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Nov 28, 2014  |  Vote 0    0

Six hospital staff fired for accessing patient files after in-hospital suicide

Violation of privacy adds to the pain of Prashant Tiwari’s family as they appeal a decision not to hold an inquest into his death at Brampton Civic Hospital.

OurWindsor.Ca

As Prashant Tiwari’s family struggled for answers about the 20-year-old’s suicide in hospital, as many as a dozen staff members at Brampton Civic Hospital were looking at his file without authorization, according to documents obtained by the Star.

Six of the staff members have been fired for the unauthorized access to the patient files, according to Rakesh Tiwari, Prashant’s father, who says he was told about the breach in a meeting with senior hospital staff in mid-October.

“Everybody could go and look at the files and all his personal information,” said Rakesh.

Tiwari’s file was accessed 15 times by 12 individual staff members who did not have authorization, according to documents obtained by the Star produced as part of a routine audit of case files. The documents identify nine individuals who were confirmed to be accessing the records without authorization and three individuals who were still under investigation.

The newfound privacy violations will form a part of Rakesh’s civil case against the hospital, which he is suing in connection with the death of his son.

Prashant killed himself on June 26, 2014, 10 days after he asked his father to drive him to Brampton Civic, saying that he didn’t want to hurt himself and that he had lost control. He was under suicide watch at the time of his death.

In a letter dated Nov. 12, the provincial Coroner’s Office refused to order an inquest into the case. Dr. William Lucas, the interim deputy chief coroner for inquests, wrote in a letter to Rakesh’s lawyer, Stewart Gillis, that he was satisfied with the hospital’s internal review and the changes it implemented.

The hospital would not discuss the individual patient’s case, citing privacy concerns, but acknowledged that a recent audit of records uncovered unauthorized access.

“This is a very rare occurrence at Osler. This situation was discovered as part of our process of regular proactive audits of patient information which are conducted to ensure the organization meets its professional and legislative requirements. Over the last few years these audits have discovered no similar incidents,” wrote William Osler Health System spokeswoman Cara Francis in an email.

Francis wrote that William Osler Health System, which runs Brampton Civic Hospital as well as Etobicoke General Hospital and Peel Memorial, has “zero tolerance” for unauthorized access to patient files. Francis would not confirm the total number of employees terminated as a result of the unauthorized access.

“As part of zero tolerance, any individual found through an investigation to have had unauthorized access to patient health information would be terminated,” wrote Francis.

In the wake of Prashant’s suicide, the family struggled to get information on his death, Rakesh said. A Toronto Star investigation revealed the hospital was conducting an investigation under the Quality of Care Information Protection Act, a process where the results and recommendations remain secret, even from family members. The province began a review of the act after the Star stories ran.

“A lot of questions are there, and there are no answers. I was surprised the inquest was denied, because this inquest can put a light on the reasons, if steps had been taken here, Prashant would still be alive. Our lives would not be in this mess now,” said Rakesh, who has been pushing for the inquest and plans to appeal the coroner’s decision through a provision in the act.

Lucas told the Star the coroner’s office analyzed the case based on criteria set out in the Coroner’s Act.

“We went through that process and ultimately decided that it would not be in the public interest to hold an inquest, and so we advised the family,” said Lucas. He said among the factors considered was whether an inquest jury could make effective recommendations and how much useful information would be gained through a full inquest.

The hospital’s internal review, according to Lucas’s letter, led to problems being corrected. Characteristics of the building that allowed the suicide, including a weight-bearing vent in the psychiatric ward washroom and a chair mistakenly left there, were addressed by the hospital. The hospital also added training to ensure staff follow the 15-minute observation policy, and is reviewing the placement and use of cameras.

The act outlines five key questions a jury should be able to answer after an inquest: who the deceased was, how, when and where he died, and by what means — natural causes, homicide, suicide, accident, or undetermined.

“Having carefully reviewed the investigation materials available, I have determined that a jury would be in no better position to answer the five questions than the investigating coroner or the pathologist,” Lucas wrote.

Gillis said they plan to file the appeal this week and argued that an inquest would be in the public interest.

“There's a real public interest in getting this fully aired in the public forum of a coroner's inquest, so that we, number one, can find out what went wrong, how come it went wrong and what has to happen to address not just Brampton Civic Hospital's problems but the systemic problems across Ontario,” said Gillis.

For Rakesh, an inquest would mean a chance to publicly address what led to his son’s death.

“I feel there were a lot of great errors, and an inquest would put a light on what went wrong. The whole system was failing us — the whole system,” said Rakesh. “Prashant went to the system. Why was the system not able to prevent his death? All these questions are unanswered.”

Toronto Star

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(2) Comment

By Susan | NOVEMBER 28, 2014 03:16 PM
if you are so determined to kill yourself you can find the means to do it no matter where you are
By Joe | NOVEMBER 28, 2014 01:59 PM
Why weren't 12 unauthorized people fired? What exactly does 'suicide watch' mean to Brampton Civic ? It seems more important to Civic to make a big deal about the firing, than providing answers to the victim's family. The family did everything right to ensure the safety of that kid and Civic FAILED, big time.'Problems'....indicates culpability on the part of the hospital. No observance of protocol. How did the chair get in there in the first place, and what was used for a ligature? In the real world, the CEO goes!
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