Legal 2000

Legal 2000 is the emergency or involuntary admission to a hospital of a person who is alleged to be a person with a mental illness. A person with a mental illness is defined as someone with a diminished capacity to exercise self-control, judgment, and discretion in the conduct of his or her affairs and social relations, or the ability to care for his or her personal needs is diminished due to a clear and present danger of harm to self or others. NRS 433A.115.

To establish a Legal 2000, there must be probable cause to believe a person is suffering from a mental illness within 30 days prior, medical clearance from a physician at a location where the physician is authorized to conduct a mental exam and certify that the patient is suffering from a mental illness, as a negligent security attorney in Las Vegas, NV, can explain. NRS 433A.150. If these factors are established, a patient will be deemed Legal 2000 for up to 72 hours. NRS 433A.150.

After the 72-hour hold, a patient must be released if a psychiatrist, psychologist, or physician assistant signs off a Certificate of Release unless a petition is filed for court-ordered admission.

Hospital Discharge Planning: Professional Negligence or Ordinary Negligence?

A question arises when a hospital negligently discharges a patient who is still perceived to be a threat to him or herself or others. NAC 449.332 describes the policies and procedures medical facilities should adhere to as it relates to its discharge planning:

1. A hospital shall:

(a) Have a process for discharge planning that applies to all inpatients; and

(b) Develop and carry out policies and procedures regarding the process for discharge planning.

2. The process for discharge planning must include the participation of registered nurses, social workers or other personnel qualified, through education or experience, to perform discharge planning.

3. A hospital shall, at the earliest possible stage of hospitalization, identify each patient who is likely to suffer adverse health consequences upon discharge if the patient does not receive adequate discharge planning. The hospital shall provide for an evaluation of the needs related to discharge planning of each patient so identified.

4. An evaluation of the needs of a patient relating to discharge planning must include, without limitation, consideration of:

(a) The needs of the patient for postoperative services and the availability for those services;

(b) The capacity of the patient for self-care; and

(c) The possibility of returning the patient to a previous care setting or making another appropriate placement of the patient after discharge.

5. If the evaluation of a patient relating to discharge planning indicates a need for a discharge plan, a discharge plan must be developed under the supervision of a registered nurse, social worker, or other person qualified to perform discharge planning.

(6) An evaluation of a patient relating to discharge planning and a discharge plan for the patient may be requested by the patient, a physician, a member of the family of the patient or the guardian of the patient, if any.

(7) If a hospital find that a patient does not need a discharge plan, the attending physician may still request a discharge plan for the patient. If the attending physician makes such a request, the physician shall collaborate as much as necessary with the hospital staff in the development of the discharge plan.

(8) Activities related to discharge planning must be conducted in a manner that does not contribute to delays in the discharge of the patient.

(9) The evaluation of the needs of a patient relating to discharge planning and the discharge plan for the patient, if any, must be documented in his or her medical record.

(10) The discharge plan must be discussed with the patient or the person acting on behalf of the patient.

(11) The patient, members of the family of the patient and any other person involved in caring for the patient must be provided with such information as is necessary to prepare them for the posthospital care of the patient.

(12) If, during the course of a patient’s hospitalization, factors arise that may affect the needs of the patient relating to his or her continuing care or current discharge plan, the needs of the patient must be reassessed and the plan, if any, must be adjusted accordingly.

(13) A hospital shall arrange for the initial implementation of the discharge plans of its patients.

(14) If identified in a discharge plan, referral of a patient to outpatient services or transfer of the patient to another facility must be accomplished in a manner that meets the identified needs of the patient, including the sharing of necessary medical information about the patient with the receiving service or facility.

Depending on the circumstances, negligent hospital discharge planning can  arise under professional negligence or ordinary negligence. Pursuant to Szymborski v. Spring Mt. Treatment Ctr., when a hospital performs nonmedical services, it can be liable under principles of ordinary negligence based on a duty to exercise reasonable care to avoid foreseeable harm when they furnish nonmedical services. However, if the claims involve medical diagnosis, judgment, or treatment or are based on nonmedical services, the claim is for professional negligence.

Importantly, when an action for professional negligence is filed, the complaint must be supported with the affidavit of a competent expert witness that (1) supports the allegations contained in the action; (2) a medical expert who practices or has practiced in an area that is substantially similar to the type of practice engaged in at the time of the alleged professional negligence; (3) identifies by name, or describes by conduct, each provider of health care who is alleged to be negligent; (4) and sets forth factually a specific act or acts of alleged negligence separately as to each defendant in simple, concise, and direct terms. NRS 41.071. Failure to comply voids the complaint and it cannot be amended.

How an Attorney Can Help

If you have a question concerning whether a hospital negligently discharged a patient, an experienced attorney can ensure that the proper negligent claim is brought against the negligent hospital.

Thanks to Eglet Adams for their insight on Legal 2000 and negligent hospital discharge.