The Iowa Court of Appeals is poised to rule on a lawsuit that pits state regulators against a nurse accused of physically abusing a hospital patient.
The case involves a 66-year-old woman who in 2017 was a patient in the Behavioral Unit of St. Luke’s Hospital in Cedar Rapids. The woman was diagnosed with bipolar disorder and severe recurrent mania, as well as insomnia and other medical conditions.
On New Year’s Eve 2017, registered nurse Elizabeth Babka found the woman sleeping in a recliner in the unit’s day room. Babka alleged woke the woman and told her she needed to sleep in her room. The woman became upset and combative, but Babka and a colleague stood the woman up, walked her toward her room, and then pulled the woman into her room by her arm.
Court records indicate surveillance video shows the woman left her room a short time later, then walked down the hall. Babka allegedly pulled the woman into the unit’s “seclusion room,” then called a physician to get authorization, telling the doctor that the woman was out of control and needed to be locked in seclusion and given an injection of the anti-psychotic medication Thorazine. According to the state, video surveillance allegedly shows the woman was calm at the time and was either quietly sitting on the mattress or wandering around the seclusion room.
At about 5 a.m., Babka administered the medication and locked the door to the seclusion room, at which point the woman began showing signs of distress and began banging on the walls and yelling.
Babka was subsequently fired, as was the nurse who helped her move the patient from the recliner. The Department of Inspections and Appeals investigated and issued a finding of dependent adult abuse involving unreasonable punishment and assault.
Babka contested that finding, and an administrative law judge ruled in her favor, reversing the finding of abuse. The director of DIA, however, confirmed his agency’s finding of abuse, but added that because the abuse was unlikely to reoccur, Babka’s name should not be placed on the state’s abuse registry. That decision was later affirmed by a district court judge, which led to an appeal.
Attorneys for Babka recently argued their case before the Iowa Court of Appeals, saying the district court judge upheld the DIA director’s decision even after determining there was “little factual evidence” to support the allegation of abuse.
“The end result is a terrifying one that should not be permitted under Iowa law,” Babka’s attorneys argued in a brief filed with the Court of Appeals. “A nurse who did not commit abuse is nevertheless found guilty of abuse despite the allegation having little factual support and a complete lack of legal justification in its final decision. Such an occurrence cannot be upheld …”
According to the state, Babka admitted that she should have allowed the patient to continue sleeping in the day room. The state also alleges Babka violated a policy that says the only time it is permissible to physically force patients to do something against their will is in an emergency and there is imminent risk of injury, as well as a policy that says seclusion is a measure of last resort not to be used for discipline or the convenience of the staff.