
Parents Break Teen Out of Mayo Clinic - patagonia
https://minnesota.cbslocal.com/2018/08/13/teenager-escape-mayo-clinic/
======
burfog
There is a huge conflict of interest here. The hospital makes diagnosis,
requests that the person lose their autonomy, gets control over that person,
financially benefits from that control, and can use that control to hide any
misdeeds or contrary evidence.

There is also a profound disrespect for human autonomy. Hospitals disrespect
autonomy for many people in many ways, with the most common being when
birthing mothers get locked in.

In this case, besides the parents, credit goes to a couple judges who denied
the Mayo clinic's requests. You'd think one should be enough of course, and
that seeking another judge should be prohibited. To give a doctor analogy:
it's like hopping from doctor to doctor in search of pills.

Hospitals that do this sort of thing ought to take a fatal hit to their
reputation. Nobody should accept being a customer. I suppose the news doesn't
get out much, memories are short, advertising works, and most hospitals have a
regional monopoly.

~~~
outside1234
On the flip side, we have thousands of obviously mentally ill people on the
street homeless because we can't commit them because of that human autonomy
that you mention.

It all points to public healthcare where there is governance at a political
level and not profit level.

~~~
lylecubed
It's unconscionable to suggest that hospitals be allowed to legally kidnap
people because of something as hand wavy as 'some homeless are mentally ill'.

~~~
PiggySpeed
This is a complicated issue. I've seen this happen in practice. As long as the
process remains conservative and respectful of the patient, it results in
better outcomes for the patient and a more peaceful society.

The cases where I have seen this happen: schizophrenia, drug-induced
psychosis, acute mania, dementia.

Patients come out far better in an institutionalized setting, as opposed to
being on the streets and walking aimlessly in dangerous traffic.

~~~
lylecubed
There's a huge, gigantic, gaping chasm between a hospital patient with no
history of mental illness with two parents, neither of which have a history of
mental illness, and a schizophrenic homeless person. Saying one has anything
to do with the other to justify a hospital kidnapping its own patients is
seriously messed up.

~~~
PiggySpeed
I was referring to your reply to outside1234's comment. His answer was in the
scope of the "obviously mentally ill" population. And I addressed your reply
to that.

It is incorrect to take my response outside of its intended context and
attempt to attack it there.

------
luddaite
It's easy to attribute this whole situation to greed and/or malice but I think
that fails Hanlon's razor. I can easily see this whole situation occurring
because of poor communication and the culture of paternalism in medicine. It
is not hard to imagine a team of healthcare providers that know or think they
know what is good for their patient and do a poor job explaining why they are
making the decisions that they are making whether that is because of poor
communication skills or because they are simply too busy. I think the article
proposes a good solution in calling up the hospital's ethics council. This
should be standard operating procedure when a patient disagrees with medical
staff and the presence of this resource should be communicated to the patient
early on and by a employee who isn't directly involved with the patient's
care.

~~~
hrktb
Is there a need to attribute to malice when all the incentives are stacked
against the correct behavior ?

Poor communication partly occurs because at no point does the Clinic have to
go against its interest, there is that much less friction in the decisions
taken.

Ethics is an issue but it seems that wouldn’t be sufficient as a focus for a
solution.

~~~
luddaite
I agree that the monetary incentives are definitely incorrectly aligned in the
current healthcare system as is. That said, I don't think that monetary
incentives are the only incentives present here. Most physicians don't go into
medicine only to make money. There are easier ways to make more money. From my
experience, most healthcare providers genuinely care about the patients' well
being. That is why I bristle whenever people rush to attribute a physician's
actions to greed. I totally agree with you that a better incentive structure
would improve the system.

------
codezero
My mother in-law was kept at a facility when we wanted to transfer her to a
better one, but we were given lots of run-around and people insisted
everything was fine. She died. She might have died anyways, but we'll never
get to know. We had serious concerns with her care and nobody was her advocate
to getting better care, except my wife (her daughter) and she was dealing with
a morass of bureaucracy that nobody should have to deal with when someone is
in critical condition. I follow the age old advice of most of the older
members of my family: stay out of hospitals as long as you can, once you go
in, you don't have much control over when you come out again, if at all.

~~~
LeftTurnSignal
When I was a child, I was hospitalized for some issues. I spent a week there,
and I only got worse. The Drs would dance around the questions when my parents
asked to have me moved to a different hospital.

At the end of the 6th day, my dad told them he was going to take me to a
better hospital whether or not they agreed. (There was more words, but that's
besides the point).

Within an hour there was an ambulance taking me to the next hospital. If my
dad didn't force their hand, I would have died later that night. All because
they either didn't care, wanted the money, or were actually that shit of Drs.

This story makes me angry.

------
nxc18
Wow. That's really horrifying. Imagine losing your rights to decide your own
medical treatment because overzealous doctors made up a 'mental health
problem'.

I lost a huge amount of respect for Mayo clinic today.

~~~
inetknght
It's especially scary if you have no trusted friends or relatives. There's an
_awful_ lot of people with asocial tendencies on the internet.

~~~
Chris_Chambers
I have no friends or family here and am too socially crippled to make friends
I would ever trust. I need a harmless procedure completed and doctors refuse
to do it unless I have someone else with me who is willing to drive me home
afterwards. Uber/Lyft/Taxi is not allowed either.

~~~
inetknght
I've been in the same boat for most of my life. I've been lucky enough to make
a few friends in the past few years but that's not to say that I trust them
with my life.

------
jakobegger
The last paragraph is pretty damning. Apparantly the mother had an argument
with a senior physician, then they labelled her as having mental issues, and
tried to take her daughter...

But luckily everyone (the biological father, the court, the police) refused to
play along.

------
arielweisberg
The medical profession really scares me. They have no respect or concern for
patients and are largely going through the motions of providing care with no
concern for successful outcomes. I find this to be consistently true in every
encounter.

I fired my last PCP because they lied about treating me for depression
complete with fictional prescriptions. I found out when I couldn't get
disability insurance (at a sane price) because there was history of depression
in my records I didn't know about.

I asked the PCP to correct it and they said they couldn't they might get sued
for insurance fraud. What a joke!

So I avoided doctors for three years. Eventually I got to a new PCP and guess
what I find when I check their notes? A herniated disk I don't have (I know, I
have the MRI to prove it) and they claimed I was being treated for ADD even
though I haven't been treated for that since I left my last PCP and we didn't
talk about it beyond my mentioning I used to "have" it.

Believe it or not ADD is a thing insurance companies think can cease to be an
ongoing issue. You just have to stop taking the medication. And then poof you
go from being mentally ill to having a history of mental illness (yes ADD is a
mental illness). It's critically important you not let medical professionals
claim you are being treated for fictional things and how long it has been
since you were treated matters a lot. If you let them claim they are treating
you for a long ago resolved condition they revive it and suddenly you are a
bigger liability.

If you go to purchase insurance on the open market or long term disability you
will be dinged for the rest of your life for anything they claim as part of
their insurance fraud. If it's an ongoing or recent issue you are dinged even
worse.

PCPs in particular are financially incentivized to invent issues they are
treating you for in their records because they can bill more for office visits
if they can increase the number, complexity, and seriousness of the conditions
they treat you for. And the insurance companies just take them at their word!

And the craziest part is that as part of HIPAA you can ask the doctor to
correct the record, but they are under no obligation to do so. They make the
final determination of medical fact, or fiction as it were. You can add a
letter to your file pointing out how insane and contradictory their records
are, but I can tell you from experience insurance companies aren't buying it
and have no appetite for risk.

~~~
luddaite
It seems pretty unfair to malign the entire field of medicine due to a single
bad actor. I went to medical school prior to becoming an engineer and my
impression was that most if not all of my classmates were genuine in their
desire to help improve the lives of others. I'm sorry that you had a bad
experience with your previous PCP but they don't represent the profession as a
whole.

Also, if ADD is not a mental illness then what is it? I think this point is a
conflation between medical definitions and social stigma.

~~~
lylecubed
> It seems pretty unfair to malign the entire field of medicine due to a
> single bad actor.

Do a little research. Prescription fraud of this sort is widespread in the US.

~~~
luddaite
I have definitely seen anecdotal stories of this occurring. Do you have any
evidence to back up your claim that this type of behavior is widespread?

------
modells
Unless the parents were crazy abusive or actually unfit, Mayo basically
stalled to steal their child and charge them more money. Also bad is a recent
scam of random average people being involuntarily assigned conservatorship and
having their assets stripped.

------
deanCommie
Seeing the Americans in this thread discuss their fear and mistrust of the
medical system and the completely befuddling incentives that have been created
in the US due to a for-profit medical system is straight up DISTURBING.

Healthcare is a human right in our modern prosperous civilization. What
America has done to it is preposterous. You should be rioting, not starting
lawsuits.

~~~
mavieengris
The Mayo Clinic is a Non-profit.

[https://en.m.wikipedia.org/wiki/Mayo_Clinic](https://en.m.wikipedia.org/wiki/Mayo_Clinic)

I agree that this particular case is egregious. But calling for riots based on
unfounded speculation isn’t going to help fix healthcare.

------
Simulacra
To me this sounds very much like the superiority complex many doctors and
hospitals take when it comes to patient care. They are the doctors. They are
the hospital. How dare you disagree. As stated, hospitals are not prisons and
unless someone is an absolutely, clear and present danger to themselves or
others, that person should be allowed to walk out. Even still, the law should
err on the side of the patient's wishes.

~~~
icelancer
>> To me this sounds very much like the superiority complex many doctors and
hospitals take when it comes to patient care. They are the doctors. They are
the hospital. How dare you disagree.

This is academia in a nutshell. They're told they are superior due to the
time/resources spent in advanced schooling and only respect the opinions of
people who have letters after their name. It is endemic amongst MDs and PhDs
alike.

------
rossdavidh
So, this looks awful. I would expect for the Mayo clinic to come out with a
response sometime soon. In the meantime, I'm just trying to remind myself that
news stories that stoke outrage often turn out to be telling the story in the
way best tuned to get forwarded and clicked on, not always the most accurate
way. But, really, this looks awful.

~~~
jessaustin
The fact that this happened a couple of years ago seems to make the "outrage
of the week" angle a bit less likely? Since the patient has recovered,
attended high school for another year to great success, and enrolled in
college, it's pretty clear that she is competent to make health care
decisions. She wanted a second opinion. Decision-makers (perhaps no longer?)
at Mayo didn't want her to get that. (A bit rich, considering Mayo's
reputation for second-guessing diagnoses across the Midwest...) When she got a
second opinion, it was for a different and more successful course of
treatment. If this report were false, threats from Mayo's lawyers would have
prevented its publication.

There's little in this report to indicate that there is any sort of "culture"
of false imprisonment at Mayo, and it seems likely that they're supervising
the social workers a bit more closely now, so it's probably a fine hospital at
which to receive health care...

~~~
rossdavidh
Yeah, probably not Mayo clinic policy to imprison 18-year olds and take over
guardianship, and the results afterwards make it clear their diagnosis was
wrong. But, although the events were a couple years ago, the news article
itself is pretty new, so I would be happy to see some comment from the Mayo
clinic as to what they think went on here, and whether it was (or is) against
their policy.

~~~
jessaustin
If actual events were largely as depicted in TFA, Mayo's interests would be
best served by not addressing them at all. The publicity of the former board
member's letter to a VP (but not his first name!) is a bit of a PR disaster...

------
arkades
As a HIPAA issue, the Mayo cannot defend itself here - it has no right to
disclose any information on this patient’s stay or condition.

Key quote,

>“You’re only hearing one side,” cautioned Dr. Chris Feudtner, a professor of
pediatrics, medical ethics and health policy at the University of Pennsylvania
Perelman School of Medicine.

They “broke her out” while she still had a feeding tube in place, and had only
just “The video shows Duane pushing Alyssa in her wheelchair down the hospital
hallway. She has a bandage on her neck where her breathing tube had been
removed a few days before.”

If you’re getting a feeding tube and a trache, you’re likely sick as shit.
Even if one thinks the Mayo docs were wrong, that course of treatment suggests
they earnestly thought she was extremely ill. Which makes their actions less
evil than the article implies.

~~~
ars
> has no right to disclose any information on this patient’s stay or condition

Except that according to the article the Mayo said they would if the patient
signed a release form. So the patient did so (called their bluff basically),
and they still refused to discuss it.

> they earnestly thought she was extremely ill. Which makes their actions less
> evil than the article implies.

Make no difference whatsoever. People have the right to stop medical treatment
whenever they like. They have zero right to force anything on anyone.

On top of that a different set of Dr's said she was just fine to go home. So
on top of everything else they were also wrong medically.

~~~
lsaferite
I'm sure their lawyer put the kibosh on that. How could they square their
claim that she was not capable of making decisions with honoring a release
also signed by her?

~~~
ars
Since when do hospitals have the ability to unilaterally decide someone is not
capable of making their own decisions?

If they believe that is the case they get a judge to give that person a
guardian, they don't just make decisions for them.

~~~
koboll
That's literally what they were trying to do; read the article.

------
ars
Can we change the URL to [https://www.cnn.com/2018/08/13/health/mayo-clinic-
escape-1-e...](https://www.cnn.com/2018/08/13/health/mayo-clinic-
escape-1-eprise/index.html) which is the original source?

~~~
mcphage
Especially since your link points to part 1 of the article, not part 2 like
this post. The article makes a lot more sense starting with part 1.

------
c3534l
According to the article, the hospital had attempted to gain medical
guardianship and that was rejected by a court. So unless I'm missing something
here, how on earth does a hospital justify keeping someone prisoner when a
judge has ordered you to allow them to transfer hospitals if they want? They
went through the rigamarole and lost. That sounds criminal. Did they lie to
the cops, too, and say they were allowed to keep her there? How did they get
an entire hospital to go along with this?

~~~
SOLAR_FIELDS
Not just one judge, but two different ones. They didn’t like it when the first
judge disagreed so they went to a different one who rejected them as well.

------
cm2012
Nothing can make you feel powerless quite like a kafkaesque bureaucracy where
the decisions are faceless and unaccountable.

------
mnm1
This is one way to make a profit off the patient. I wonder if it would have
happened if she had no insurance. Highly unlikely as the hospital wouldn't be
able to milk the patient for money.

A second issue is these social workers whose main goal seems to want to remove
children from parents and break up families in general for what I can only say
is their own sick amusement. This is a fucked up job that gives way too much
power to people who really don't care about others and often are unsuited to
work with others. No one or even two individuals should have this kind of
power. Removing someone's legal ability to make choices for themselves or
their children should only be done by a consensus of multiple, independent
parties that are not allowed to communicate with each other.

Finally, why did the DA not file charges of wrongful detainment / kidnapping
against the hospital? This is not a mere disagreement. The article brushing
this off as some petty doctor ignores the kidnapping and sending the police
after the patient based on false statements to the police. At the very least
the social worker, doctor, and nurse who contributed to this should all be
fired and lose their licenses. These people should not be working on their
respective fields and likely should be in jail. I hope the patient does sue
but that won't prevent greedy or petty healthcare workers with too much power
from doing this in the future.

~~~
DoreenMichele
_This is one way to make a profit off the patient. I wonder if it would have
happened if she had no insurance. Highly unlikely as the hospital wouldn 't be
able to milk the patient for money._

I have no idea how to find it, but your comment reminds me of some horrifying
article about the addiction treatment industry leeching all the money they
could from patients with good insurance without really getting them better,
not sincerely trying to do so.

~~~
mnm1
They made a documentary about it as well:
[http://www.thebusinessofrecovery.com/phone/index.html](http://www.thebusinessofrecovery.com/phone/index.html)

Hardly surprising. Every other medical specialty does the same and addiction
treatment is essentially unregulated. Lots of suffering and misery to exploit
here to make a ton of money for people with no morals (of which there are
many).

------
captain_perl
This is the second similar news story this month.

The thing in common is that both sets of parents were either divorced or not
biological, and the hospital tried to use leverage to push them off balance
with bogus law citations and police involvement.

The trump card that hospitals play in a dispute is to call police and have you
arrested for trespassing.

------
humantiy
Really would like to know how it got to that point. I'm not far from Mayo and
its of course a well ('world renown') known hospital. I haven't heard many
good stories. I know of close friends who have gone there to get help and
heard multiple stories about how the Drs ego got in the way of patient care
and listening to what the patient was telling them. It's sad that this is
reflected in this story to what I think is the extreme and then to boot what
looks to be attempts to cover it up by adding stuff onto her records after she
had already left.

Would like to hear Mayo's story on this, but I have a feeling it will be more
excuse/finger pointing than explanation.

I do hope that they take this as a lesson on patient care especially the
Doctors.

------
altmind
What is shocking that Mayo legal department was contacted and there was no
reaction, nobody cared to prevent this blowout. Mayo vice president was
contacted by the board member, and nothing was done. Social worker who
should've defended patient rights actually acted against patient's will. Mayo
Patient Experience office was contacted and nothing was done.

Basically every person and institution whose jobs are to protect patient
rights, failed. I wonder if all departments so unaccountable and dysfunctional
in Mayo?

If its a case of one bad doctor, why so many of the hospital departments
failed to do their job?

------
fipple
Imagine what happens to people like this who have no family.

~~~
JoeAltmaier
They stay in a reputable medical institution and get better after a
debilitating aneurism?

~~~
ars
That demonstrates an ignorance of what the medical profession is like in
practice.

People without family to watch them get terrible care.

There are exceptions (ICU for example is usually pretty good), but any care
that doesn't have someone watching/caring for them 24/7 is going to be bad.

You NEED someone in the hospital watching out for you, unless you are in a
unit where there is a permanent nurse on duty with you (not doing rounds).
Typically family or friends fulfill this role because hospitals can not afford
to do it.

~~~
JoeAltmaier
We weren't talking county general here. This was the Mayo clinic.

I'm appalled at the anti-science luddite response to this yellow journalism
that's called a news article, especially from HN folk.

~~~
fipple
LOL... my mother was in a hospital more famous than Mayo and it’s a lot
different than you might think. My mother got 1000% better care than her
roommates that didn’t have 24/7 family coverage.

------
jchw
This is way beyond Hanlon's Razor assuming this article is both complete and
accurate. Mayo Clinic clearly acted in a way that would protect their income
and not their patient, going as far as to try to use legal leverage to ensure
neither the patient nor the parents could decide to get even a second opinion.
Would you step foot into a Mayo Clinic the same ever again if this happened to
you?

------
gouggoug
I am having a hard time understanding how Mayo was able to basically hold one
of their patient hostage. Isn't that akin to kidnapping?

But also:

What prevented Alyssa from getting up her bed and walk out? When did her
parents start "figuring out _how to escape_ " and how long for? If they were
at that point were they believed they needed to "escape" from the hospital,
why didn't they call the police?

~~~
larkeith
> What prevented Alyssa from getting up her bed and walk out?

She needed to be pushed out in a wheelchair. She was presumably only provided
access to one due to the pretext of "Grandma Betty" who (it was claimed) could
not access Alyssa's room. Additionally, hospital staff attempted to physically
restrain her from leaving, which may have been more successful without the
ruse.

> If they were at that point were they believed they needed to "escape" from
> the hospital, why didn't they call the police?

This is a good question that's not fully addressed by the article, however,
given that the police initially did side with the hospital when it came to a
"our word vs theirs" situation, it may have been the correct choice.

------
neillyons
This reminds me of the film Unsane
[https://www.imdb.com/title/tt7153766/](https://www.imdb.com/title/tt7153766/)

------
3327
They should definitely be taking Mayo to court. Absurd. But a good lesson and
next time I check anyone into the hospital I will have legal counsel at hand.

------
deadwing0
know how I know this story has falsehoods?

"After the calls from police, Alyssa’s parents figured out that their phones
were being pinged and took the batteries out."

90% chance they all had iPhones. can't take iPhone batteries out. if they
didn't, what phones have removable batteries?

riddle me that.

~~~
dsfyu404ed
>90% chance they all had iPhones

Not necessarily. Outside of tech and the wealthy android has pretty good
market share. It wasn't mentioned what her parents did for work but among blue
collar professionals cheaper Android phones are the norm because their work
environment tends to be hazardous to phones with large, thin glass screens.

------
mikorym
I would consider this click bait and irrelevant on HN. The article is very
long and contains very little factual information, making it impossible to
understand the story or any of the arguments that could be made.

