Southwest Memorial cited for shock treatment lapses


Houston Chronicle Austin Bureau

AUSTIN -- Southwest Memorial Hospital in Houston, which ranks third in Texas in the number of electroshock patients, was cited by state authorities last year for several violations of state law.

The Texas Department of Health found during an inspection last February that the hospital had failed to put a tracking system in place to make sure the maximum number of treatments for any one patient was not exceeded.

Health officials also discovered that one of the recovery nurses on duty was not certified in shock therapy procedures and that there was no evidence that any of the staff attending the treatments had been certified in advanced cardiorespiratory life support.

If problems existed at the time of the state inspection, they have since been remedied, said James Eastham, the hospital's chief executive officer.

"All the nurses on the unit are trained psychiatric nurses and have been familiar with ECT (electroconvulsive therapy) procedures for the past 17 years," he said. "We put in a formal training program in 1993 to ensure nurses were trained on that. One nurse in question had not completed the training at the time of the state review."

The state also complained that for three out of five outpatients, the hospital had no documentation that a physical or psychiatric evaluation had been conducted 30 days before shock therapy.

Eastham said all of the cases involved outpatients who were referred to the hospital by doctors who kept the records at their individual offices. "We've since implemented a process to receive copies of histories and physicals for those outpatients as part of our record before the ECT is provided," he said.

Statistics gathered by the state also show that 87 women and 38 men received electroshock treatments at the hospital last year, and that patients receiving publicly assisted medical care outnumbered those on private insurance or family funds 73 to 53.

Dr. Donald Hauser, medical director of the hospital's psychiatric unit, said the statistics reflect the breakdown for the hospital's psychiatric ward in general.

"Depression is three times more prevalent in women than in men,"he said. "It's pretty much a fact in our field that you see more women, particularly for depression. I don't have an answer why. Why do more men get high blood pressure? It's hard to say."