Man: NY Hospital Forced Rectal Exam

(01-16) 08:26 PST New York (AP) --

A construction worker claimed in a lawsuit that when he went to a hospital after being hit on the forehead by a falling wooden beam, emergency room staffers forcibly gave him a rectal examination.

Brian Persaud, 38, says in court papers that after he denied a request by NewYork-Presbyterian Hospital emergency room employees to examine his rectum, he was "assaulted, battered and falsely imprisoned."

His lawyer, Gerrard M. Marrone, said he and Persaud later learned the exam was one way of determining whether he had suffered spinal damage in the accident.

Marrone said his client got eight stitches for a cut over his eyebrow.


http://www.sfgate.com/cgi-bin/article/article?f=/n/a/2008/01/16/national/a075247S94.DTL


Oh the humanity. :eyes:

:rofl:

Damn near killed him!

(old joke)

poopoo head, butt, uranus, teeheehee

naw, gradeschool bathroom humor is more important.

Somebody give him his Vicodin!

Even if there was a legitimate need to give him the exam, the hospital appears to have gone about it the wrong way.

Would there be as many jokes here if it had been a woman forced to undergo a vaginal exam?

And no, I won't lighten up.

After reading the other replies here, I decided it wasn't worth it.

have an anal reflex, you probably have a spinal injury in the sacral region. (S1-S5) for those who took anatomy.

It's common procedure in the ER, as physicians are also looking for blood.

Nobody ever said the ER is pleasant. You're sprawled out naked with no fewer than half a dozen people poking at you.

It may have been explained poorly, although I suspect the patient was being overly uptight.

Ba-dum-bum!

what he said, and besides how else could they find out if getting hit in the head knocked the shit out of him?

A forcible rectal exam for a head injury? Interns Gone Wild. Some cops shouldn't have guns and, apparently, some doctors shouldn't have finger cots and lube.

I was a passenger in a car accident in college and the EMTs kept trying to look at a cut on my forehead. I told them over and over that I was not purchasing any service from them and to leave me alone. It finally took the state trooper that arrived to convince them to stop, one of them was literally screaming at me about it.

Once an ambulance drives up or you set foot in an ER all you are is an ATM to them.

I have a hard time with that statement. Never have I ever felt that dealing with EMT's or ambulance service that they were forcing me into anything. Just last week BB Maine-ah whacked her head on the corner of the fridge, very bad too. Grew to the size of a golf ball in a matter of seconds and turned a terrible blue color (yes this is my first child) I called 911, it was that bad. They checked her out in the ambulance, did not force us to ride with them to the hospital, in fact, we refused transport after they were pretty sure she was fine and I called the pedi. Wonderful people, all volunteer in my area. I have also had trips with the non volunteer service in town, never had any problems. Same goes with the emergency rooms too. All have been wonderful people. Sometimes it takes a little longer than I would like, but that comes with the territory.

Head injuries are serious, and I'm sure that the EMT's were just looking out for your well being regardless of what you were thinking at the time.

enter someone's body without their consent. There has to be other ways to determine if he had spinal damage.

If in ER, you can still say no. They may check you out ama (against medical advice) which means insurance won't pay, but if you are alert and oriented, you have the right to refuse treatment and walk out. They need to explain better, or listen to "no".

But there is something else going on in this story that I am sure that we are not hearing since this is completely one-sided.
He had a head injury and was combative. He was sedated and then intubated. They do NOT sedate and intubate you unless there are some indicators (which can be born out by lab work and other tests)for it.
"It is not always clear what is the patient’s capacity to make decisions, especially if the doctor suspects a head injury.”
IF he ended up with a SCI and paralyzed, undoubtedly his lawyer would be suing because they did NOT do a rectal exam and initiate SoluMedrol spinal cord protocol in time (must be initiated within a certain time frame)claiming that he had an obvious head injury and was clinically unable to make decisions regarding his care.
As one who is deeply concerned about women's rights and read upthread that if a woman was given a pelvic exam against her will, it would be a different story. However, how many women that are raped show up at an ER expecting to NOT have a pelvic exam? Conversely, a head injury with combativeness deems it necessary for a rectal exam.

The comments on the article are summed up very well here:


When patients arrive to the Emergency Department with a possible head injury, it is imperative that a full exam be performed. This includes a rectal exam. Advanced Trauma Life Support (ATLS) takes place in this situation much as Advanced Cardiac Life Support (ACLS) does in a cardiac arrest. Per these protocols and standards of care, a rectal exam should be performed. One can’t rely on the refusal of a patient because head injuries can cause confusion, impaired judgement, and at times combative behavior. In fact, his combativeness likely heightened the worry for a head injury to the point that his physicians protected him by chemically sedating him. The story doesn’t state this, but he likely had CT Scans of his head after being intubated to check for intracranial bleeding or injury.
These physicians acted appropriately, in following the ATLS guidelines. If you should be unfortunate enough to be involved in a serious accident, expect to have a full head-to-toe exam, your clothes cut off (even if it’s your best suit), and yes a rectal exam.
Jairo Santanilla, MD
Diplomat American Board of Emergency Medicine

— Posted by Jairo Santanilla

http://www.myfoxny.com/myfox/pages/News/Detail?contentId=5501885&version=1&locale=EN-US&layoutCode=TSTY&pageId=3.2.1
Medical records state Persaud was "alert and oriented times three" when a resident informed Persaud that he needed a rectal examination.


"However, how many women that are raped show up at an ER expecting to NOT have a pelvic exam? Conversely, a head injury with combativeness deems it necessary for a rectal exam." If I had a head injury, WHEN I had a head injury, I didn't expect or get a rectal exam. And yes, I am a health care provider.

The head injury doesn't buy you a rectal exam...but if a spinal cord injury is suspected, it does. The head injury is critical in deciding whether or not the patient (without any family members present) is capable of giving informed consent. Since the patient was also combative (which is common in severe head injuries), it was a hard call to make.
Obviously the hospital cannot release what they have in their records because of HIPAA...but the account is very one-sided and it shows.

Will wait now and see what other info comes out. Here is a question. Was pt combative before staff didn't take denial seriously? Was pt combative before was denied ability to refuse exam?

Having been in position of pt and provider and nurse called to calm down ER pt who was refusing exam, I'd like to know more.

I try very hard to stay out of the trauma part of things these days...but occasionally the hospital has other plans--you know how that goes.
In my experience when a trauma patient comes in, they are generally given the rectal exam as they logroll them looking for other obvious injuries...one of the first things that is done, even before the x-rays. So it is hard to say.:shrug:

:)

his lawyers would be suing for their NOT doing the exam. This man has probably sued before?

And you called me crazy when I said that this day would come.

If a patient refuses an exam, a test, any kind of care, the doctor documents it in the chart (to CYA), and moves on to a different test. End of story. Patients have the right of refusal, even if it causes death. It's a cornerstone of medicine.

I hope that resident gets busted down a couple of notches. S/He obviously missed the medical ethics classes in med school.

kinda suspect to me.

You're going to force a head trauma patient with a possible SPI?

I suspect the DRE was performed on the roll, and the patient objected that he felt someone's finger near his rectum.

Is it possible it was forced? Of course.

But I think we're missing some important information from the ER.

That part I agree with--if you're going to attack your caregivers, they have the right to restrain and sedate if needed. They don't know how dangerous you're going to get, and they have to keep themselves and other patients safe.

If he was coerced, it's a lawsuit. If it turns out he nodded or seemed to give consent, he won't get anything.

This guy is suing because he was EMBARASSED to have a doctor stick a finger up his pooper? :shrug:

If that's the worst thing ever to happen to this guy, he should count himself very lucky. Especially considering that he had a potentially serious head injury and got off with 8 stitches.

Everyone has a right not to be treated. The big long permission forms in medical settings is formal permission for treatment. Anything else is unwanted touching.

He is not embarrassed. When he refused the exam they tackled the guy, sedated him and forced the exam. This is an insult to his body integrity and should not have happened.

Suing because of embarrassment or humiliation is not trivial. Imagine a black guy going to work every day and having his boss refer to him as his "House N*****". The guy keeps his job and even gets promoted. But his boss keeps calling him this name in front of everybody. It would be embarrassing and humiliating. I don't think anyone would have a problem with the black guy suing.

Ethically the staff needed to listen and stop when he said no. He had the right to say no. Ethically, they needed to listen to him. The legal way to do it is check him out ama (against medical advice), not force him.

Here's another article on informed consent and being able to deny something.
http://cityroom.blogs.nytimes.com/2008/01/16/forced-rectal-exam-stirs-ethics-questions/