PATIENT SAFETY ALERT: Tennessee Code Annotated Title 33 & DMHT

Wednesday, March 18, 2009

HIPPA Confidential Report: 6044

Please confirm receipt of this email and note that I have made several requests for EOBs from AmeriChoice and have had more than one unauthorized disclosure of my medical records due to problems with TennCare when they transferred patients into AmeriChoice and AmeriGroup.

Please log all requests for medical information and do not release any information without my prior consent and HIPPA compliant medical release.

RE: Confidential Report: 6044

On March 7, I sought treatment at the emergency room and was asked to sign a blank release form for treatment. I refused to sign consent for treatment because they would not pull my primary care records that list allergy information.

At that point, I was escorted upstairs by upstairs two security officers who did not have any employee identification badge or ID number on their uniform.

Once inside the unit, I tried to call my sister, my medical proxy, and emergency contact person. I felt someone should know where I was and alert her that I was being held at the emergency room. They placed two wristbands on my right arm, the MR numbers (Medical Record Numbers) did not match.

Security would not allow me to make a phone call and used excessive force to grab me by the arm and take the cell phone out of my hand. Neither of the two ID bands listed or medical history or allergy alerts.

I tried to explain that I had a medical allergy; was intolerant to Haldol; and suffer from a degenerative condition concentrated on around T2-T3 on my thoracic spine, with cord damage from T1-T6. Because of the way I was being “handled” I told them over and over again that my physical health could be placed in further jeopardy due to the way the were forcing me into submission.

They refused to listen to my pleas, and escalated the situation by forcefully grabbing items out of my hands: my cell phone, my medical records, my disability papers including my treatment preferences and medical crisis plan that was developed with Ms. Nikki Freisinger-Chambless, a former employee of the Mental Health Cooperative in Nashville, Tennessee. Since the Mental Health Cooperative also houses the Mobile Crisis Unit (Respond) for middle Tennessee, I thought that they would certainly have a copy on record. I was wrong. In fact, several hours before I went to the Emergency Room, I was taken to Mobile Crisis, and they could not locate a simple glass of orange juice or chapstick to soothe my dehydrated state. They placed me in handcuffs, and treated me as if I had never been there before.

The Mental Health Coop is the very last place I would ever want to be in a crisis, and I say that as someone who has received “treatment” there, and participated in staff training and policy forums to address the needs of the persons with emotional disorders, mental illness, or other brain disorders.

After leaving the Mental Health Coop, I quickly realized that the years I spent as a patient advocate was not going to help me

research community verbal and written requests were completely disregarded at intake, assessment, and completely ignored by security. With the exception of a night Nurse named Monica, the night staff was condescending, dismissive, and inconsistent with rules and regulations we were expected to abide by.

They acted as if I was requesting special treatment to call my family members, all of whom are located outside of Tennessee. They refused to allow me to call my family, primary care provider, or anyone who may be able to verify my medical history and locate my treatment history and crisis plan.

They forcibly pulled the phone out of my hands and grabbed my left arm, pushed me into the ground face against the floor and forcefully held my arms behind my back.

I was then placed into a room with no emergency buttons, intercom, bathroom, fire alarms and forcibly pushed into a plastic mattress in the corner;

I was then forced down face first into a mattress on the floor, held down by two men who used excessive force twisting my arms behind my back.

With my head still pushed into the plastic mat, arms behind me into my back, with the weight of their bodies pressing into my back; when one of the men began to pull down the black leggings I was wearing, removed my underwear, and injected me with an unknown substance.

One of the men returned a few minutes later to taunt me through the observation window.

The man who injected me refused to give me his name, an employee ID number, or tell me what kind of medication they used to keep me safe. He told me he was “self employed” and taunted me about through the observation window. He threatened me, and laughed when I told him that I hope he remembers my face the next time he looks his own daughter in the face.

He thought this was hysterical, made physical gestures towards me, and kept moving towards me despite my repeated requests that to stand two feet away from my body. He kept making rapid threatening movements towards me and removed his identification badge, from his uniform, and told me that unless I sit down he would be forced to restrain me using whatever means necessary.

I have been trained TAPS (Therapeutic Assault Prevention System) and was certified on October 15, 2004 through the Tennessee Department of Children’s Services. I can assure you that there was nothing “therapeutic” about the way I was treated.

I was placed on a 6044 hold (Two-Physician Commitment) under Title 33 of the Mental Health Hygiene Code, Title 33 of the Mental Health and Hygiene Code, involuntary from March 7 – March 13.

The medical personnel completely disregarded my medical wishes, and failed to recognize that any such plan had been developed shortly after I was hospitalized in New York City after the bombing of the World Trade Center.


It was my understanding that in filing such a plan, it becomes an official part of your medical record, but, again, I was wrong about that one too. The Declaration for Mental Health Treatment (DMHT) is a document I completed and updated annually through the State of Tennessee. I became quite familiar with that document since I have been both a consumer and a provider of mental health services in Tennessee.

I update it annually and have provided a link to that document below:

The DMHT is a comprehensive treatment plan that includes a crisis plan and allows consumers to take an active role in their treatment plan. The DMHT allows consumers to identify and plan for medical treatment, and identifies a medical proxy (decision maker) who can make appropriate medical decisions on their behalf in the event of a medical crisis.

The document helps the consumer identify symptoms and events leading up to a crisis; and is a helps consumers become more compliant and self-aware, active participants in their own recovery.

For any one out there who has ever felt on the verge of “losing it,” I would strongly encourage you to read this document even if only to become more self aware of your own mental well-being.

For those who wish to fill out the document, I would suggest that you do so in the presence of another person so that your wishes do not exist in a vacuum.

Much like a living will, the DMHT allows consumers to think about their own emotional health so they can monitor themselves before someone else does it for them.

Most of us are tend to know how to soothe ourselves, albeit through music, art, exercise, or even a nice cold drink or a hot bath.

No one solution works all of the time. However, given several options, it is easy to take responsibility for your own behaviors before you are locked up as I was last week.

By identifying treatment modalities that have worked well in the past; one can also identify those that have not and avoid treatments that may have caused adverse reactions or complications in the past.

The most important thing to consider is that people are not all cut from the same cloth. Just because one medication works well for one patient, we cannot assume that it will work well for all patients.

Many time-tested medications have been found to cause long-term t may cause another patient adverse reactions or life threatening events in others.

And just as one medication may work well for one person, the same is true of medical interventions procedures and interventions including but not limited to holistic medicine, meditation, and yes, even prayer.

DHMT form developed by

The Tennessee Department of Mental Health and Developmental Disabilities.
Tennessee Code Annotated Title 33, Chapter 6, Part 10.
TITLE 4 Chapter 3, Part 16 Creation of Department of Mental Health and Developmental Disabilities


I have cuts bruises and injuries that were not treated or evaluated medically during my stay, given multiple injections, and discharged without meds. They refused to acknowledge that I have an allergy / intolerance to Haldol.

I had a 4-day supply of Geodon, Klonopin that I paid out of pocket. Trazodone was covered. The Geodon cost $243.19 for an 18-day supply, so I could only get a 5-day supply with a manufacturer’s coupon they gave me when I left the hospital.

In addition, I have up to seven puncture wounds from multiple injections, multiple cuts and bruises and abrasions that were not medically treated or evaluated during my stay.

They are unable to locate the record for the second injection that I was given while unconscious face down on the plastic mat.

I am waiting for my Celexa to be approved at the pharmacy, since Effexor was not covered.

I have a primary care appt scheduled for Wednesday, and must file more appeals. I have no fax machine and I am running low on gasoline. I am writing this email from my cell phone that is rather inefficient at best.

Kindly take note of this complaint and I will follow up when I have better access to a computer.

In short, I need Geodon preauthorization, med transport to pharmacy and to a medical appt on Wednesday at 10am Effexor prior authorization, a copy of my medical records from the psych unit, and do not feel I should have to pay $2/pg for a copy.

I had to pay $54 in cash for parking, and this is all I can type for right now.

Thank you for your efforts to improve patient care and safety.

Sincerely yours,

Elyssa Durant
Cell: 6154248810
Sent via BlackBerry from T-Mobile


Author: Chilleh Penguin

A frisky penguin.

Leave a Reply

Please log in using one of these methods to post your comment: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s