Occupational Hazard: The Experience of a False Patient Accusation

Abstract

Living through the events described below has been a learning experience for me and will likely influence the way I practice child psychiatry throughout my career. I hope that, by my sharing my experience in this essay, others will learn something, as well. On a Wednesday afternoon, 4 months before I was scheduled to complete my child psychiatry fellowship, I was summoned to my supervisor’s office. He informed me that a 9-year-old patient of mine had made an allegation that I had touched him inappropriately and had taken a picture of him inappropriately during an appointment 1 month earlier. I was told that the patient’s mother “did not believe him,” but “thought she should tell somebody.” The hospital elected to do an internal investigation, which included a risk-management person meeting with me later that day. During this meeting I stated that although I routinely do take the patient’s blood pressure in the presence of his or her parents, I otherwise never touch any of my patients, nor do I photograph patients. I added that I was quite sure I had never met with this patient apart from his mother, since he regularly met with a therapist on an individual basis, and most of the interaction during our psychopharmacology clinic visits was between me and the patient’s mother. The risk-management person asked whether I was working alone on the day in question. I told her that I could not remember whether someone such as a medical student or visiting resident was present with me that day and added that unfortunately I, like many others, did not routinely document their presence. She pointed out to me that I was finding myself in a situation that is “an occupational hazard” for anyone who works with children. I was told to continue with my clinical duties while the internal investigation was being conducted and did so dutifully the next day, with a renewed respect for defensive medicine. On Thursday evening, it dawned on me that, a few weeks earlier, a pediatric resident had “shadowed” me in my psychopharmacology clinic. Could this have been the same day that the misconduct allegedly took place? I certainly hoped so. On Friday morning, I decided to do some investigating on my own. I made some phone calls and was able to confirm that I indeed had a resident shadowing me on the day in question. I relayed my discovery to those involved in the internal investigation and was told that “things were looking good.” I breathed a sigh of relief. What had blindsided me less than 48 hours earlier appeared to be going away about as quickly as it had arrived. So I was doubly surprised when, several minutes later, the risk-manager called and said, “Oh my God, I just received a call informing me that the sheriffs are on the way to the hospital to arrest you. Do not go anywhere; I’ll be right over.” Moments later, I was being discreetly escorted down the freight elevator by hospital security staff. We met an unmarked sheriff’s car at the loading dock, where they proceeded to pat me down, put me in handcuffs, and take me to the station for questioning. I was placed in a secure room after having my belt and shoelaces safely removed, and I was then read my “Miranda rights.” They proceeded to try to question me, but I elected to follow the advice the risk-manager had given me shortly before I was handcuffed, and refused to answer any questions until I could speak to an attorney. After sitting in the secure room alone for about an hour (by far the worst part of the day) I was informed that the decision had been made to “book and release” me with orders to return for a “charging date” about 31⁄2 weeks later. The charge in question: first-degree sexual assault of a child—a felony. It turns out that “book-and-release” is a process that can take between 3 and 9 hours, involving a Received August 19, 2010; revised November 16, 2010; accepted November 30, 2010. The author’s contact information has been withheld because of the sensitive nature of the article contents. Any comments may be directed to the editors, at acadpsych@gmail.com. Copyright © 2011 Academic Psychiatry