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Default Nov 20, 2021 at 06:09 AM
  #21
It seems like a patient advocate could help you at least delete incorrect information about a boyfriend beating you up. Any incorrect information that is about another patient should be deleted from your medical records.
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Default Nov 26, 2021 at 03:39 PM
  #22
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Originally Posted by zapatoes View Post
It seems like a patient advocate could help you at least delete incorrect information about a boyfriend beating you up. Any incorrect information that is about another patient should be deleted from your medical records.


Some of the comments are so ridiculous. There was another one about me being assaulted at a bar during a weekend pass and getting drunk. What the ****?????? I never did that.

Apparently the hospital records department submits a patient's correction request to the head of department they received care from, if their attending physician no longer works at the hospital. This individual can make the requested changes.

I plan to contact the hospital's family and patient advocacy office after I am done reviewing my records and submitting my correction request.

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Default Nov 26, 2021 at 03:55 PM
  #23
I'll never seek psychiatric care at any of the local hospitals again. Not after reading my records that are filled with examples of misdiagnosis, systemic racism and cognitive bias.

This is what you get in Canada's capital city. Healthcare is terrible here unless you have cancer or some other critical illness.

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Default Feb 12, 2022 at 04:57 PM
  #24
The hospital copied my entire chart. Last night I picked up the records and sorted through them until the early hours.

I now know I had some kind of psychiatric drug toxicity that made me quite ill at the age of 18. The emergency department had no idea what it was, so diagnosed it as anticholingeric toxicity, because I was dehydrated and had dilated pupils. They treated the possible OD with 50 g of charcoal with sorbitol and admitted me to the psych service.

Whatever happened affected my ability to form memories. It also caused erratic and bizarre behavior, with periods of confusion. A nurse wrote that I was a "poor historian". Others also noted they couldn't get an accurate history. -- I have no recollection of this hospitalization, besides standing in a strange hallway and trying to leave.

How did I get there? Apparently I fainted in a public place and someone called an ambulance.

I wasn't suicidal.

I discussed this incident previously with my psychiatrist who felt it was probably serotonin toxicity. Another possibility is a drug interaction. At the time I was 5 different medications three at very high doses. It does seem to fit and could explain why it took weeks to recover from. After this happened the medications were slowly discontinued on the order of the outpatient psychiatrist, who noted a change in my alertness about 6 weeks later.

For years I believed it was a brief psychosis. The records don't support that diagnosis at all. The most responsible diagnosis would be delirium.

This is a consequence of polypharmacy due to a prescribing cascade.

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Default Feb 12, 2022 at 05:34 PM
  #25
My presentation was mostly medication side effects. The signs and symptoms of mental illness that I displayed appear to be iatrogenic rather than genuine psychopathology and the malingering I was accused of.

Apparently I had a dissociative disorder. That disappeared after I stopped all pills in fall 1998. Clonazepam and lorazepam were the main offenders. The sedating properties of the antipsychotic Loxapine also contributed. It put me in a perpetual state that resembled the transition from wakefulness to stage 1 sleep. I hallucinate before I fall asleep on most nights. It's normal for me. I've always been like that. That got misdiagnosed as micropsychosis, another point to confirm the BPD diagnosis.

A lot of my bad behavior was a combination of desperation to be heard and the disinhibition caused by medication, especially SSRIs and anxiolytics.

I have to point out an interesting pattern. Almost all my admissions (suicidal ideation) were caused by either initiating SSRI treatment, adjusting the dose or abrupt discontinuation.

This is cognitive bias at it's finest.




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Default Feb 12, 2022 at 05:37 PM
  #26
The Dx List:
Complex PTSD
PTSD
Bipolar Affective Disorder II
Cyclothymia
Adjustment Disorder
BPD
Depression NOS
Schizoaffective Disorder
Psychotic Disorder NOS
Possible Anxiety Disorder
R/O Panic Disorder
Polysubstance Abuse
Anorexia Nervosa, restricting type
Dysthymia
(I think I got them all)



This list suggests something was very wrong with my care.

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Default Feb 12, 2022 at 05:43 PM
  #27
My traumatizing ordeal is not the fault of one person but the way the service is structured along with a lack of critical thinking, patient advocation, and thorough assessment. My story is an example of iatrogenic harm and florid cognitive bias perpetuated by nearly all clinicians who interacted with me.

Did this really have to happen? Was it necessary? Could it have been prevented?





--- I was lucky unlike a lot of people. I didn't die due to medical error.

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Default Feb 12, 2022 at 06:20 PM
  #28
This is the last entry in the case chronology that severed the ties with the 4North OPD clinic:

The nameless clinician wrote on November 29, 1999:

I left a message for Didgee to change the day of her appointment. She called back and said that she wanted to talk if I could spend some time on the phone with her. – She said it had nothing to do with me, she really appreciates the help she received from me but has to leave the system, it will be better for her. She feels that having a psychiatric diagnosis penalized her in life in general, maintains she was misdiagnosed and wants the diagnosis removed from her file, etc. She apparently is having problems; went to ER where she felt she wasn’t treated right because of her diagnosis.

She wished me a good Christmas. Because she decided it was better for her to be out of the “system”. She has been trying to do things to help herself the best she could. She feels that the diagnosis will stop her from doing what she wants in life. i.e. choosing a career etc.


----


I wasted 5 years of my life. My 20s were nearly wasted due to crippling psychiatric trauma. I became a recluse and avoided doctors as much as possible. I was profoundly affected by this experience.

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Default May 14, 2022 at 02:16 PM
  #29
Last week I sent an email to the health records department at the General. In the email I didn't hold back my feelings. Somehow I was able to remain pleasant and respectful even though I was irate. A supervisor replied and answered most of my questions and offered two solutions to correct the racist and stereotyped notes in some of the discharge summaries that are available on Epic.

Here in Ontario a doctor is required to keep records for 10 years after they close their practice. Hospitals don't appear to have a time limit. The supervisor wasn't able to tell me how long the hospital is required to keep records. He did tell me that destruction was possible for my paper records from 1996 to 1999. He promised me he would not scan and upload them to Epic if he can authorize their destruction.

Wow if the records could be destroyed that would help me recover from the trauma caused by 4North and the Emergency Department..... but can I trust them?

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Default May 14, 2022 at 02:31 PM
  #30
I'm after one more thing; the diagnoses on the encounters list in Epic that any clinician can see if I authorize them to "Break the Glass" or access my records. They are only listed for emergency department visits. I want them removed since I have a privacy directive.

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Default Jul 03, 2022 at 05:40 PM
  #31
I sent an email to TOH's Patient Advocacy service. This is an excerpt.

This is an old story just before The Ottawa Hospital came into existence. It’s a story that takes place at the Civic and the General.

The hospital is a dangerous place behind its facade. Iatrogenic harm seeps out of its foundation and into its walls. It’s everywhere waiting to strike an unsuspecting patient via the staff who unknowingly transmit the pathogen. A patient gets infected in many ways such as procedures, IVs, medication errors, and misdiagnosis. Some die, others are temporarily affected and a large portion suffer for years at the hands of their treatment team, the ones who are supposed to heal them.

Imagine being an 18 year old female with undiagnosed autism spectrum disorder and a moderate to severe anxiety disorder that is not recognized by anyone, who has passed through the threshold of the General’s emergency department entrance. It’s her entry into hell. All the on-call psychiatrists see is the adverse reaction to a SSRI that she started 10 days previously. It suddenly caused suicidal ideation and impulsivity. The rigid and obsessive thinking and a delay in social development along with the SSRI reaction make it appear that the patient has a personality disorder, specifically Borderline – a diagnosis that is known to ostracize people and deny them treatment. After one clinician labels the patient it sticks. After that most cannot see past it and the patient is condemned.

A few months later polypharmacy is ravaging her body. She can hardly eat, is drowsy due to all the pills, is profoundly disinhibited, is hallucinating like she’s stuck in perpetual stage one sleep, is confused and disoriented, and has trouble forming memories. She is missing time and is a poor historian. Apparently she fabricated the whole entire incident. Dr. (name withheld) wrote in his discharge summary: In Emergency, it seemed that her behavior was kind of weird and there was possibly some mild disorientation at times that readily disappeared when she was proposed hospitalization and the patient and the doctor finally agreed on 1-3 day admission. – A resident noted it was either the 5mg of Haldol that they gave her or the offer of hospitalization that stopped the bizarre behaviour.

A week later she ended up at the Civic Hospital and has no recollection of it. There like at the General, her bizarre behaviour was noticed. Possible anticholinergic syndrome? Her symptoms seem to resemble it. Dilated pupils, confusion, low glucose, tremor, visual hallucinations, elevated anion gap, dehydration and a bunch of abnormal ECGs were not enough to make the psychiatry resident question his diagnosis and harsh judgement of her. Dr. (name withheld) wrote: pt states having auditory command suicidal ideation, but we are very uncertain about the authenticity of those voices. His notes are filled with opinion rather than observation. Even Dr. (name withheld) thought she was malingering.

She has no recollection of any of this. How could she have been faking? Friend and neighbours noticed her bizarre behaviour and at times incoherent speech. Even a security guard at a government office on Booth Street and Carling Avenue did when she tried to enter the building in her dishevelled and confused state.

No, she wasn't faking it. She was delirious and no one saw it except for the emergency physicians who failed to question the psychiatrists. They went along with the BPD diagnosis and interpreted the behavior as manipulative to gain hospitalization.



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Last edited by The_little_didgee; Jul 03, 2022 at 08:24 PM..
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Default Jul 03, 2022 at 06:05 PM
  #32
This is the pharmacy she was taking and without question during that time:

Perphenazine 2 mg t.i.d. and 8 mg h.s.
Prozac 60 mg q.a.m.
Trazadone 150 mg h.s.
Cogentin 2 mg b.i.d. p.r.n

This is a lot for a 100 lb small framed lady. Why was she on this? It all started with Paxil. Side effects were misinterpreted as symptoms of BPD.

The prescribing cascade, misdiagnosis and cognitive biases contributed to iatrogenic harm.

Some individuals are vulnerable to medication side effects. It's probably genetic and has to do with how they are metabolized by the body.

If hallucinations, impulsivity, and suicidal ideation manifest themselves shortly after a medication is started, it is most likely due to that.

I had psychosis in my mid twenties that developed spontaneously. It was very different than the hallucinations I experienced from medication and delirium.

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Default Jul 03, 2022 at 07:27 PM
  #33
I had delirium. There is no doubt. It fits my experience and what people observed when they saw me in that state.

This info is from The Mayo Clinic:

Signs and symptoms of delirium usually begin over a few hours or a few days. They often fluctuate throughout the day, and there may be periods of no symptoms. Symptoms tend to be worse during the night when it's dark and things look less familiar.

It was sudden and started with the inability to form memories. I vaguely remember walking to a house to watch a sporting event. I don't remember the afternoon.

I stayed at a friend's house that night and tried to leave in the middle of the night in a confused state. Apparently I couldn't dress myself. After that day my memories are fragmented. Lots of time is missing, which is something I never ever experienced before. Weeks of my life are missing.

My behaviour became very bizarre. People who knew me believed I was acutely ill with some unknown illness. The doctors refused to consider that I had a genuine illness. I did things so out of character, but because I was misdiagnosed they blamed it on BPD and didn't treat me. They actually suspected and accused me of abusing drugs because my symptoms were puzzling. I couldn't even give a reliable history, something they recognized but didn't bother to obtain from other sources.

They misinterpreted everything.

Some of the delirium symptoms made me appear spaced out. So I was accused of dissociating which they said was due to my history of abuse. That was false.

My records suggest that I had mixed delirium. Hospital staff noted the disorientation and irritability. I became very uncooperative at times and even signed out AMA from the Civic's psych unit. I have no memory of this.

Types of delirium:

  • Hyperactive delirium. Probably the most easily recognized type, this may include restlessness (for example, pacing), agitation, rapid mood changes or hallucinations, and refusal to cooperate with care.
  • Hypoactive delirium. This may include inactivity or reduced motor activity, sluggishness, abnormal drowsiness, or seeming to be in a daze.
  • Mixed delirium. This includes both hyperactive and hypoactive signs and symptoms. The person may quickly switch back and forth from hyperactive to hypoactive states.
What is really interesting about delirium is there can be periods of normalcy. My records reveal this.

May and June of 1996 are a blur. Things started to improve in July when my then new psychiatrist took me off almost all the medications.

I wish someone could have recognized what was really going on. The emergency doctors at both hospitals were puzzled but didn't bother to pursue it after the psychiatrists told them it was due to BPD even though there was plenty of physical evidence to contradict that diagnosis. So many of the notes contain question marks and wonder about what is going on. No one bothered. Apparently I wasn't worth the effort.

Stopping all the medication was what I needed.

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Last edited by The_little_didgee; Jul 03, 2022 at 07:44 PM..
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Default Jul 03, 2022 at 07:57 PM
  #34
On May 5th, 1996 an incident happened that haunts me to this day. It was very out of character. Now I understand why it happened. It was beyond my control. My judgement was impaired. Unfortunately it wasn't recognized at the time.

This incident occurred at the General's emergency department. I exploded and while trying to flee, I was accused of assaulting a nurse. They called an orderly code, put me in 6 point restraints and gave me an injection of CPZ. An Ottawa Police officer came and interviewed me and decided not to charge me. I never ever tried to assault a nurse when I tried to flee. I just wanted to leave.

I got a precaution code tagged on my chart for that incident.

This incident always bothered me. I'm not the type to hurt people. Now I know that I was not in a coherent state of mind and had impaired judgement. I can finally forgive myself.

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Default Jul 03, 2022 at 09:03 PM
  #35
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Originally Posted by SlumberKitty View Post
Thank you for this thread @The_little_didgee There are things in my hospital records that are wrong. Namely that I was suicidal when I wasn't which led to me being 5150'ed (or kept for 72 hours involuntarily and then switched to voluntary which I didn't want to sign but it was better than being involuntary so I signed it). One of my T's said I could go and correct the hospital records but it's at two hospitals and it seems overwhelming. I don't even know where to start. I don't know what else is wrong that is in them but that is what I know for sure is wrong. I did write a letter of compliant to the hospital but I don't think it did any good. I'm scared of going to the hospital to this day though. I'm sorry you went through these experiences. HUGS Kit
There are a lot of examples of misinterpretation in my records. It appears to be common.

I was accused of being suicidal on May 17th 1996 while at the Civic even though I wasn't. A fainting spell sent me there. That only surfaced after they spoke to a psychiatrist from the General. Questioning me probably contributed. At the time I was in a bad state of delirium that they failed to recognize. Many different staff members noticed and mentioned that they were unable to get a history due to my mental state and that info I provided was questionable.

Reading records is worth it but you have to be prepared. There is a lot written in them that is not communicated to the patient. E.g., apparent malingering. No one ever discussed that with me.

Having a clinician assist you will be very helpful. That person can explain the notes. My psychiatrist helped me with this.

I have noticed that really good clinicians will wrote comprehensive notes, and leave out personal opinion or character attacks. If a note is consistent with an encounter that highly suggests the clinician is somewhat honest and interested. A good clinician will show their notes to a patient when asked.

Reading my records made me realize that not all doctors can be trusted. Ones who lack self-awareness and the inability to reflect are dangerous.

Everyone should read their records.






P.S. Here in Ontario a Form 1 is equivalent to a 5150.

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Default Jul 07, 2022 at 12:24 AM
  #36
They replied:


Dear Didgee,

Thank you for contacting the Department of Patient Relations at The Ottawa Hospital to share your experience and provide constructive feedback on how we can improve patient services. I am very sorry to hear of your medical experiences. I would like to assure you that your email will be forwarded to the appropriate departmental stakeholders for review and consideration, so that they may learn from your feedback.

Thank you again for taking the time to share your experience with us.





I wonder if they will do it? Will it get lost? This hospital is really bad a communicating. It gives the impression the patient doesn't matter.

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Default Jul 14, 2022 at 11:11 AM
  #37
They sent an email to notify me that my paper chart will be will be destroyed within the next 24 months. They also told me they would not scan and upload it to Epic.

The amount of data this hospital collects and retains is incredible. If I had known this I would never have used their services. There is really nothing confidential about it at all.





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Default Nov 26, 2022 at 02:33 PM
  #38
Yesterday I met with an advocate from an Indigenous organization to discuss my traumatic dealings with the General Hospital. The psych service now called Mental Health diagnosed me based on the side effects of medications and misdiagnosed delirium due to polypharmacy because certain staff psychiatrists didn't recognize their cognitive biases and stereotyping. Note that it was easier to destroy me than try to figure out what was going on.

I laughed when the lady asked me what floor I was on. When I blurted out 4 North, she knew exactly what I was in the hospital for before I even told her.

The plan is to write the corrections request letter for all my discharge summaries first. There is a lot of inaccurate information contained in these documents. They wrote my father was an an alcoholic who sexually and physically abused me. He did not.

We also discussed the possibility of contacting a lawyer. I'm not interested in suing for malpractice at this point even though I may have a case for the drug induced delirium I had. I also told her I want to submit a complaint to the Ontario Privacy Commissioner's office about the hospital's encounters list on EPIC and OACIS. Some visits list psychiatric diagnoses entered by emergency medicine physicians without me seeing the psych service which was usually a resident.

I have a consent directive on my records that is supposed to protect me and my privacy. It is useless with the encounters list because it contains psych diagnoses made by emergency physicians. -- This list was used by a nurse to gather information and a misdiagnosis since nothing else was available to him.

For the curious: Consent Directives - The Ottawa Hospital

Something positive in going to come out of this. I can feel it. I'm not the only Indigenous person mistreated by this hospital. There are a lot of us. We are going to bring it to their attention.

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Default Nov 26, 2022 at 02:44 PM
  #39
This is what I want:

The opportunity to lecture medical students and residents on cognitive bias and it's consequences.

All the psychiatric diagnoses wiped off the encounters list.

My discharge summaries corrected. E.g., the reference of my Cree father being an alcoholic and abuser.

An apology and a letter stating what happened uploaded to my mental health section of my record.

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Default Jan 07, 2023 at 05:10 AM
  #40
"I was sorry to read of your experience with systemic racism within our organization, and we would be happy to assist in reviewing and removing any such documentation contained within your records."

Really?

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