A case of a man left at a Jacksonville bus stop for at least six days has sparked many questions about why he sat in front of a hospital with a broken leg without getting any help.
News4JAX has learned Mohammad, 46, is getting surgery on his hand this week. On Friday, he had surgery on his leg.
He is in stable condition, back in HCA Memorial, the same hospital that previously discharged him.
RELATED | Man who spent days at bus stop after being discharged from local hospital to undergo leg surgery
There are still so many questions about Mohammad, the man who was found shivering, crying, and in human waste on the side of University Boulevard on Feb. 14 after getting hit by a car, treated, and discharged from the emergency room.
News4JAX photojournalist Foad Raja helped talk to him in Arabic – the man’s first language.
Mohammad said he’s in the U.S. on a green card and has no local family members or permanent home.
News4JAX is not showing Mohammad’s face or giving his full name because we are unsure of his ability to make decisions on his own.
“The concern is whether or not he was provided the information he needed. And was he in the right mental state to make those decisions and to know where to go? And the emergency room just can’t rely upon we have a broken leg, we have bruises, we fix the leg, you’re stabilized, you can go to outpatient treat afterwards, they have to make sure that from a mental health standpoint that he is okay,” Attorney Gene Nichols said.
Nichols said state and federal laws require all hospitals, for-profits and nonprofits, to treat anyone that comes in.
HCA Memorial, on Jacksonville’s Southside, is part of a for-profit healthcare system.
The Emergency Medical Treatment and Active Labor Law prohibits hospitals from discharging patients until their serious medical conditions are stabilized. The federal government fines hospitals $50,000 per violation.
Because the patient’s records are confidential, it is unclear if what happened with Mohammad violated any laws.
“Whenever they accept Medicare, Medicaid, they have certain obligations to treat everybody, no matter the insurance,” Nichols said.
News4JAX sent more than a dozen questions to Memorial’s communications team. They didn’t answer the questions, but replied with the following statement:
“Above all else, we are committed to the care and improvement of human life. That’s our mission statement and the foundation for every interaction with every patient we serve. Even with our best and most compassionate efforts, there may be times when a patient declines treatment. There may also be times when a patient declines our help coordinating follow-up care or placement and transportation to a shelter. While those cases are uncommon, they are heartbreaking. What we can ensure is that a patient has the resources and information needed to make rational decisions about their care.”
HCA Florida Memorial Hospital
But did Mohammad, who is from Morocco, have the ability to make decisions for himself – having struggled with homelessness and getting hit by a car?
News4JAX found him after getting a news tip and called for rescue. He’s been back in the hospital since then.
“I have a lot of questions about what he was told on the day, the person who you interviewed was clearly in a bad state. What was he advised regarding his discharge paperwork, when he left that hospital? And did they take the time to translate the discharge paperwork? Did he know that Sulzbacher was the place to go?” Nichols said.
Sulzbacher is one of several local centers that care for people in vulnerable situations. Management said they would have found help for Mohammad had they known.
“It’s just, it’s just, it’s really just comes down to communication and correspondence with each other,” Sulzbacher Center’s president of housing Brian Snow said.
Ann Bittinger, a healthcare law attorney, said hospitals should offer thorough discharge planning.
“An investigator would probably look at why Mohammed was not admitted to the hospital,” Bittinger wrote. “An investigator might also explore whether the staff at Memorial and the Arabic-speaking patient could understand each other, and if he could read any forms he signed, such as if he refused treatment and left against medical advice.”
She said violations of federal law, under 482.43, would be investigated if someone filed a complain.
“If a complaint was filed against the hospital for Mohammed’s discharge, the investigator would look first for whether the patient had an emergency medical condition,” she told News4JAX. “One might think a car accident victim taken to the hospital by ambulance would have an emergency medical condition, but it depends on whether the patient’s condition is ‘manifested by acute symptoms of sufficient severity (including pain) such that the absence of immediate medical attention could reasonably be expected to result in: Placing the health of the Individual in serious jeopardy, serious impairment to bodily functions, or serious function of any bodily organ or part.’ Psychiatric issues can also be emergency medical conditions, such as suicidal ideations and symptoms of substance abuse.
Meanwhile, questions for the hospital continue.
News4JAX followed up Monday to ask if there’s an internal investigation into what happened or if any policies or procedures are changing because of Mohammad’s case. While some questions may fall under patient privacy, general questions about how a hospital operates are not protected by HIPAA.
At the time this story was published, we hadn’t heard back from them.