The Mirror is reporting that police investigators will be interviewing everyone who was on the private plane carrying the late pop star Prince that made an emergency landing at Quad City International Airport in Moline, Illinois in the early hours of April 15.
The report does not specifically identify the Carver County, Minnesota Sheriff’s Office, the local law enforcement agency in Chanhassen, Minnesota, where Prince died on April 21, as the investigating organization.
As Breitbart News reported previously, a private plane made an emergency landing at Quad City International Airport at 1:15 am on the morning of April 15, 2016 to secure medical treatment on the ground for a passenger who was described as unresponsive.
TMZ and multiple outlets are reporting that Prince was the unresponsive passenger.
Quad City International Airport Public Safety Director Jeff Patterson told Breitbart News the unresponsive passenger was taken from the airport by the Moline Fire Department to UnityPoint Health – Trinity Hospital in Moline.
The private plane departed from Quad City International Airport at 11:30 am that same day, according to Patterson.
The Mirror reported on the emerging details of the police investigation:
Everyone aboard the flight on which Prince allegedly suffered an overdose of painkillers days before his death is to be quizzed by police.
Investigators said they want to speak to the singer’s friends, staff and flight crew – as it was claimed he had needed emergency treatment for the same drug used by fierce rival Michael Jackson.
Sources say the 57-year-old took so many Percocet painkillers shortly after performing in Atlanta eight days ago that his condition became critical.
And his team were so fearful for his safety they diverted the Gulfstream jet to Moline, Illinois to get urgent medical attention – despite being only 48 minutes from his home.
At the hospital the pop superstar was reportedly administered a “save shot” normally given in dire circumstances to overdose victims.
Doctors advised Prince would need to be monitored for 24 hours – but when his management failed to secure him a private room they discharged him.
When he left the hospital after just three hours he was described as “not doing well”.
Yet the 5ft 2ins singer made an appearance at a party in Minnesota the next day, assuring worried fans they should “wait a few days before you waste any prayers”.
A police source said: “We understand Prince suffered chronic pain after developing a hip problem. Naturally he took painkillers to ease his troubles but police are looking into if he was prescribed too many.”
Reporting on the events surrounding Prince’s medical treatment during his brief 10 hour and 15 minutes stay in Moline, Illinois on April 15 has been hampered by the HIPAA privacy law that the local hospital that treated him is required to follow.
Consequently, most of the reported “facts” come from anonymous sources — either members of Prince’s entourage or individuals who may have been involved in some part of his treatment that day.
One recurring assertion, first reported by TMZ and subsequently repeated by other sources, is that “when his management failed to secure him a private room [at the hospital in Moline] they discharged him.”
The anonymous source for this claim is most likely a member of Prince’s entourage, and its veracity is questionable.
Hospital administrators throughout the country, regardless of the size of the hospital or market, are very well trained on privacy issues.
In the case of a patient who is a world-wide celebrity like Prince with a life threatening medical emergency, it seems highly unlikely that a hospital administrator would not quickly and readily find a way to make a private room available for that patient.
Another recurring assertion, which seems more credible and is supported by the fact that the stay in Moline was so brief, despite its urgent nature, is that Prince left the hospital in Moline against the advice of “[d]octors [who] advised Prince would need to be monitored for 24 hours.”
When this occurs, a specific release document commonly referred to as an Against Medical Advice (AMA) form is signed by the patient and the attending physician absolving the hospital of subsequent legal liability for the release.
A typical Against Medical Advice (AMA) form, though not necessarily the one presumably in use at the Moline hospital, reads as follows:
This is to certify that I, _________, a patient at ___________________(hospital name), am refusing at my own insistence and without the authority of and against the advice of my attending physician(s) _________________, request to leave against medical advice.
The medical risks/benefits have been explained to me by a member of the medical staff and I understand those risks.
I hereby release the medical center, its administration, personnel, and my attending and/or resident physicians from any responsibility for all consequences, which may result by my leaving under these circumstances.
The AMA form is then signed and dated by the patient and the attending physician(s).
It is possible that such a document exists in the records of the Moline hospital and that the signatures on the document are likely those of the attending physician(s) and Prince. Questions will then arise as to his capacity to sign, given that just a few hours earlier he had been deemed “unresponsive.”
A 2012 article in The Journal of Emergency Medicine written by several well respected emergency physicians and a lawyer notes, “three requirements should be met for the AMA process to confer optimal legal protection.”
Given the prevalence of AMA discharges and the serious problems that they present, emergency physicians should make every attempt to prevent a patient from leaving AMA. However, if it is unavoidable, three requirements should be met for the AMA process to confer optimal legal protection. First, a patient should be deemed to have the capacity to refuse care. Second, all potential risks should be disclosed. Third, the AMA consent should be properly documented in the chart. (emphasis added)
“Capacity is not the same thing as competence,” the article continues:
Competence is determined by a court of law and uses issues of capacity in evaluating the legal ability to contract. Although courts have found that intoxication can impair a patient’s competence and ability to refuse medical treatment, a patient who is intoxicated does not automatically lack the competence or capacity to make medical decisions. Similarly, as noted above, patients with psychiatric complaints can also be difficult to assess, but do not necessarily lack capacity or competence.
In general, the determination of capacity is relatively straightforward. However, patients presenting with intoxication or psychiatric disorders can make such determinations challenging. Moreover, it is inappropriate to assume that a patient with mental pathology, sedation, or cognitive deficit lacks decision-making capacity. A formal assessment of capacity is necessary.
If the capacity of the patient is unclear and the patient wishes to leave AMA, emergency physicians should consult Psychiatry whenever feasible. If, after consultation, the patient’s capacity remains uncertain, the best course of action may be a period of prolonged observation. In cases of intoxication, a patient’s mental capacity often returns as the effects of the ingested substance clear. In those cases where intoxication persists and hampers capacity, involuntary admission may be the only remaining course of action for a patient who wishes to leave AMA but lacks capacity.
Apparently, patients sometimes leave the hospital against medical advice and refuse to sign the AMA form. The article offers this advice to emergency physicians and hospitals who encounter this situation:
If the patient refuses to sign the AMA form, the physician should read it aloud, document the refusal to sign, and document the fact that the patient was made aware of the risks of leaving.
If a properly executed AMA form, signed by Prince and the attending Moline hospital emergency physician(s) exists, it may limit the potential legal liabilities of the hospital and those physicians. However, The Journal of Emergency Medicine 2012 article concludes, “the AMA form and documentation in the chart may provide vital evidence for any ensuing litigation,” indicating that the form is often used for defensive purposes when a lawsuit is filed by a patient or the heirs of the patient:
A properly executed and documented AMA form can provide significant protection from liability risk. If a patient is deemed to have capacity, is disclosed and understands the risks of leaving and still refuses care, emergency physicians may be protected from potential liability from adverse outcomes. Specifically, case precedent shows that emergency physicians may be able to claim that the legal duty to treat was terminated when the patient signed out AMA.
In addition, emergency physicians may be able to rely on a defense that the patient “assumed” the risk of his or her actions upon discharge. Finally, the AMA form and documentation in the chart may provide vital evidence for any ensuing litigation. Providers would be well advised to take the additional time required to execute an AMA discharge so as to avail themselves of these added legal protections.
Police investigators are apparently seeking answers to this mystery, along with many others, related to Prince’s 10 hours and 15 minutes in Moline, Illinois on April 15.
If an AMA form, dated April 15, 2016 signed by Prince and the attending physician(s) at the Moline hospital exists, police investigators are certain to ask to see it.
Whether the hospital will choose to release that document, short of a court order, remains to be seen. Given the legal thicket of issues involved and the international attention associated with Prince’s death, any hospital or physician involved in his medical treatment in the days immediately preceding his death can be expected to proceed with great caution.