Sunday, March 14, 2010

If you can't trust Dr. Koczapski who can you trust?

Originally published on March 14th, 2010. For an update see the end of the post.

This is the true story of a young woman currently in the Concurrent Care Unit of Vancouver General Hospital. She's twenty two years old, and could be the sister or daughter of anyone on this list. Tonight she will not be going home to her mother. Instead she is in a seclusion room in the Unit, having been involuntarily sedated.

Confidentiality concerns prevent me from mentioning her name, however I am able to mention her doctor's name. Dr. Koczapski ordered her involuntary sedation. Now, a quick word about seclusion wards and sedation. A seclusion room is a room containing a mattress and nothing else. It has a small window for the staff to inspect the occupant. It is, within the corrections world, the equivalent of 'Solitary Confinement'. The patient may be let out at certain times at the discretion of a nurse.

Involuntary sedation is a questionable practice at best. There are strict rules about it's use, however the nature of a psyche ward being what it is, the overseeing doctor can use his discretion about it's application. It is not meant to be used as a punishment – and should only be applied if the patient is a risk to themselves or others on the ward.

In this instance the patient was requested to go to the common area, and when her visitor stepped out for a moment was apprehended and forcibly sedated. Obviously, if she was asked to be in the common area, she was not considered a risk to other patients. Instead she was herded into a seclusion room, stripped naked and sedated.

The patient in question is barely 120 lbs. Three nurses and four Paladin security guards were used to sedate the patient. The doctor (male) was present. Also present were outside contracted male security staff. When asked what the nature of their medical training was Dr. Koczapski was unable to tell me. This process was witnessed, however and the witness has agreed to provide an affidavit should it be necessary to do so. Paladin security guards are usually charged with the testing task of patrolling the car park. The nature of their medical training remains a mystery.

That male non-medical staff were used is a gross indignity committed on a helpless young woman, traumatised by the experience. That the doctor was unable to describe the nature of their training was equally worrying. As a professional contracted in the care of a patient, his lack of knowledge of the background of people on his ward is somewhat like having a baby sitter you don't know look after a child. This young woman, who could be anyones daughter or sister, was exposed to a gross invasion of her privacy at a time when she was at her most fearful and vulnerable.

I am not going to detail the history of this patient, however I will say I did see her as a client at some point. At that time she was functional, working and pursuing her studies diligently. She was involuntarily certified at VGH Concurrent Disorders Unit on February 22nd, 2010, and subsequently put on Epival.

Her dosage was increased following her forced sedation. One effect of the high dosages is the dysfunction of her eyes – one now constantly wanders. She is incoherent. She is unable to function effectively. While no existing addiction was in place prior to her being certified, she was offered was offered MDMA on March 8th, whilst in the ward. Dr. K was informed of this by the patient on March 9th.

On March 11th I was made aware of the situation regarding the MDMA, and asked Dr. K precisely what action he had taken after being informed of the presence of MDMA on the ward – supplied by a patient – I have his christian name and will provide it to anyone interested. Dr. K would not respond to the question. This suggests that no action was taken – however if he is able to show documentary proof that written instruction to his staff, or some other form of action about the issue was taken, I would gladly publish it here. I am interested in the truth. I would like to see what he did to safeguard the patients in his care on the ward. There is additionally the question of whether or not Dr. K reported the incident to the police. If not, why not?

Asked if he thought her condition were improving, he inexplicably said 'yes'. She now has an epival addiction, is traumatised by her brutal treatment and is possibly using MDMA. Her eye function is reduced, and her overall health is substantially worse. No one has thought to address the question of drug interaction between her high doses of Epival and her use of MDMA.

The BC Mental Health Act states, under section 8 paragraph A, “(a) that each patient admitted to the designated facility is provided with professional service, care and treatment appropriate to the patient's condition and appropriate to the function of the designated facility” Failure to provide 'appropriate' treatment can result in immediate release (Section 32, para 2). The unsupervised use of street drugs, the inappropriate use of untrained opposite sex staff easily satisfy the term 'inappropriate' care.

Now the tragedy of this story. This is the sad punchline. Actually, the safest place for this patient is probably in the Concurrent Care Unit. She is a sick woman. She belongs in care. Her family cannot pay for private treatment, and few treatment centres would take her even if they could. And so we are left having to trust the Dr. Koczapski's of the world with the care of those less fortunate than ourselves. And that really is a tragedy.

Perhaps you'd like to ask Dr. Koczapski about the nature of his treatment. He can be reached on:(604) 875-4139 during office hours. They are quite happy to take a message for him outside of office hours.

Alternatively you can email him on: pcqo@vch.ca

Please forward this email to anyone you feel should know. This could, after all be your daughter or sister.

----- Post Script ----

Our client was granted a two hour pass about two weeks after this blog post was written. She left the facility to get a coffee at a nearby Starbucks. Immediately on leaving the hospital she hailed a taxi and made for the US border. That was five years ago.  She now runs a very successful company in Los Angeles and is thriving, no thanks to the treatment she got at VGH.