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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