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Mother sues Holy Spirit Hospital after daughter’s suicide

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A Steelton woman is suing Holy Spirit Hospital after her daughter left the facility last April and killed herself.

According to court documents filed on behalf of the estate of Dawn Martin, 30, the woman “suffered from serious mental health problems and had the mindset of a 12-year-old.”

On April 17, 2012, her mother, Susan, called police after Dawn locked herself in her room, turned up her music loudly and wasn’t responding to her mom.

“So, I got scared. And, she wouldn’t let me in the room, wouldn’t answer me. I thought she did something. So, then I called the police,” said Susan Martin in an interview Monday with Fox43 WPMT. “And, when I later found out she went to Holy Spirit, I felt good about that because my daughter trusted Holy Spirit.”

The state Health Department, which investigated the case in the days following Dawn’s death, found she had arrived at Holy Spirit Hospital in East Pennsboro Township, Cumberland County, around 9:30 p.m.

At 10:20 p.m., she told staff members she wished the police “would have let me jump” out of her home’s second-story window.

At 10:45 p.m., she was observed to be resting in bed, but 20 minutes later she was missing.

Martin says her daughter, dressed in a blue hospital gown and socks, went through several unlocked doors and left through the Emergency Department. The Health Department looked at surveillance video confirming that.

Holy Spirit staff members called police at 11:13 p.m. By that point, Dawn Martin had rolled in front of oncoming traffic on Route 11/15 near the Harvey Taylor Bridge bypass and had died.

” But I didn’t find out that anything happened to her until the next morning when the coroner called me. I had no clue,” said Susan Martin.

In the weeks after Dawn died, the state Health Department fined the hospital $26,000 and worked with administrators on making changes to protocol.

Investigators found eight other cases of mentally ill patients, some also with suicidal ideation, arriving at the hospital in the months before Dawn arrived. They found the patients were not evaluated by Crisis Intervention and left on their own.

Health Department documents show the hospital added a STAT Crisis Protocol. Any patient thought to be suicidal or willing to harm himself will “have continuous observation by a staff member” until evaluated by a Crisis Intervention worker and a plan of care developed.

“Emergency Department staff will monitor 100% of patients meeting Code Crisis criteria to assure appropriate care was provided,” the plan of correction states.

Martin said, “I wish they would have done this before my daughter left the hospital. All the other patients that left, they should have fixed it then. Why wait until someone dies?”

Martin said the hospital was “negligent” and “reckless” and has filed a lawsuit after a year of hoping the hospital would reach a settlement with her. She says while negotiations were ongoing, there was a gag order. But, that is no longer in effect.

“The money isn’t, nothing’s going to bring my daughter back. I just want them to be held responsible. I want them to be held responsible because whether my daughter meant anything to them or not, she meant the world to me,” Martin said.

A Holy Spirit spokeswoman released the following statement to Fox43:

“We continue to be a vital resource for families and patients dealing with serious behavioral health issues. In fact, the hospital managed more than 60,000 behavioral health patient encounters last year alone. 
 
“Following the death of a patient who left our emergency room last year, we worked closely with the Department of Health to develop additional protocols and standards for the treatment of behavioral health patients in our care. We remain committed to providing our healthcare providers with the training, education and leadership required to serve this patient population. Quality and patient safety are our highest priorities.
 
“We remained open with the patient’s family and all involved parties at the time of the incident. We believe our healthcare providers exercised the utmost compassion and respect in caring for this patient. Even though many of the facts surrounding this incident became public, we are bound by federal privacy laws and will not speak further about the complaint or about other specific details regarding this patient’s care.”

1 Comment

  • Observer

    This is a very difficult situation. The patient has a free will. Determining when to take away a person's free will and lock them up is a very difficult process. The law suit could work either way, if the hospital kept the girl and she didn't want to be held against her will, would the family have sued then?

    Mental Illness is very difficult and complex. And also, patients who have been in the system a long time are very good at masking their symptoms and manipulating the system to get what they want. That takes a lot of "ability" to do.

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