A federal regulator has launched an investigation into a Baltimore hospital after a passerby shot a video earlier this month of a confused patient discharged at a bus stop on a cold night in just a hospital gown.
The video provoked outrage around the country, prompting an apology and an investigation by the University of Maryland Medical Center Midtown Campus.
Now, a Centers for Medicare and Medicaid Services spokesperson tells NPR that it has authorized a federal investigation into the hospital over potential violations of federal regulatory requirements. CMS says it initiated the investigation because it heard about the incident through media coverage.
It's not clear precisely which regulatory requirements are being investigated and what the penalties would be.
It's worth noting that CMS is responsible for investigating potential violations of the Emergency Medical Treatment and Labor Act, which requires Medicare-participating hospitals to examine all patients who come into the emergency room.
EMTALA also requires care providers to stabilize or provide a transfer to those who are having a medical emergency. Penalties for breaking this law could be a fine of up to $50,000 or, more rarely, termination of Medicare and Medicaid status.
"If you get the federal government involved and they're looking into your actions and non-actions, it's a big deal, practically and symbolically," said Frankie Berger, the director of advocacy at the Treatment Advocacy Center, an organization that advocates for medical treatment for people with severe mental illness.
The video captured by Imamu Baraka, a psychotherapist, shows four security guards walking away from a bus stop next to the hospital. They appear to have just left the patient, later identified as Rebecca, at the stop. Here's more from our previous coverage:
"The woman is standing next to the bus stop in a thin yellow hospital gown and socks. She appears scared as she staggers and softly mutters. Several bags of what appear to be her belongings are sitting at the bus stop. The woman moans and cries and coughs, and her breath forms white clouds in the cold.
"Baraka calls 911, and rescue workers arrive quickly. They take her back to the hospital where she was discharged just moments before."
Rebecca's lawyer J. Wyndal Gordon told reporters that she was in a state of "acute psychosis," and that the family is considering legal action against the hospital.
"More investigation needs to be done before we figure out all of the contours of the civil litigation," he says, "But the University of Maryland is in our crosshairs, the doctors who mistreated her are in our crosshairs, the security guards – if they are in any way responsible for the trauma that she suffered – are in our crosshairs."
Rebecca's mother Cheryl Chandler said she believes Baraka saved Rebecca's life. During the emotional press conference last week, she said that Rebecca is not homeless. "Rebecca has insurance. Rebecca has a family who loves her dearly," says Chandler. She describes desperately trying to find her after seeing her in the video that went viral, eventually discovering that the hospital had sent her to a homeless shelter.
"If the University of Maryland Medical Center Midtown had provided Rebecca the slightest modicum of care, then Mr. Baraka wouldn't have had the opportunity to record the most inhumane lack of compassion and empathy for my daughter," said Chandler.
"My daughter did not choose to be the face of mental illness. She didn't choose to be an example of the impact of a failed mental health care system," Chandler added.
Advocates for people with severe mental illness believe this case is indicative of broader structural problems in Maryland's health system.
"This is symptomatic of a systemwide failure," says John Snook, the executive director of the Treatment Advocacy Center. "I think this specific case will hopefully catalyze the entire system to recognize that we're just doing the wrong things for those most in need."