, or she is not capable in which case they should be held liable for letting her make all of her previous decisions.

That's just the thing - all we have is part of the story. Was she really making all of her medical decisions, or were they just getting her opinion on those things that weren't life-and-death?

I'm still withholding judgment, but the only thing that really made my Hawk Sense tingle was the possibility that the mother was one of those 'know it all' parents who tries to control the doctors. It's supported by the fact that they apparently requested replacements for staff member after staff member because they wouldn't do things the way the mother wanted things done.

[Punisher]

According to the story, they also claimed that the mother was mentally ill...Even though there was no formal diagnosis.
Also, as Daehawk mentioned, teh hospital let the girl make all of her decisions for months, except the decision to leave. Either she is capable of making her own decisions, in which case, let her leave, or she is not capable in which case they should be held liable for letting her make all of her previous decisions.

That's just the thing - all we have is part of the story. Was she really making all of her medical decisions, or were they just getting her opinion on those things that weren't life-and-death?

I'm still withholding judgment, but the only thing that really made my Hawk Sense tingle was the possibility that the mother was one of those 'know it all' parents who tries to control the doctors. It's supported by the fact that they apparently requested replacements for staff member after staff member because they wouldn't do things the way the mother wanted things done.

I could have sworn I saw another article that did quote some of the staff, the social workers, and the police involved that backed up the above claims. I cant find it now. I'll post it if I do.

[stessier]

"Hospitals aren't prisons. They can't hold you there against your will," said George Annas, an attorney and director of the Center for Health Law, Ethics & Human Rights at the Boston University School of Public Health.

But Alyssa's doctors say she wasn't a typical patient.

"Due to the severity of her brain injury, she does not have the capacity to make medical decisions," her doctors wrote in her records after she'd left the hospital.

In that report, the doctors specified that assessments in the last week of her hospital stay showed that she lacked "the capacity to decide to sign releases of information, make pain medication dose changes, and make disposition decisions. This includes signing paperwork agreeing to leave the hospital against medical advice."

That hadn't jibed with the captain of investigations for the Rochester police. Sherwin said it didn't make sense that Mayo staffers told police Alyssa had been making her own decisions, yet in the discharge note, they stated she wasn't capable of making her own decisions.
It didn't jibe with the experts, either.

"They can't eat their cake and have it, too," said Feudtner, the medical ethicist at the University of Pennsylvania.

And what got the police to back off -

They explained to Sanford doctors that she'd had an aneurysm and left Mayo against medical advice, according to medical records from that emergency room visit.

The Sanford doctors disagreed with the Mayo doctors on two crucial points.

Although Mayo doctors had insisted that Alyssa needed to be in the hospital, the Sanford doctors came to the opposite conclusion: They prescribed Alyssa medications, gave instructions for her to follow up with a doctor and told her she could go home.

Mayo had determined that Alyssa lacked the mental capacity to make her own decisions. The Sanford doctors again came to the opposite conclusion: They allowed her to make her own decisions and sign her own forms consenting to treatment.

When police learned that a hospital had cleared Alyssa to go home, they stepped aside.

"If a doctor at another facility says she's fine and comes up with a second opinion, that kind of takes the law out of it," said Chris Vasvick, a Martin County sheriff's deputy. "That's one doctor's opinion against another, and that doesn't have anything to do with law enforcement at all."

Sherwin, the Rochester detective, agreed.

"We didn't have any reason for the police to intervene," Sherwin said.

He added that Alyssa and her parents had done nothing illegal. No charges were filed against them.

[LawBeefaroni]

From what I read, the patient/family requested a transfer that would result in discharge at the other hospital. This discharge was AMA at Mayo. So Mayo wouldn't let her transfer. It may have looked like "doctor shopping" to them or something.

Not enough info and probably won't be if mental state is at issue. Mayo won't ever comment on what made them think she wasn't mentally competent.

[stessier]

From what I read, the patient/family requested a transfer that would result in discharge at the other hospital. This discharge was AMA at Mayo. So Mayo wouldn't let her transfer. It may have looked like "doctor shopping" to them or something.

What is AMA?

And why is doctor shopping bad? It should be the patient's choice, no?

Edit: Oh - Against Medical Advice? Still seems like it was up to the patient. Seems like we should all have Medical Powers of Attorney in a drawer somewhere to prevent this.

[Daehawk]

Not once in my life have I ever thought that going to the hospital would result in me not being able to leave if I wanted to. I mean if Im thinking straight. Now after reading this it is on my mind I must admit. I still need to go for kidney surgery but this will be in the back of my mind. My wife is a genius from IQ tests but now I worry the hospital could try to circumvent her in some way if they really wanted too. With medical records sealed and such it would be hell to find out otherwise.

[El Guapo]

Not once in my life have I ever thought that going to the hospital would result in me not being able to leave if I wanted to. I mean if Im thinking straight. Now after reading this it is on my mind I must admit. I still need to go for kidney surgery but this will be in the back of my mind. My wife is a genius from IQ tests but now I worry the hospital could try to circumvent her in some way if they really wanted too. With medical records sealed and such it would be hell to find out otherwise.

That's the key part, right? The hospital's only grounds for not letting you go if that's what you want are based on mental capability - they don't think that you are thinking straight.

[gilraen]

You keep talking about it like Mayo did it to get more money...you do realize that there's a waitlist to even get an appointment at the Mayo Clinic? If they didn't think this girl needed to stay as an inpatient, I can guarantee you they could fill that bed the same day, with a patient just as seriously ill and with potentially better insurance.

[El Guapo]

You keep talking about it like Mayo did it to get more money...you do realize that there's a waitlist to even get an appointment at the Mayo Clinic? If they didn't think this girl needed to stay as an inpatient, I can guarantee you they could fill that bed the same day, with a patient just as seriously ill and with potentially better insurance.

Yeah it's ridiculous to think that the Mayo made the decision to make money. It's entirely possible that the doctors were being unreasonable or were wrong or what have you, but it's not about the money.

[Zarathud]

Get yourself a power of attorney for health care (or the local equivalent) to empower someone to act as your agent if disabled.

[Fretmute]

You keep talking about it like Mayo did it to get more money...you do realize that there's a waitlist to even get an appointment at the Mayo Clinic? If they didn't think this girl needed to stay as an inpatient, I can guarantee you they could fill that bed the same day, with a patient just as seriously ill and with potentially better insurance.

Yeah it's ridiculous to think that the Mayo made the decision to make money. It's entirely possible that the doctors were being unreasonable or were wrong or what have you, but it's not about the money.

It certainly is from the perspective that no business that's taking my money should have to power to decide that I'm not capable of telling them to stop taking my money.

[Isgrimnur]

NYTimes, 2009

At the Mayo Clinic, Cleveland Clinic, Kaiser Permanente and other integrated systems, doctors are salaried to improve quality. They’re unfettered from having to deal with the dizzyingly complicated current payment systems. And they can do it precisely because they have an integrated system.

[LordMortis]

I'm still withholding judgment, but the only thing that really made my Hawk Sense tingle was the possibility that the mother was one of those 'know it all' parents who tries to control the doctors. It's supported by the fact that they apparently requested replacements for staff member after staff member because they wouldn't do things the way the mother wanted things done.

I have no judgement to make but the only thing that made my mort senses dull was that the hospital said they would need a release to discuss the case, and then, having been provided a release, said they weren't going to discuss the case to protect the patient.

Can't judge it (especially not from CNN) but this feels snakelike.

A spokeswoman for the Mayo Clinic said hospital officials would be willing to answer CNN's questions if Alyssa signed a privacy release form giving them permission to discuss her case publicly with CNN. The spokeswoman, Ginger Plumbo, supplied that form to CNN.
Alyssa signed the form, but Plumbo declined to answer CNN's questions on the record. Instead, she provided a statement, which said in part, "We will not address these questionable allegations or publicly share the facts of this complex situation, because we do not believe it's in the best interest of the patient and the family. ... 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 honored that value for this patient and that also took into account the safety and well-being of the team caring for the patient."

Aside from that I just don't trust CNN to give me a story without sensationalism obscuring history.

[El Guapo]

You keep talking about it like Mayo did it to get more money...you do realize that there's a waitlist to even get an appointment at the Mayo Clinic? If they didn't think this girl needed to stay as an inpatient, I can guarantee you they could fill that bed the same day, with a patient just as seriously ill and with potentially better insurance.

Yeah it's ridiculous to think that the Mayo made the decision to make money. It's entirely possible that the doctors were being unreasonable or were wrong or what have you, but it's not about the money.

It certainly is from the perspective that no business that's taking my money should have to power to decide that I'm not capable of telling them to stop taking my money.

Hospitals are a unique sort of business, though, insofar as they are necessarily making judgments about life and death in a situation where people are severely impaired due to injury.

But the real point is that the notion that the Mayo clinic is doing this for money is not very credible, because the Mayo clinic is not hard up for patients or cash, and (just from a self-interested perspective) it would be insane to try to keep a capable patient for the marginal value of their (insurance's) daily payments (and potentially risk losing medical licenses and jail time), rather than discharge them and fill the bed with another patient.

It's plausible that the doctors here were being arrogant or callous or made mistakes, though.

[Daehawk]

The step dad did say something about feeling it was the doctor in charge taking some kinda revenge on him for a dispute they had.

[Freyland]

So much of this, with the one-sided story we have, sounds really bad for the hospital.

What is giving me a hard stop is this: For this captivity scenario to work, the entire rehab system at that hospital would have to be complicit. If the Doc was acting out of revenge or ego or whatnot, I don't see how he could rally all the staff, all the social workers, and whatever admin capacity was associated with the unit to keep this patient a prisoner. I work at a rural hospital, but this hospital is part of a leading hospital network, so there are some pretty serious structures in place. Even with me being in charge of my unit, and having pretty decent clout as a physician, I absolutely would have no chance of making this happen. None.

The hospital may very well have been on the wrong in this case, but I strongly, strongly suspect that we are not being told something(s) very important.

[Paingod]

The hospital may very well have been on the wrong in this case, but I strongly, strongly suspect that we are not being told something(s) very important.

And so it shall stay until the legal department stops glaring at the PR department.

[LawBeefaroni]

From what I read, the patient/family requested a transfer that would result in discharge at the other hospital. This discharge was AMA at Mayo. So Mayo wouldn't let her transfer. It may have looked like "doctor shopping" to them or something.

What is AMA?

And why is doctor shopping bad? It should be the patient's choice, no?

Edit: Oh - Against Medical Advice? Still seems like it was up to the patient. Seems like we should all have Medical Powers of Attorney in a drawer somewhere to prevent this.

Doctor shopping isn't bad unless it's done solely to seek a coruse of treatment that is harmful to the patient. Even then it's hard to stop but that's the only reason I can think of that they would try to stop the transfer.

Leaving AMA can have liability for the hospital. But as long as they document that they did everything reasonable to stop it (kidnapping, of course, is not reasonable), the hospital should be ok.

I'm not siding with Mayo here. Just trying to guess at what was going on there

[Drazzil]

This is just such a wierd case.

[Unagi]

something tells me that the Mayo clinic isn't turning to kidnapping to make cash.