New York State Mental Hygiene Law on Restraints
     By clicking on the links below, the reader can review the
New York State Law governing the use of restraints.  This 
Law was broken in multiple ways. The relevant sections of 
New York State Mental Hygiene Law that were broken are
as follows:
b.  "It (restraints) may be applied only if less restrictive techniques
     have been clinically determined to be inappropriate or 
     insufficient to avoid such injury."
          Seth was never put "deeply asleep" as is described in
          the humane Standard of Care.  This would have removed 
          the need  for any restraining at all.
      "It may not be employed....as a substitute for treatment
        programs."
          Clearly, the restraints were a substitute for the needed
          treatment of deep sedation.
d.   "The order (for restraints) shall set forth the facts justifying
      the restraint and shall specify the nature of the restraint
      and any conditions for maintaining the restraint."
          Neither the order of Dr. Ortiz or Dr. Mayer provide
          the detailed information required by the Law. This is
          particularly true regarding Seth's physical condition
          and behavior which would have justified continued
          need for restraints.
       "The order shall also set forth the time of expiration of the
       authorization, with such order to apply for a period of no
       more than four hours, provided, however, that any such order
       imposing restraint after nine o'clock p.m. may extend until
       nine o'clock a.m. of the next day.
            The order of Dr. Ortiz was good only until 9a.m. on
            Tuesday, August 24, 1993 under the above Law.
            The only other order, the order of Dr. Mayer, did 
            not come until 5p.m. in the late afternoon.
            This 5p.m. order of Dr. Mayer was the only order
            for the restraints placed on Seth during the entire time
            he was in the ICU.  This was a clear violation of the
            New York State Mental Hygiene Law
f.     "An assessment of the patient's condition shall be made
       at least once every thirty minutes or at more frequent 
       intervals as directed by a physician.  The assessment
       shall be recorded and placed in the patient's file.
       
            There are claims in the nurses notes that the restraints
            were being loosened "q 15 minutes".  Yet, there were no
            records of assessments being done every 30 minutes as
            required by law.
        "A patient in restraint shall be released from restraint at least
        every two hours, except when asleep.  If at any time a patient
        upon being released from restraint makes no overt gestures 
        that would threaten serious harm or injury to himself or others,
        restraints shall not be reimposed and an physician shall be 
        immediately notified.  Restraint shall not be reimposed in such
        situation unless in the physician's professional judgment release
        would be harmful to the patient or others.
              There is no indication that this part of the Law was ever
        obeyed.  Even when Seth was clearly calmer from the nurse's
        description, the restraints were left on.  No physician ever
        re-ordered (after Dr. Mayer's order) or reassessed the need
        for restraints.
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