An 80-year-old woman was found dead after carrying patients

When a woman in her 80s does not attend the health centre, the staff raise the alarm. More than twelve hours later, she was found dead.

It was minus five degrees and a light wind on the afternoon of December 7 when an elderly woman was taken from Diakonjemmet Hospital to the Lilliborg Health Center in Oslo.

She has white hair. The last time anyone saw her, she was wearing a dark brown puffer jacket and dark pants. According to the police search warrant, he was carrying two bags.

A request from the hospital to Pasiontreiser said the woman needed help with transportation. According to the notice seen by Viji, she is energetic and physically fit. She is also mentally retarded, according to the police search warrant.

The staff of the hospital help her to take a taxi. At 5.20pm, the nurse on duty at Diakonjemmet calls the Lillebourg Health Center and says the patient is on her way.

It is said that the health center responded to the notice saying, ‘The notice has come, we will accept the patient’.

Leaving the woman alone

According to Google Maps, a taxi ride from the west edge of Oslo to the east edge takes about twenty minutes.

The driver told Diaconjemmet that he was following the patient to the ward at the Lillebourg Health Centre. But when he can’t find any staff, he says he leaves the woman alone, according to the notice.

At 19.24 the health center calls the patient. They themselves inform VG about this.

Deacon Home replies that the girl has already been sent to them. An immediate search was launched – but the woman was nowhere to be found in the building. He did not answer his mobile phone, the notice said.

Police were called at 20.54. The search will start at 21.08. Police are looking around the woman’s home and former workplace. They are assisted by Norwegian rescue dogs and a helicopter.

The girl was found dead the next morning.

According to Yr, the temperature dropped to minus nine degrees that night.

Patient journeys at Oslo University Hospital (OUS) account for more than 900,000 operations per year. VG reports that this is the first transport-related death of their patients since 2014.

– An incident has occurred with a tragic outcome. We are very sorry, Veslemoy Karmark, Head of Department at Diakonjemmet Hospital, tells VG.

The Norwegian Health Authority has announced

The hospital has notified the Norwegian Health Authority about the case, which is being investigated by the state administrator in Oslo and Vigen. Oslo police have also launched an investigation into the death.

Diagonjemmet ordered a taxi for the woman. The hospital says it followed its own guidelines for patient transport in this case.

They mentioned that the patient should be assisted to get to and from the taxi.

– At the time in question, we considered that the transporter had enough information to handle the entire transfer in a responsible manner, Diakonjemmet Mette Karevol, clinic manager, tells VG.

In the patient travel form, there is a free text field that informs the driver whether the patient should be fully accompanied or cannot be left alone.

– In this case there is nothing about it, patient journey OUS department manager Egil Johannessen informs VG.

It only said to accompany her in the taxi.

He emphasizes that the person ordering the patient’s transport bears responsibility for ensuring the pacemaker receives adequate information.

– I have been working in the healthcare setting for over 30 years and have experienced many times that I did not immediately realize that a patient I did not know was depressed. How can a taxi driver with no professional background know for himself if those educated in the area miss out?

He waited for half an hour

Johannesen emphasizes that drivers should not have the patient’s diagnosis, but should have enough information to understand the patient’s needs. As if they could not give themselves up.

– Many taxi drivers come from cultures where respect for the elderly is high. If patients say they don’t want to be followed all the way and manage themselves, the driver will comply with their wishes unless told otherwise.

– But how do you explain that the patient needs help getting in and out of the car?

– If you put yourself in the driver’s seat, it’s reasonable to assume that she has poor physical function and needs the support of an arm until she’s inside the door. Especially this winter we were at the forefront, Johannesen says.

In Oslo, Akershus and Klammdalen, patient journeys run over 15 million kilometers per year.

– The doors were locked

Henrik Mevold, director of community relations at the Nursing Home Agency in Oslo, says the nursing home’s doors are locked at 4 p.m.

– Staff who were on duty that day said they were not allowed to carry these patients.

– But why did it take so long from when they knew the patient was on her way until they heard her?

– The patient should be called before two hours have passed. “We apologize for that,” Mewoldt said.

Unfortunately, he says, it is unfortunate that patients are transferred from hospitals to health centers in the evening as the staff is less than the day shift.

– This is the busiest time of the day with important nutritional, nursing and care work for staff.

Mewoldt says that transports often take much longer when using an ambulance, and that the staff handles all visits sequentially, regardless of the type of transport.

It is not routine to receive care that the patient has arrived, VG was told by Diakonhjemmet.

Thinking of next of kin

The director of the department at the hospital’s agency states that the hospital’s transport contract contains guidelines for how the patient’s needs should be addressed during transport.

– Cognitively impaired patients must always remain in the ward and be received by a staff member. Mewoldt writes that this patient was not received by us after transport from the hospital.

Deacon Home says they revised the current guidelines after the tragic incident.

– We have done this to make it absolutely clear that ticking the “cannot be left alone” code in the request form for patient travel should also be considered in special cases, says Clinic Manager Carvol.

Following death, nursing home agency asks transporter to clarify guidelines for transport of cognitively impaired patients.

– This is a sad incident and our thoughts go out to the patient’s family and relatives. Department director Henrik Mewoldt says they are waiting for the police to find out what happened.

He starts an investigation

Rune Skjold, division chief of the Oslo Police District, assures VG that the case is being pursued through a preliminary investigation to investigate whether any criminal activity took place before the woman’s death.

He says the police’s main focus is “following her condition in the period before she was found”.

– Don’t want to go into details about the death, or about the health follow-up, for the sake of the investigation. So the matter has been forwarded to the state administrator for evaluation, Skjold says.