After it took seven months to get patient information from George Town Hospital, the Grand Court wanted to know why.
The answer came last Monday, along with a promise from Assistant Solicitor General Douglas Schofield that there will be a procedure to handle future requests more smoothly.
On the previous Friday, Mrs. Justice Priya Levers heard that Defence Attorney Nicholas Dixey had requested medical records for a man he was representing. A Grand Court judge made the order requesting the records in March.
The man’s trial had to be adjourned because the records were not served before a mid-October deadline. The judge who ordered the adjournment asked why the documents had been obtained so late.
Told that several attempts had been made to obtain them, the judge ordered a subpoena in November for the person who seemed to be responsible for producing the records.
On 8 December, the medical records manager attended court. She explained that her department had no access to mental health records. She said when she received the request she forwarded it to the mental health section.
Mrs. Justice Levers said the manager had not acted responsibly. If she was not responsible for mental health records, she should have told somebody.
‘I don’t think you understand how important a court order is,’ she said.
The judge said she needed to know what was happening in the hospital and she required the persons who were responsible to attend court.
A psychiatrist appeared in court shortly afterwards. He thought there had been some miscommunication or misunderstanding, since he had provided a letter in September.
The judge pointed out that a letter was not the records.
The police officer in the case told the court she had submitted the request to the medical department on a prescribed form. She thought it was forwarded to mental health in April. She then spoke to the clerk in mental health, who indicated there was a separate form for that department.
The officer received the second form by fax, filled it out, faxed it back and also hand-delivered it. That was in May, at the latest.
In July she faxed a copy again. ‘I had problems obtaining the documents. I’m not sure they understood what was needed,’ she said. When she received the letter from the doctor, she hand-delivered a memo saying it was not sufficient.
Later the patient’s records were produced. But the officer was told that they could not be released without a letter from the court. That was on 10 October.
The judge told the records manager to stay and asked the psychiatrist to tell the mental health clerk to come to court that afternoon.
Answering the judge’s questions, the clerk said she did know the request was a court order and when she got it she went to the psychiatrist and had to wait on him. Asked how long she had to wait, the clerk did not answer.
The judge suggested she take the matter seriously. ‘When I fine you there will be a hue and cry that the court is being unfair.’
The judge also suggested that the clerk prepare a report of what had happened and return on Monday morning.
An order of the court is to be obeyed and if it is not obeyed there will be serious consequences, she said.
On Monday the clerk supplied her report.
Mr. Schofield was also present and offered to assist. He said he had looked at the patient’s file and the first communication in it was dated in June.
It appeared that when the request came in, the psychiatrist indicated through the officer that the patient would have to sign in consent because there was no physical court order.
Mr. Schofield said the patient signed his consent and it was faxed to the hospital on 4 July. But the clerk had left on vacation on 3 July, so somebody else had put the information in the file.
He acknowledged that the request sat in the mental health department until the defence attorney, Mr. Dixey, refreshed their memory.
Mr. Schofield said he personally had not been aware that records were kept in two different places. He advised that he would send a memo to the medical director that there must be a protocol in place for dealing with requests. He said he would see to it that everyone in a position to receive such a request is aware of the proper procedure.
In the present case, he said, the fault lay with his office because someone should have obtained a proper signed order.
The judge this matter had turned out okay because it was not a life or death. But court requests are made for a reason and it is important that someone deals with them urgently. In this matter, apparently the mental health clerk had been made the scapegoat.