Alyshia Smith
Medical Center Director
Carl T. Hayden VA Hospital
650 E Indian School Rd
Phoenix, AZ 85012
08 July 2020
Dr. M. Dave Salisbury Ph.D.
10002 N 7th St
APT 1125
Phoenix, AX 85020
Subject: Healthcare policies that endanger patients.
Dear Ms. Smith,
I have been a patient of the Carl T. Hayden VA Hospital since 1998 when my family first moved to Phoenix. I was a witness to the award-winning days, and have been a witness to the dead veterans, paper waiting lists, and incredible fall of the Phoenix VA Medical Center. I want to help fix this VA Medical Center and moved back to Phoenix specifically for this purpose. As an organizational psychologist, I have made a careful study of the VA, as a patient, as a previous employee, and as a concerned citizen. I blog about VA issues because “I-Care” about the VA.
One of the first lessons taught me in new hire orientation training, concerned the Emergency Room and the Emergency Medical Treatment and Labor Act (EMTALA; 1986), a federal law that requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay. EMTALA was being abused in the hospital I worked at and I reported this issue. EMTALA is being abused at the Phoenix, VA Medical Center. Twice I have followed my primary care providers’ instructions to report to the VA ER for treatment, and twice I have been refused service.
30 June 2020, I was refused service at the VA ER because I cannot wear a mask due to breathing issues. I was informed upon entering that I could hold the mask in front of my face and this is an acceptable workaround. Upon entering the ER to be checked in, the office staff refused the information provided at the entrance, and said: “If the mask is not worn, we are refusing service.” I have had shortness of breath, not lung-related, for many years now and cannot wear a mask. This information is noted in my VA Medical records. I have been through several rounds of breathing tests which confirm my lungs work great, but I remain short of breath, and when I wear any mask my problems breathing include lightheadedness, dizziness, nausea, and eventually my vision grays and I pass out. The original problem was diagnosed at the Salt Lake City VA Medical Center (2010/2011).
08 July 2020, I walked into the VA through the South Entrance. Not wearing a mask and those performing the COVID check did not offer a mask, offer a face shield, or say anything. I walked to the ER, the admitting person did not mention my need for a mask, nor did they ask why I was not wearing a mask, I was checked in to be seen in the ER. I was triaged and the triage nurse did not say anything about a mask. I sat in the ER for 3-hours and none of the medical staff, hospital staff, employees, or Federal Officers walking past ever mentioned the need for a mask. I walked to the Patriot Store feeling sick because of diabetes and needing food. On my way, an employee whines about me not wearing a mask, and I ignore this person as my medical information is private and I should not have to explain to every nosy-nelly about why I am not wearing a mask. I go to complete my purchases and suddenly the VA Police, who were called by the unknown VA Employee, are there insisting I need to wear a mask. I explained, for the first of at least 40-times that I cannot physically wear a mask to protect my health and safety.
I realize the VA Police are executioners of policies that they have no say in forming and I refused to be anything less than professional as we walked back to the ER. By the time I arrive back in the ER, my police escort has grown from 2 to 7 or 8, led by one plainclothes person claiming to be a Lieutenant and the other was a uniformed Lieutenant. My intransigence at wearing a mask was not disorderly conduct, but a patient safety issue. I have a hard time breathing and when I must speak, this exacerbates my breathing condition. I was accused of yelling, and before I could explain, I am being threatened with being arrested, cited, and thrown out of the VA ER. By this time, I am in trouble physically and neurologically, between diabetes and my need for food, and the neurological condition I suffer through, my stress levels are making a bad situation worse.
A person identifying themselves as a doctor handed me a face shield and my wearing of the face shield did not stop the harassment from the VA Police over not wearing a mask. During my conversations with Timothy Mikulski from the Patient Advocates Office after the last time, I was refused care illegally at the VA ER, I was told wearing a face shield is acceptable. Thus, when I put the face shield on, I was expecting to be left alone. Instead, I was demanded to either wear a mask or be arrested. My third threat in less than 5-minutes for not wearing a mask, even though I now had the face shield properly worn for the same 5-minutes.
Eventually, I am arrested, I experience a seizure where I fell to the floor and injured my knee, then was hit repeatedly in the spine while being “patted down,” which continued to collapse my legs and increase my pain. I was handcuffed to a bench in a holding cell where I bruised my right wrist because my seizures include my arms jerking and with one arm handcuffed to an immovable bench, I could not control my body and the handcuff was not allowing my involuntary movements increasing patient harm. I have a bruise and scratches from the handcuff on my right wrist.
Here is the problem, the policy for wearing a mask does not have exclusions for those of us who cannot wear a mask. Thus, wearing a mask creates more health problems, the potential for injury, and issues for the medical staff who are already overworked. If a face shield is acceptable as a replacement for a mask, why was my wearing the face shield insufficient to closing the police issue? If a face shield is not acceptable as a replacement for the mask, why is the patient advocates claiming this is acceptable? If wearing a mask is so important, why was no one bothered by my not wearing a mask until the nosy employee called the Federal Police?
I sat in the bench seat beside the bookshelf in the ER. Multiple officers, staff, and more walked past and no one was bothered, no one said anything, no one made any fuss over my not wearing a mask for three full hours while I was waiting in the ER. Even when I interacted with the employee’s passing nobody made any comments. This is a failure of policy, or it is the unfair harassment of a single person by overzealous police officers.
Let us talk about access to medical records. The Federal Officers harassing me, sent one of their own to view my medical record for a statement from my PCP regarding my inability to wear a mask for health reasons. I told the officers what they would find, “Records pertaining to my being diagnosed with shortness of breath and difficulty breathing.” They claimed that since those records were from my time in Albuquerque, I was “blowing rainbows up their butts.” Hence, even if my medical records had reported a message from my PCP, I would still have been in the wrong.
From my time as an employee, Medical Support Assistant, VA ER, Albuquerque, I know that the police do not have a reason to be surfing my medical records. Yet, in the holding cell, I heard them discussing my medical records, my mental health diagnosis and cracking wise about details in my medical folder. How did they get my medical records? Why did they have possession of my medical records? What is the purpose of the police having access to my personal medical files?
I freely admit, by the time the VA Police handcuffed me, my “cherub-like demeanor” had melted away. When I am in extensive pain, I cannot think clearly, speak coherently, and my ability to suffer fools and liars is non-existent. But this entire affair was brought about by a policy that does not make sense, a nosy employee who does not need to know my medical history and two overzealous lieutenants who need their ego’s clipped!
Another issue, why is my full SSN, DOB, and Full Name printed on the triage wrist bands? Why are all VA ER patient’s data displayed in human-readable data on the wristbands? This is a HIPPA and PII security issue that was supposed to have been corrected back in 2014. Human readable data being bandied about places patients at greater risk for having their identity stolen. This is especially true on an item regularly thrown away. As someone who has followed the VA problems with protecting veterans, protecting data, and adhering to rules and regulations, I find this lapse highly questionable.
The following is requested:
- Remove the arrest and cancel the citations.
- Correct the policy.
- Train so the policy is properly applied, fairly communicated, and a standard is set. Removing individual adaptation and personal interpretation.
- Correct the PII on the wrist bands and other printed patient documents to protect the identity of the veterans. This is a simple fix of programming and your IT department should be able to complete this task easily.
Thank you for your prompt response in this regard.
Sincerely,
Dr. M. Dave Salisbury Ph.D./MBA
© Copyright 2020 – M. Dave Salisbury
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