Hospital didn't follow rules for autistic man left in chair for nearly 2 hours

The mother of a severely autistic man who was restrained in a chair for approximately two hours at the Nova Scotia Hospital says she feels vindicated after an investigation into the incident found proper steps were not followed.

The Nova Scotia Department of Health and Wellness looked into the case of Matthew Meisner, 31, amid allegations of mistreatment by a staff member at the Dartmouth mental health facility last fall.

The policy at the hospital is for patients to be restrained in the chair for no more than an hour. Anything beyond that must be approved by a physician.

"I want him out of that facility," said Matthew Meisner's mother, Tracey Meisner.

"Too much has happened over the years. And this one complaint was just one of seven."

Placed in 'time-out chair'

The report, dated Friday and addressed to Tracey Meisner, states that in the early morning hours Sept. 3, 2016, a staff member heard loud banging coming from Matthew Meisner's room.

A code white — used in cases of aggression — was called and according to the report, "the patient was naked and banging his head and hands on the Plexiglas. The patient was covered in feces."

The report, which refers to Meisner only as "the patient," goes on to say he was restrained in a so-called "time-out chair" and moved to a room where he was monitored by security staff. Other staff cleaned his room.

The report said there is evidence that Meisner remained in the chair for an hour and 55 minutes.

Witnesses reported that a towel was used to cover Meisner's face twice during the code white, said the report.

"The person implicated denied that the patient's head was covered; however, the person implicated documented that the patient was spitting and the patient's face had to be covered by a pillowcase to clean and assess the patient," said the report.

Steps not followed

According to hospital policy, and Meisner's own specific care protocol, staff must stay in the room and keep constant eye contact with him while subdued in the chair.

There are a number of other steps in Meisner's care plan that staff are supposed to take to try to reduce his stress, "including verbally telling the patient what the expected behaviour is and allowing time for de-escalation."

However, the report found these were not followed before Meisner was placed in the chair. His vital signs were also not documented during the incident.

The report also confirmed allegations that the staff member in question — a nurse — used foul language while speaking about Meisner.

The staff member at the centre of the complaint admitted to making the comments, said the report, but denied they were made in Meisner's presence.

Tracey Meisner described the events outlined in the report as awful.

"How bad do things have to get?" she said.

Directives issued

A number of directives have been issued to the hospital as a result of the incident, including ensuring the staff member at the centre of the complaint undergoes sensitivity training.

The report said the hospital should also review the effectiveness of time-out chairs and ensure staff are aware of important information contained in patient care plans.

The nurse in question still has a licence to practise but there are restrictions.

In a statement, the College of Registered Nurses of Nova Scotia said the woman's "nursing practice is restricted to environments in which she provides no direct, in-person nursing care to patients or clients."

Report doesn't go far enough

Meisner said she's glad to hear about the restrictions but said her son must be taken out of the Nova Scotia Hospital.

"We've had enough of Emerald Hall," she said of the facility's locked unit.

"We want the Department of Health and Wellness to help us get Matthew out of Emerald Hall and into a therapeutic, small options home with competent, caring and educated staff."

A group called Advocating Parents of Nova Scotia said the directives in the report don't go far enough and that police should have laid charges.

"We ask that the decision to not lay charges against the nurse by Halifax police be reviewed," said chair Brenda Hardiman.

"If this decision remains as is, it sends a loud and clear message that if you abuse a vulnerable person, you might not be held accountable under criminal law despite your proved misconduct."