Hospital safety measures remain secret after alleged sexual assault

Ever since one of its employees was charged with drugging and sexually assaulting a patient, London’s largest hospital has been refusing to disclose how it prevents medication from being stolen and misused, erecting a wall of silence that seems foreign to a leader of patient safety at Canada’s largest hospital network.

Emily Musing is no stranger to investigating when staff at University Health Network (UHN) report medication has been administered incorrectly or has gone missing: She’s a pharmacist and a vice-president who serves as her hospital’s chief risk officer and runs a program dedicated to improving safety there and at SickKids in Toronto, formally known as the Hospital for Sick Children - writes

Tasked with running six hospitals in and around Toronto, UHN believes that by sharing its safety protocols and practices, officials can learn how to improve.

“UHN has clearly tried to be as open as possible,” Musing told The Free Press after her hospital network provided to the newspaper the detailed measures it takes to reduce the risk that medications such as narcotics are stolen and misused.

Those measures include requiring two staff to sign when they dispose of unused narcotics and making medication carts more secure by limiting access to authorized staff who verify their identity using a biometric marker such as a fingerprint or an eye iris scan.

“We try to answer questions to the best of our ability. From a UHN perspective, we (want) to be as open and transparent as possible,” Musing said.

Asked if UHN would ever refuse to make public specific measures they use to reduce the risk of harm to patients, Musing said, “I can’t think of any situation where that would be the case.”

Her comments come in the aftermath of criminal charges laid in June against a technician at the London Health Sciences Centre (LHSC) whose job was to attach electrodes to the heads of patients being tested for abnormal electrical activity linked to seizures, a procedure called electroencephalography or EEG.

Such technicians aren’t authorized to handle or administer drugs.

Police have said the patient was injected with a sedative, and if that is true, it suggests the sedative was a liquid narcotic, Musing said.

At UHN, staff are required to take extra safeguards when tracking, administering or disposing of narcotics, the precautionary measures the hospital provided to The Free Press show.

But while Canada’s biggest hospital seems transparent about its safety measures, the head of LHSC, Dr. Paul Woods, took a different tack when questioned by the media after police charged 24-year-old Vincent Gauthier with sexual assault and overcoming resistance by administering a drug to a patient. The charges have not been tested in court.

Gauthier has been released on bail. He wasn’t in court Tuesday when the case was discussed briefly before it was put over to July 31.

Woods’ answer could be boiled down to this: No details, but trust us.

“LHSC has a robust system of medication control, with checks and balances in place for the safety of patients and staff, and we are confident in this system,” he wrote to The Free Press in June. “For the safety of patients and staff, LHSC does not share medication safety and security protocols publicly.”

The response came three months after The Free Press exposed a major security breach in the way the hospital managed medication carts. Many staff were locking carts using the identical and predictable four-digit security code of 1, 2, 3, 4.

Hospital brass learned of that risky practice after the newspaper reported how a Londoner with mental illness used that code to steal insulin and try to kill himself.After the article was published, LHSC directed staff to enter new and varied codes.

Since Gauthier was charged in June, Woods has turned away suggestions that the sedative could have been stolen from the hospital.

“LHSC has reviewed pharmacy records for the areas Mr. Gauthier was working at the time of the alleged incident, and we can confirm that no discrepancies were found,” Woods said.

But Woods refused to disclose if the hospital searched medical records beyond a single day.

“Isn’t it possible (someone) misappropriated the sedatives weeks or months earlier? Wouldn’t such misappropriation be missed by a review limited to the time of the alleged incident? (What) period of time did you review? One hour? Four hours? Eight hours? 24 hours? Please specify how many hours/days/weeks of pharmacy records were searched,” The Free Press asked Woods.

Those questions drew this from a hospital spokesperson: “Given that there are formal proceedings underway both in the courts and through the (labour contract) grievance procedure, and with our internal investigation still ongoing, we cannot provide the details you are requesting at this time.”

While UHN’s Musing won’t address what LHSC did or did not do, she made clear that if narcotics go missing at one of the network’s Toronto hospitals, investigators likely probe records beyond a single day.

“We can generate reporting beyond a day and we’d likely would,” she said.

By seeking how narcotics go missing over a longer course of time, a hospital can identify patterns of theft and which patients may have been affected, Musing said

“What is the big picture?” she said.

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