Failla, who took over the reins at Intermountain in June of last year, was Pavilion administrator when one of its patients testified before the Texas Senate Health and Services Committee. As reported by the Amarillo Globe-News, Pavilion patient Jane Betzen asserted that she had been administered a series of shocks without either a prior medical examination or informed consent. At the time Failla was quoted as declining to comment on Betzen's case for reasons of confidentiality. He also told a reporter that "I am not aware of any adverse outcomes from the administration of ECT, and all of the psychiatric literature reflects that as well."
Acting upon Betzen's testimony, the Texas Department of Health nevertheless cited the Pavilion for a number of violations related to its ECT program. These included assigning "voluntary inpatient" status despite a lack of sufficient data to assign that classification and prompting incompetent patients into signing informed consent forms. The citations were prompted by a number of patient, staff and clinician accusations. The Texas Department of Health discovered that while other Texas hospitals had discontinued ECT altogether, the Pavilion recorded over 990 procedures in 1996 alone. Nearly half these treatments were given to Medicare patients aged 65 and older. It was estimated that each course of ten ECT sessions cost between $10,000 and $20,000 per inpatient, most of it paid for from government subsidized medical care insurance funds. Rather than lose its Medicare privileges, the Pavilion discontinued its in-house ECT program.
At the time, Failla denied several of the charges and reiterated that "We're still in favor of the procedure. We think it's an excellent procedure," despite a 1995 Houston Chronicle article reporting that "Eight people died in Texas within two weeks of receiving electroshock therapy." Even though one Pavilion patient passed away less than 24 hours, an ECT patient, Failla claimed that "We have had no deaths whatsoever associated with" the procedure. Nevertheless, the program was shut down by the Pavilion's corporate owner, Northwest Texas Healthcare System, Inc. When Texas Republican State Senator Jerry Patterson and Democratic Representative Senfronia Thompson sponsored bipartisan legislation to ban the use of ECT in Texas altogether, Failla objected that there was "no credible evidence" to justify the move.
"I challenge them to produce their data," he publicly stated. "It's not there." Supporters of the bill cited evidence that ten deaths statewide in 1996 were directly attributable to ECT. The original bill died in committee but the Texas Legislature placed restrictions on the application of ECT to minors and raised reporting requirements.
Accounts of Failla's involvement has been posted on a web site (www.healthyplace.com) and staff members at Intermountain, who spoke to Boise Weekly on a confidential basis for fear of retaliation, mentioned that printed downloads were being surreptitiously circulated much to the senior staff's displeasure. Failla allegedly found copies in his personal mailbox.
All attempts to contact Failla and Intermountain Hospital's community relations person, Maralyn Baughman, for purposes of this story were referred to Intermountain's parent company, Ardent Health of Tennessee. When asked if other Ardent behavioral health hospitals used ECTs, what kind of equipment Intermountain would be buying, and whether Ardent would make its informed consent forms available Shea Davis, Ardent's Vice President for Communications stated flatly, "I can't help you."
Many mental health advocates and professionals remain skeptical about the efficacy and long-term benefits of ECT, especially given the promising development of a less intrusive technique called Transcranial Magnetic Stimulation. Jim Baugh, executive director of Co-Ad, an Idaho disability rights organization, expressed surprise when informed of Intermountain's application. "I'm sorry to hear that," Baugh said, given the lack of regulation over ECT in this state, and the fact that consumer groups have determined that the procedure "is not nearly as safe or effective as practitioners would have us believe."
Peter Wollheim was recently awarded for the second time the Idaho State Planning Council on Mental Health's media award for his work reporting on psychiatric and medical issues in Idaho. In 2003 he was also awarded first place for his watchdog, investigative report on Intermountain Hospital (Boise Weekly, Crazy Bad, Sept. 18, 2002) at the Idaho Press Club Awards.
Since Boise Weekly's original profile by Peter Wollehim of Intermountain Hospital's BFS violations ("Crazy Bad," Sept. 18-24, 2002), the record continues to grow in terms of types and numbers. Among the most recent investigations:
June 12, 2004--One patient assaulted another patient. The incident was partly blamed on understaffing and lack of supervision.
June 18, 2004--A patient failed to receive a timely physical exam and stabilizing treatment during a medical emergency. Also, during a "patient dumping" incident, a 19-year old male "noted as having a significant past psychiatric history and history of violence" was nevertheless "coerced into leaving the facility without treatment because of his inability to pay." The BFS examiner wrote that "The patient presented a concerning history and unreassuring findings on exam. It appears that financial criteria could have been a motivating factor" in his untreated discharge.
July 18, 2004--A distraught adolescent patient complained that she "overheard staff using vulgar language in reference to her."
September 8, 2004--Complaints include unsupervised patients roaming into other patient rooms; failure to address various physical and mental problems; "the place was filthy;" inability to treat patients suffering from eating disorders; and "failure to investigate patient complaints in a timely manner."
September 9, 2004--More unsupervised roaming which in one instance led to a male groping a female's breasts. Related incidents involve thefts of patient property, and verbal and sexual harassment of patients again due to understaffing and lack of supervision.
Source: Idaho Department of Health and Welfare, Bureau of Facilities Standards.