The San Francisco General Hospital patient who vanished from her bed and was later found dead in a hospital stairwell succumbed to a lethal combination of apparent dehydration and liver problems related to chronic alcoholism, the city medical examiner said Friday.
The autopsy report for 57-year-old Lynne Spalding, who disappeared 17 days before her body was discovered in the little-used stairwell near her room on Oct. 8, does not reveal exactly when she died, saying only that she “was deceased for some days before being found.”
But it ruled out foul play. The manner of death was listed as an “accident.”
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The cause of death was listed as a “probable electrolyte imbalance with delirium” because of “complications of chronic ethanolism.” Experts said electrolyte imbalance can be brought on by a lack of water or liver problems, or both.
The medical examiner said Spalding’s body showed no signs of head wounds or other trauma that would have caused her to lose consciousness. No alcohol, tobacco or drugs were found in the stairwell with her, according to the report.
The report sheds some light on the mystery that surrounds Spalding’s death. She had checked into the hospital on Sept. 19 for a urinary tract infection and had been suffering from disorientation and weight loss, according to her friends and family.
Patient’s home was nearby
She was last seen on Sept. 21 in her room on the fifth floor. Her home in a four-unit apartment building was less than a mile from the hospital, and “missing” flyers featuring her picture soon marked the path.
Then, more than two weeks later, a hospital maintenance worker conducting a routine quarterly check found her faceup and in her everyday clothing on the fourth-floor landing of the stairwell.
The stairwell was used as a fire escape, and the door accessing it was equipped with an alarm. But the door was locked from inside, meaning a person in the stairwell could not return to the halls of the hospital – though the person could exit the building on the first floor.
San Francisco Sheriff Ross Mirkarimi, whose agency provides security at the hospital, has admitted that deputies did not consider Spalding to be a missing person in the first days after she vanished and never conducted a complete search of the building’s stairwells, including the one where her body was found.
Deputies did not act on a report made Oct. 4 about a sighting of a body in the area where Spalding was ultimately discovered, Mirkarimi said.
The Sheriff’s Department declined to comment on the death report.
The disclosures about the failure to search for Spalding prompted outrage from friends and relatives of Spalding, a native of England with two grown children. David Perry, a family spokesman, expressed even more outrage at the autopsy report, which he says fails to answer the most basic question – the date and time of her death.
He said “issues leading to the cause of her death, previous to her coming to San Francisco General” – the ruling that her death was possibly caused by chronic alcoholism – “are completely beside the point.”
“A woman went into the hospital for medical care and then was lost and discarded and found dead and abandoned on a stairwell 17 days later,” he said. “Right now, this report leads us to believe that the cause of death is neglect. The idea that our friend and family member died out of neglect and either starved to death or died from lack of fluids just feet away from medical attention is almost too much to bear.”
In the days after Spalding’s death, San Francisco General Hospital officials announced measures requiring employees and sheriff’s deputies to manually deactivate all alarms and check fire escapes when they sound, on top of conducting daily sweeps of all of the building’s stairwells.
‘Whatever it takes’
Sue Currin, the hospital’s chief executive officer, said hospital officials have yet to review Spalding’s autopsy report, but that the external UCSF review of hospital safety operations is under way and that San Francisco General is committed to “having a safe and secure environment for our patients, staff and visitors.”
“We will do whatever it takes to make that happen, and make any and all required changes so that our hospital meets the highest standards,” she said.
A sheriff’s sergeant, two senior deputies and a civilian sheriff’s dispatcher were reassigned amid the fallout from Spalding’s death. Several days later, two hospital deputies were transferred after being told they face possible discipline in the case.
In their place, a full-time sheriff’s deputy training officer has been assigned to the hospital, as well as two full-time lieutenants and a captain, according to Currin.
