This Blog is a resource provided by the Disability Law Committee of the Florida Bar. We welcome your participation. Marc Dubin, Esq., Chair of the Committee, can be reached at and at 305-896-3000. He is available for consultations.

Sunday, March 4, 2007

Patients With Psychiatric Disabilities and Strip Searches

Lawsuit filed over forced strip search
(August/September 2006 Issue)

By Pamela Berard

A 50-year-old Massachusetts woman with psychiatric disabilities filed a federal lawsuit against Beth Israel Deaconess Medical Center in June, alleging she was forcibly undressed by five male security guards last year during a visit to the emergency department for migraine treatment.

Cassandra Sampson, who says she pleaded to keep her pants on because of a history of sexual abuse, charges she was physically bruised, emotionally devastated and became suicidal after the incident.

The lawsuit seeks more than $1 million in damages and a change in the hospital policy regarding disrobing of people with psychiatric disabilities, in particular, forcible stripping by security guards.

According to the lawsuit, Sampson went to Beth Israel's Emergency Department on March 22, 2005, for migraine treatment at the referral of her primary care physician. Sampson, who has a history of self-injury, was moved to the psychiatric portion of the department after admitting to a triage nurse that she had struggled with safety issues, although she was not suicidal, did not have any desire to injure herself and had never attempted to injure herself in an emergency department.

The lawsuit alleges the nurse asked her to completely disrobe prior to her psychiatric evaluation. Sampson said she asked to keep her pants on.

"(Sampson) offered to take off her shirt, her shoes and give them her purse," explains Susan Stefan, a lawyer for the Center for Public Representation, and one of the lawyers representing Sampson. "She did submit to a thorough pat down with security guards present, which found nothing." She also repeatedly asked for a patient advocate, and even though one was on the premises, she was denied that request, Stefan says.

Sampson alleges she was forcibly stripped by five male security guards as she cried out that she was being raped and sobbed.

Jerry Berger, director of media relations for Beth Israel Deaconess Medical Center, says the center has decided to refrain from any comment on this pending legal matter.

Stefan says the policy that mandatory disrobing is expected of patients on the psychiatric unit is discriminatory under the Americans with Disabilities Act, by treating people with psychiatric disabilities disadvantageously with exaggerated fears.

"In most cases, the only increase is the psychiatric crisis. It increases the chance of injuries to others, it increases the chance of danger to the patients themselves and many hospitals don't do this without compromising patient safety," Stefan says. "One of our messages is that what hospitals believe increases safety isn't really what feels safe to patients when it comes to having to take their clothes off. Many, many people with psychiatric disabilities have histories of terrible sexual abuse, like our client. And she felt like she was being raped."

Stefan has written a book, "Emergency Department Treatment of the Psychiatric Patient: Policy Issues and Legal Requirements."

"We did a survey for this book, and mandatory disrobing was a huge issue in response to our survey," she says.

"We're very sympathetic" to hospitals, Stefan said. "I want to be very clear; we understand that hospitals need to be safe places.

"Our contention is that doing this makes hospitals less safe. I think they do it with the best of intentions, but I don't think that they understand that for example, stripping a struggling patient is a recipe for injury."

"We're not arguing for a policy that would ban request for clothing removal," she adds. "We're only saying that before you require a person with psychiatric disability to remove his/her clothing or forcibly remove the clothing, there should be a thorough assessment by a psychiatric professional that documents that the risk involved in allowing the patient to keep her clothes is greater than the risk to the patient and others by forcibly stripping.

"As a general matter, those kinds of experiences in emergency departments of being stripped haunt women and increase their chances of self-injury," Stefan says.

Mary Jean Murk, director of psychiatric central services for Maine Medical Center, says its center's general practice is to request patients (psychiatric or not) put on a patient gown in the emergency department. However, she says the policy is currently in the modification phase. She says some consumers had stated concern about the policy. "We're trying to maintain the same level of safety and not have to get into change or not change into gowns," she says.

In any case, "We would not force somebody to change. If we were worried about weapons or other things we would deal with (those issues), not with the changing of the clothes," she says.

Joyce Brennan, media relations coordinator of Southcoast Health System, which has hospitals in the Massachusetts communities of New Bedford, Fall River and Wareham, says patients who go to the emergency department are asked to put on a patient gown only if it's appropriate to their care. "For example, a hand injury probably would not require wearing a patient gown, but an abdominal complaint would," she says.

"If the patient is not comfortable with putting the gown on the health care provider would work toward a comparable solution," she says.

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