Published Thursday May 27, 2010
Suicide has family asking how
By Rick Ruggles
WORLD-HERALD STAFF WRITER
John Bighia cut his wrists at work the evening of May 11 and was taken by ambulance to the Immanuel Medical Center emergency room.
Although police had placed him in the emergency protective custody of Immanuel because he was considered a danger to himself, Bighia hanged himself within about three hours in a room on the hospital’s psychiatric floor.
Bighia’s relatives wonder why hospital staffers left a suicidal person alone on a psychiatric ward with the means to kill himself. Immanuel’s psychiatric floor should be a place where a patient is protected from harming himself, they said.
“They dropped the ball in many directions,” Bighia’s half-brother, Omahan Dan Bighia, said of the hospital.
The Nebraska Department of Health and Human Services is investigating. Agency spokeswoman Marla Augustine said Nebraska hospitals had reported no suicides since at least 2006, when such suicides first had to be registered.
Alegent Health, the parent firm of Immanuel, said through a written statement: “We are deeply saddened by the death of our patient. . . . We are conducting an internal investigation and cooperating fully with police, the state and the family. Our hearts and prayers are with the family during this difficult time.”
Alegent declined to speak further about the situation.
Bighia, 41, was on anti-depressant medication and perhaps receiving some kind of psychological counseling, said Dan Bighia, with whom John Bighia lived in central Omaha. But John Bighia (pronounced Big-ya) was a private person who didn’t give a lot of details about that kind of thing, the brother said.
“He was seeking help,” Dan Bighia said.
John Bighia’s grandfather, Dean Olsen of Bennington, helped raise him when he was a toddler, and the two remained close to the end. Bighia would visit Olsen on Mondays and have lunch.
Olsen, 84, said Bighia didn’t mix well and tended to be reclusive. Olsen said Bighia wouldn’t fight or argue, but would walk away from conflict.
Bighia had always been “big-boned,” but over the past 18 months or so, Olsen said, his grandson’s weight had ballooned.
“He was the type of person that you really couldn’t get much information out of,” Olsen said. “He was a very good person. . . . I knew that there was something wrong with him, but I didn’t realize that it was that bad.”
Bighia worked at Home Depot at 4545 N. 72nd St., and Olsen had purchased paint from him just a week or so before Bighia died. Bighia seemed at ease at work and appeared to know what he was doing, his grandfather said.
The police report from May 11 said an employee told police Bighia “became upset over a conversation he had with a supervisor, at which point Bighia could not be found for over an hour.” Then an employee found Bighia outside with cuts to his wrists.
Police responded just before 8 p.m. An ambulance was called, and the rescue squad took Bighia to Immanuel, where police placed him in emergency protective custody. That is a 48-hour committal, a police spokeswoman said.
At 11:20 p.m., police returned to Immanuel because Bighia had hanged himself with a bedsheet.
Dan Reidenberg, executive director of the Minnesota-based Suicide Awareness Voices of Education, said psychiatric wards typically are vigilant in monitoring a suicidal patient admitted within the previous 24 hours.
Reidenberg, who wasn’t familiar with Bighia’s case, said psychiatric wards do their best to protect suicidal patients. They can lock doors so only staffers can open them, use door hinges from which it’s hard to suspend anything, and pull out beds and put in only a mattress. Sometimes suicidal patients need one-on-one staffing, Reidenberg said.
“You’ve got to be intent on this type of thing or you do have terrible tragedies happen,” he said.
Sometimes, suicidal patients in psychiatric units find ways to harm themselves despite great precaution, he said.
“It’s not a foolproof system,” he said.
The Joint Commission, which provides accreditation for Immanuel and thousands of hospitals nationwide, doesn’t order specific staff-patient ratios for psychiatric wards. But the commission has an expectation of appropriate staffing, said Kenneth Powers of the Illinois-based organization.
The commission also asks that hospitals assess a patient’s risk of suicide and environmental features that increase the risk, Powers said.
Hospitals accredited by the commission meet the requirements of the federal Medicare program, and loss of accreditation could jeopardize that.
Rita Fidler of Council Bluffs, Bighia’s mother, said the hospital should have served her son far better. “I don’t feel what happened is right,” Fidler said. “It never should have happened. It just doesn’t make any sense.”
She knew he was depressed, knew his weight bothered him, and speculated that the two factors exacerbated one another. “I didn’t realize he was suicidal,” she said. His birthday slipped by in April without her calling him.
“I’m feeling kind of guilty about that,” she said.
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