TEASER: LAXMAN PATEL IS NOW THE CHIEF MEDICAL OFFICER AT THE ARIZONA STATE HOSPITAL.
Wherein, a quick glance at a Phoenix newspaper article from 2004 illustrates the undeniable fact that the substandard conditions and related unlawful clinical practices currently in effect at The Arizona State Hospital are anything but unusual. The fact is, ASH and it's associate senior clinicians, including current Chief Medical Officer Laxman P. Patel, have a clear history of graphic misconduct that cuts to the quick in terms of established human rights in this context, but for some reason, the situation has effectively remained unchanged, and the clinicians who were centrally involved in exposed wrongdoing at ASH are still up to their evil ways. As follows.

Friday, August 6th, 2004

New state hospital fails to win feds' approval.
The Arizona Republic

Surprise review at facility for the mentally ill finds patients handcuffed, kept in seclusion for hours.   (full article further below)

General THE NEED TO MAINTAIN A VIGILANT STANCE SPECIFIC TO THE SUBSTANDARD MENTAL-MEDICAL HEALTH CARE AND PRACTICES AT THE ARIZONA STATE HOSPITAL IS VERY REAL, AND THIS INCLUDES TAKING AN OCCASIONAL LOOK BACKWARDS IN ORDER TO GAIN A BETTER UNDERSTANDING OF THE SITUATION. THE FACT IS, ASH HAS AND POTENTIALLY WILL CONTINUE TO OPERATE WELL OUTSIDE OF ESTABLISHED HEALTH CARE STANDARDS IF UNPARALLELED ACTION DOES NOT OCCUR WITH THE SPECIFIC INTENT OF ESTABLISHING PERMANENT OVERSIGHT AND UNAVOIDABLE ACCOUNTABILITY. IN THE RECENT PAST, THE ADMINISTRATORS AND SENIOR CLINICIANS AT ASH HAVE BEEN FOUND TO BE IN RADICAL VIOLATION OF STATE AND FEDERAL LAW, WITH FAIRLY RIGOROUS RESULTS IN TERMS OF DISCIPLINARY ACTION. BUT IN SPITE OF THE SEVERITY OF GRAPHICALLY INHUMANE ISSUES REVEALED IN THE RECENT PAST, INCLUDING HIGHLY ABUSIVE PHYSICAL PRACTICES AND RELATED CLINICAL NEGLIGENCE TO THE Nth DEGREE, THE RECORD INDICATES NO FORMAL CONSEQUENCES IN TERMS OF LEGAL ACTION DIRECTLY TAKEN AGAINST THE ONES MOST RESPONSIBLE FOR IT ALL. THE SENIOR CLINICIANS, THAT IS, WHO ARE REQUIRED TO DILIGENTLY MAINTAIN FULL AWARENESS OF ALL/ANY DETAILS SPECIFIC TO PATIENT CARE AT ASH. THUS, THE RECORD AS IT STANDS TODAY ALSO SHOWS IT IS SIMPLY NOT ENOUGH FOR US TO RELY ON OCCASIONAL ACTS OF ARGUABLY INEFFECTIVE DISCIPLINE, AS ILLUSTRATED IN THE FOLLOWING 2004 ARTICLE, BECAUSE THE REAL PROBLEMS RESIDES IN THE BLACKHEARTED CHARACTER(S) OF INDIVIDUALS LIKE LAXMAN P. PATEL, WHO IS NOW THE TOP DOG AT ASH, A FACT THAT SHOCKS THE CONSCIENCE OF ANYONE REASONABLY FAMILIAR WITH THE ONGOING CRISIS AT ASH. SO LONG AS THE STATE OF ARIZONA IS UNWILLING TO REMOVE SUCH INDIVIDUALS FROM THE PUBLIC HEALTH CARE SYSTEM THAT WE THE CITIZENS FUND WITH OUR TAXES, WE THE PEOPLE NEED TO EXERCISE OUR RIGHT TO TAKE ACTION. NOW.

Laxman P. Patel was already high in the food chain in terms of the clinical hierarchy at The Arizona State Hospital by the turn of the century; he had worked at ASH, in fact, for some 20 odd years by that time. Therein, following an intensive 2000-2004 investigation that was conducted by inspectors from the federal Medicare program, a host of highly inhumane conditions and related practices at ASH were clearly revealed, which consequently led to what I can only describe, today, as a virtual slap on the wrist. Patel was there before these matters were revealed, Patel was there during the period of "discipline" specific to them, and Patel remained there- high on the food chain at ASH- after it all settled down; and today, as we know, Patel is the very doctor with the highest authority at ASH. This is beyond unacceptable. It is horrific, and seemingly unimaginable in these times, and yet here it is, right in front of us. Because one can safely presume beyond all doubt that Patel was very, very aware of the details specific to those revelations at that time, and as such, was been in a profoundly great position in his own right to step forward and do the right thing, without needing to be redirected and brought into alignment with the established health care standards. Patel has, in fact, been in that position for three decades. Patel is a licensed physician currently practicing medicine in the United States of America, and as such, Patel is bound by professional codes of conduct that demand him to diligently take action in defense of the care needs and related rights of his patients, codes that flow outward from the Hippocratic Oath itself. Patel had and has no excuse. 

    But did he? Did Dr. Laxman P. Patel diligently take action to serve his patients to the fullest of his given ability as a doctor? No. He did not. And what reason is there for anyone to presume that this man's character is such that he will act any differently today? None. He and his associates were willfully turning blind eye to the conditions that were exposed between 2000-2004, and once those revelations were established, Patel and company budged only so far as they needed to in order comply with directives that were derived of commonly recognized terms of decency. In other words, short of formal baby sitting, the doctors at ASH are incapable of recognizing such commonly recognized terms decency. They are incompetent, unethical, and due the full accountability that any other American is subject to in terms of justice.

  New state hospital fails to win feds' approval.

Friday, August 6th, 2004

The Arizona Republic

Surprise review at facility for the mentally ill finds patients handcuffed, kept in seclusion for hours.

The Arizona Republic

PHOENIX – The new Arizona State Hospital faces federal penalties if it doesn’t correct problems found during a surprise review that painted a grim picture of some patients not getting psychiatric care, being handcuffed inappropriately and being secluded for hours unnecessarily.

Federal officials have already rejected one state proposal for improvements at the hospital, which treats the state’s most seriously mentally ill. Another should be filed today. If the second plan is not approved, the hospital could lose its Medicare certification and as much as $2.7 million in federal payments. Federal officials could also pull $28 million in funding for Arizona hospitals that serve a large number of poor patients.

The findings come six years after a disastrous federal review that revealed dirty and dangerous conditions for patients. That hospital was decertified for two years. Two years ago the state opened the new $80 million hospital for the very patients that now concern inspectors. State officials had said the new facility was key to improving care. Inspectors with the Centers for Medicare & Medicaid Services reviewed 12 patient cases during a May visit to the State Hospital, at 24th and Van Buren streets. They found a hospital where patients were plunked in front of televisions or allowed to wander instead of being engaged in treatment.

The review found:

• Patients have cookie-cutter, incomplete or ineffective treatment plans. One patient who had been at the hospital four months told them he couldn’t remember any treatment other than “going to the library once,” “movies and popcorn” and “medicine.” A nurse told investigators he couldn’t leave his unit to attend activities because of his assaultive behavior and instead gets one-on-one time with staff and extra medications when needed.

• Patients are handcuffed at the hospital, which violates federal standards. Top hospital officials told inspectors that nurses ordered security staff to use handcuffs during emergencies.

• Patients are put into seclusion for hours. A female patient was secluded at 3:35 a.m. She was supposed to be released “when calm and cooperative,” and by 5 a.m. she was “crying, apologizing for wrongdoings.” Follow-up checks on her showed no reason for her to remain in isolation, but the staff didn’t release her until 6:20 a.m. Inspectors noted a hospital policy requiring such seclusion to end once a patient regains control and is no longer a danger.

Jack Silver, the hospital’s chief executive officer, said there were several reasons reviewers found the problems, but overall, “I think things are going good. We treat people, and there’s always improvements that can be made, and we’re looking to make improvements,” he said.

Inspectors noted that some patients didn’t take part in treatment and observed them wandering around; they didn’t see staff members following up with patients. One staff member said, “Once I let them out their door, they are on their own. I do not do the 30-minute rounds to check on the patient’s location and activity out on the mall or in the rehab groups.”

Silver said, “We need to obviously think more creatively about how to motivate people.”

He said the hospital must strike a balance between “personal choice and responsibility for treatment.”

The hospital changed some of its policies to comply with federal standards. Silver said the hospital stopped using handcuffs after inspectors left. He said he didn’t know about standards that bar the practice.

He said the hospital also wasn’t following federal standards that dictate how long a patient stays in seclusion; it is now in compliance. Finally, the hospital didn’t consider a brief “personal hold,” such as putting an arm around a patient, a formal restraint. It now requires a doctor’s order for such holds and documents them as restraints.

Lawmakers said they were surprised by the results of the federal review.

Lawmakers approved the new hospital in 2000 after the old hospital was decertified. That had threatened federal funding in 1998 because a federal review found assaults, filth, overcrowding and patients getting the wrong medications.

Rep. John Huppenthal, R-Chandler, said legislators realized it would take more than a new building to treat the people who are committed there. “It comes down to operating the hospital, which is a difficult challenge considering you have the sickest of the sick there,” he said.

About half of the hospital’s 300 patients are under court-ordered treatment because they are a danger to themselves or others. The other half are criminals under court-ordered hospitalization rather than imprisonment.
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AGAIN, THIS ARTICLE IS A TEASER OF SORTS, INTENDED TO SERVE AS A QUICK READ THAT CAN READILY ILLUMINATE THE ENDEMIC SHORTFALLS AND RELATED SUBSTANDARD HEALTH CARE PRACTICES AT THE ARIZONA STATE HOSPITAL, CONDITIONS WHICH ARE WILLFULLY CONDONED BY THE STATE OF ARIZONA'S HIGHEST AUTHORITIES, INCLUDING BUT NOT LIMITED TO THE EXECUTIVE DIRECTOR OF THE ARIZONA HEALTH DEPARTMENT', WILL HUMBLE, AND MYRIAD STATE EMPLOYEES WITH THE AZ DIVISION OF BEHAVIORAL HEALTH SERVICES WHOM FUNCTION  UNDER HIS SPECIFIC AUTHORITY. THESE PEOPLE ARE FLAGRANTLY BREACHING THE PUBLIC TRUST, AND THEY MUST BE HELD FULLY ACCOUNTABLE UNDER DIRECTLY APPLICABLE PROVISIONS OF LAW AND POLICY. THE BASIS OF THAT ACCOUNTABILITY MUST RADIATE UPWARDS FROM THE EXPERIENTIAL KNOWLEDGE BASE ACCRUED AT THE PATIENT-CLIENT LEVEL, FOR THE PATIENTS ARE THE ONES MOST FAMILIAR WITH THE FACTUAL REALITIES RELATING TO THESE MATTERS; UPWARDS AND OUTWARDS AND DIRECTLY INTO THE OFFICE(S) OF WILL HUMBLE, CORY NELSON, DONNA NORIEGA, STEVEN DINGLE, AND LAXMAN. P. PATEL, FOR THEY ARE THE ONE'S MOST CULPABLY RESPONSIBLE FOR THE UNABATED STATE OF CRISIS AT ASH, AND THEY KNOW IT. UNTIL THAT HAPPENS, BAND-AID APPLICATIONS SUCH AS THOSE ILLUSTRATED IN THE ABOVE 2004 NEWSPAPER ARTICLE WILL SIMPLY NOT SUFFICE IN TERMS OF MEANINGFULLY SERVING THE CURRENT NEEDS OF ASH'S PATIENT COMMUNITY. BOTTOM LINE. ONLY DIRECT PUBLIC OVERSIGHT FASHIONED IN A SUCH WAY THAT IT RESEMBLES OUTRIGHT BABYSITTING WILL SUFFICE, BECAUSE IF THESE SORTS OF MISCREANTS ARE TO BE CONTINUALLY GRANTED THE PRIVILEGE OF CARING FOR ARIZONA'S MOST SERIOUSLY MENTALLY ILL AND DISABLED CITIZENS, HISTORY HAS ALREADY SERVED TO PROVE THAT THEY CANNOT BE TRUSTED OTHERWISE. 

Did Dr. Laxman P. Patel dutifully serve his patients to the fullest of his given ability as a doctor in the 1980, 1990s, or during my thirteen full months at The Arizona State Hospital (2011). No. He did not. What reason is there for anyone to presume that this man's character and related competence as a doctor are any different today? None.  And as illustrated by the above news article from 2004, Patel his associate miscreants were willfully turning a blind eye to the conditions that were exposed in relation to those revelations. In fact, at that time, Patel and company budged only so far as they needed to in order comply with directives that were derived of commonly recognized terms of decency. Which obviously implies that short of formal baby sitting, the doctors at ASH are incapable of maintaining themselves in accordance such commonly recognized terms of decency. I attest to the fact that, in my experience, the passing of time since those specific revelations arose has only led to these rat bastards slipping backwards again and into the abysmal roots of their earlier behavior. Vermin will do that, you know. Where any reasonably managed hospital would learn and evolve in relation to such processes, ASH is a public mental hospital, and such growth is beyond the character and capabilities of ASH's administrators, including officials in the state's department of health. It really is that bad. 

There is no explanation for how and why a man like this would today be entrusted with overseeing the clinical affairs of The Arizona State Hospital. No explanation, that is, behind the fact that we are talking about the Arizona Department of Health Services and one of its affiliate facilities. Substandard medical-mental health care, and they are still getting away with it.  

       HISTORY HAS SHOWN US TIME AND TIME AGAIN 

THAT THESE PEOPLE 

CANNOT BE TRUSTED. 

LET'S GET TO THE BOTTOM OF THIS, AND LET'S DO IT TODAY. THE PATIENTS AT ASH ARE SERIOUSLY MENTALLY ILL AND DISABLED, AND AS SUCH, HIGHLY VULNERABLE TO WHATEVER DEGREE OF INEPTITUDE PEOPLE LIKE PATEL ARE CAPABLE OF. AND AS WE NOW KNOW, THAT VERY INEPTITUDE EXTENDS WELL BACK INTO THE LAST CENTURY, AND IS STILL BEING IMPARTED ON THE PATIENTS AT ASH ON A DAY TO DAY BASIS. 

BOTTOM LINE: THE CITIZENS OF ARIZONA DESERVE BETTER.

paoloreed@gmail.com