Patient dies after taking SN inside an emergency department

[bluemistbec]

Hey guys, I wanted to share the basic details of a really challenging case I had. Unfortunately I cannot go into specifics due to confidentiality. There was a public review about this case online so I don't think I am breaking any laws by sharing previously available public information. I have tried to find the report to share (without saying I was involved) but it has been removed from its only location. If you do manage to find the report, please do not share it here as I dont want to be DOX'ed.

A young otherwise heathy person came in emergency wanting help with their mental health. They were in an emergency bed waiting for a psychiatrist to see them, but had only been waiting for a few hours. There was a nurse checking in on them semi-regularly.

Without us knowing, they took SN. They start vomitting then very rapidly deteriorated. Very quickly they were placed on oxygen, quickly intubated, and then on life support in ICU.

We had no idea what was going on. It took maybe an hour (or maybe even longer) for us to realise it was SN and methylene blue was administered. They were later declared brain dead, life support was removed, and the patient passed away.

SN is so so powerful. Please be careful guys. I know that person wanted help and I worry that it might have been impulsive. As I have said in a previous post, I have challenging thoughts balancing my own previous suicidality versus trying to help people. I do really want to help though. Lots of love.

 

[flightless bird]

could you tell if s/he was experiencing any pain or distress?

 

[MatiSendiri]

Sorry for experiencing that. I too am studying in medical school and SN is wildly available here. I have the same fight here and still fighting to this day. I hope that you'll have better days ahead and can escape the suicidality. Lots of love bro

 

[Kalista]

If you do manage to find the report, please do not share it here as I dont want to be DOX'ed.

next time, don't make it obvious by mentioning it in the first place. people don't need to know this detail if it needed to be kept private to avoid possible connections. now people who would want to and somehow got hold of the information, will.

now the questions are, how the hell was he able to keep the sn on him in the first place while getting checked into the emergency room? is there no existing protocol to check a suicidal person's pockets or belongings and removing his access from all of it?
he brought the damn thing with him to the hospital with the intent to drink it, if that was the case -- or sn was somehow around unsupervised (which doesn't make sense so it must be close to the former).

either way, whatever went through his mind was more than enough to get him to drink and be done with it. he's gone and no longer has to deal with any of his suffering. he can rest well

 

[darksouls]

thanks for sharing the information
may this poor soul rest in peace

 

[bluemistbec]

could you tell if s/he was experiencing any pain or distress?

I'm not entirely sure sorry :( I wasn't there for the start, but when they reviewed the CCTV after he took it and before the nurse had realised he was unwell, they made no comment about him being in visible pain.

next time, don't make it obvious by mentioning it in the first place. people don't need to know this detail if it needed to be kept private to avoid possible connections. now people who would want to and somehow got hold of the information, will.

now the questions are, how the hell was he able to keep the sn on him in the first place while getting checked into the emergency room? is there no existing protocol to check a suicidal person's pockets or belongings and removing his access from all of it?
he brought the damn thing with him to the hospital with the intent to drink it, if that was the case -- or sn was somehow around unsupervised (which doesn't make sense so it must be close to the former).

either way, whatever went through his mind was more than enough to get him to drink and be done with it. he's gone and no longer has to deal with any of his suffering. he can rest well

I guess i balanced the risk of me being DOXX'ED of me just wanting to express what an awful this situation was. I know the only location of the report and it's now been removed (presumably because they thought it might encourage people to use SN). I have looked at cached version of the website but still can't find it. I have googled the keywords in the report and nothing comes up. I also use a fake name here. I guess I worry about my professional reputation or even getting a formal report on my licence because I post here if anyone ever figured it out.

That hospital's psychiatric director has a big focus on respecting patient's rights. For instance, the general part of the psychiatric ward isn't even a locked ward but patients just don't realise they can press a green button to get out (but they try and keep a nurse nearby the door to monitor this, and if someone who is there involuntarily does leave then call security immediately called and grab them by the time they're at the hospital exit). There was no protocol to check bags/pockets, and it was only done if it was thought a patient was at high risk. Most patients that come in asking for help are deemed low risk. We have so many people come in every day with thoughts of hurting themselves, and the vast majority of them we send back home anyway with community follow up. I think their rationale was that taking away bags may do more harm than good. People bring their bag in for a reason, they want to have their phone or whatever with thme. I haven't worked there for a number of years now, so this may have changed, especially in light of this case.

I disagree with your point that whatever went through his mind was enough to get him to drink it. If you ever do CTB, you need to be 100% certain this is what you want. If they really wanted to die, why would they be taking it in the hospital when there's a higher chance they could've survived or ended up alive but hurt? I'm worried they weren't certain about it. If someone does choose to end their suffering, they should be completely sure.

I feel bad because they came in for help so they must have had some hope that they could get better. There was also an error our part because everyone was in a frenzy and missed an important thing in their blood tests. For some reason, met-Haemoglobin level (which is raised in SN) did not come up in bold like things normally do when out of the nromal range. And we never really look at met-Haemoglobin unless we think someone has carbon monoxide poisoning which we didn't in this case because they were fine when they came in.

 

[Linda]

So you had a patient who was in a bad state and then (perhaps impulsively) took SN. Why are you blaming yourself? He could have done that anywhere. The fact that he did it on your doorstep doesn't make it your fault.
You are not responsible for everything that happens at your place of work. You are not required to practice medicine to the very highest standard that perhaps one or two people on the planet might be able to attain. You are required only to carry out your job in the way a normal, competent member of the medical profession would. I think you and your colleagues did that in this case. Don't try to take all the world's problems on your own shoulders. If you do try, you will fail, and you might destroy yourself in the process.

 

[GeminiButter]

now the questions are, how the hell was he able to keep the sn on him in the first place while getting checked into the emergency room? is there no existing protocol to check a suicidal person's pockets or belongings and removing his access from all of it?

I've been in a&e numerous times over the years (15+) and never once had items taken off of me or my bags checked or pockets etc. I don't think it's guaranteed that something like that would happen.

 

[Daenerys Targaryen]

Good luck and envy for him, rest in peace

 

[rozeske]

Unfortunately this isn't a rare case. There are several cases of people drinking it around people or asking for help right after drinking it in which many of whom could still not be saved. Shows the high lethality of it that some keep on underestimating. Sorry you had to be put in that position.