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VA Reviews Death of Mental Patient

June 27, 2005|Wendy Thermos | Times Staff Writer

The Westwood Veterans Affairs Hospital is "intensively reviewing" the case of a 65-year-old psychiatric patient discharged early this month who was missing for nearly three weeks and found dead June 20 outside the facility's gates.

The Antelope Valley man's widow is angry that the hospital did not call her to pick him up.

"I was shocked when I went to visit him and they said, 'He didn't make it home?' " Katherine Miller, 63, said Thursday.

While his family and the VA police searched for him, Peter Norman Miller apparently lived for about three weeks in a homeless camp next to the hospital before his body was found under a Wilshire Boulevard onramp of the San Diego Freeway, said Det. Diane Harris of the Los Angeles County Sheriff Department's missing persons bureau.

Dr. Dean Norman, the hospital's chief of staff, said everything was done according to policy but that internal reviews are underway "to see if we made a mistake and if there is an area where we can improve."

Officials said the death is unrelated to sharply disputed cuts in the VA's psychiatric inpatient services.

"There was no push to get him out of here," Norman said. "The outcome is something we consider a tragedy, and we are intensively reviewing the case."

Katherine Miller said she should have been called "immediately" on June 1 when her husband, admitted April 26 for treatment of depression, insisted on being discharged. She did not learn of his discharge until two days later, when she came to tell him that her surgery for a malignant tumor was successful.

Peter Miller, who served in the Air Force as a young man and was a maintenance worker for the Lancaster School District, had been suffering from depression for two years, said his wife of 32 years. "When he found out I had cancer, he kind of went over the edge," she said. "I think he was afraid he was going to be left alone."

"I can't imagine why they didn't call me to come and get him," she said. She and her daughter searched the Westwood and Santa Monica areas and passed out fliers. There were rumored sightings of Miller. The VA police said they had searched the spot where he was later found at least twice.

An autopsy found no apparent cause of death or evidence of foul play. Coroner's investigator Mario Sainz is awaiting results of toxicology tests.

Norman said Peter Miller and the attending physician agreed he should be discharged. The VA does not release patients disabled by surgery or drugs unless someone is there to pick them up, but procedures are different for psychiatric patients deemed fit to return home, officials said.

The hospital does not require release to a third party "unless we feel they are impaired and require additional assistance," Norman said. "If you're under psychiatric care and you're impaired, you shouldn't be discharged."

The chief of staff said Miller's death was not related to changes in VA psychiatric care that have come under criticism.

In the last decade, veterans hospitals across the country have reduced the number of inpatient psychiatric beds, replacing them with outpatient programs and homeless services that officials say cost less and are as effective. Experts disagree on whether outpatient care can replace inpatient treatment.

The hospital is conducting a peer review and a "root cause analysis" to determine whether a medical mistake was made in evaluating Miller or whether procedures should be changed.

Norman said it's possible the review would conclude that a third party should be contacted in such cases, but that could conflict with other regulations. "Sometimes a patient says, 'Don't tell my wife I'm here.' Then we can't notify her because of patient privacy laws."

Times staff writer Charles Ornstein contributed to this report.

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