The Maine State Board of Nursing is considering disciplinary action against nurses who failed to report a case of patient abuse at Riverview Psychiatric Center in which a corrections officer pepper-sprayed a naked patient in a “defenseless pose.” Hospital employees are required by law to report abuse to state officials.

Meanwhile, the sole employee who alerted authorities – Jeanne Carroll, Riverview’s nursing director at the time of the incident – was fired by the hospital in June for an undisclosed reason, according to a former co-worker.

Carroll wrote a letter to the nursing board Aug. 9, informing it that four nurses failed to report the pepper-spray incident. In the letter, obtained by the Portland Press Herald this week, she writes how she informed Adult Protective Services within one day of being asked by a colleague Feb. 26 to view the pepper-spray video from Dec. 2 taken by surveillance cameras at the hospital.

She wrote in the letter that Jay Harper, Riverview’s interim superintendent, discouraged her from reporting on the aftermath of the pepper-spray incident.

Harper “refused to allow me to report (the nurses) from RPC and specifically instructed me not to use RPC stationery,” Carroll wrote. “I informed him I would report the (nurses) as well as other issues related to violating standards of care.”

Harper didn’t respond to messages requesting comment Thursday.


Previously, he had said that one employee was fired and a contractor was not permitted on state grounds as a result of the pepper-spray incident. In addition, he said two employees involved in the incident left on their own.

Shortly after Carroll saw the video, investigators with the Maine Division of Licensing and Regulatory Services viewed it and concluded that the staff had abused the patient and that numerous employees who knew about the incident the same day or soon after failed to report the abuse. Maine law requires medical professionals who know about abuse to report it within one day.

Myra Broadway, director of the nursing board, confirmed Thursday that the matter is before the board but would not provide details. If the nurses are disciplined, the results will be posted on the nursing board’s website, she said.

“We take these matters very seriously, especially if a patient was harmed,” Broadway said.

Carroll declined to comment Thursday when reached by the Press Herald.

On Dec. 2, a corrections officer pepper-sprayed a woman while she was in her room after having a verbal spat with Riverview employees, according to a Division of Licensing and Regulatory Services report. Despite not threatening employees and being compliant during the episode, she was held in restraints for hours afterward, which is against Riverview’s policy, the report said.


Carroll claims in her letter that the four nurses she names knew about the abuse but failed to report it. One of them was the nurse on duty that day, according to the state report. Several other employees who were not nurses but are required to notify authorities also failed to report the incident, investigators found.

Harper took over at Riverview in March, after former Superintendent Mary Louise McEwen was fired.

A former patient advocate at the 92-bed, state-run hospital, Harper was tasked by the LePage administration with reforming Riverview, which had lost its federal certification in September 2013 and the $20 million in federal funding that goes with it. The U.S. Centers for Medicare and Medicaid Services has cited numerous deficiencies at Riverview, including officers using stun guns and handcuffs on patients and substandard medical treatment.

Riverview is one of two state mental hospitals in Maine – the other is Dorothea Dix Psychiatric Center in Bangor – and the only mental institution in Maine that accepts forensic patients, who have been found not criminally responsible by the courts.

Last week, Harper told the Press Herald that he is fostering a culture where employees feel emboldened to report when they see fellow workers not following proper procedures in patient care.

Judith Dorsey, a former Riverview social worker who has spoken out against patient abuse, said Carroll told her she was fired by Riverview in June after refusing to sign a resignation letter. In Carroll’s letter, she states that she was nursing director from Oct. 7 to June 23, but she does not state the reason for her departure.


Dorsey said Carroll told her that in the months after reporting the pepper-spray incident, Riverview administrators started giving Carroll the cold shoulder.

More than 10 employees have come forward to the newspaper or lawmakers claiming that some Riverview employees routinely provoke, punish or abuse patients, and that the hospital has a dysfunctional work environment. Harper has said many reforms are underway to improve working conditions at Riverview and minimize patient abuse.

The Office of Program Evaluation and Government Accountability is beginning an investigation of conditions at Riverview. Also, Daniel Wathen, the court master charged with making sure that Riverview is treating patients well and complying with a court-ordered consent decree, will start a formal investigation next month.

The state Attorney General’s Office, through its Health Care Crimes Unit, is also looking at Riverview incidents, said OPEGA Director Beth Ashcroft. The Attorney General’s Office would not confirm the investigation Thursday.


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