N.Y. MHY Law § 33.04 — New York Code / Act MHY / Title E / Article 33 / Section 33.04
Restraint of patients
Status: in_force

§ 33.04 Restraint of patients.\n  (a) As used in this section, "restraint" means the use of an apparatus\non a patient which prevents the free movement of both arms or both legs\nor which totally immobilizes such patient, and which the patient is\nunable to remove easily.\n  (b) Restraint shall be employed only when necessary to prevent a\npatient from seriously injuring himself or others. It may be applied\nonly if less restrictive techniques have been clinically determined to\nbe inappropriate or insufficient to avoid such injury. It may not be\nemployed as punishment, for the convenience of staff, or as a substitute\nfor treatment programs.\n  (c) The "camisole" and the "full or partial restraining sheet", or\nsuch other less restrictive restraints authorized by the commissioner,\nshall be the only permissible forms of restraint.\n  (d) Restraint shall be effected only by written order of a physician\nafter a personal examination of the patient except in an emergency\nsituation, as provided by subdivision (e) of this section. The order\nshall set forth the facts justifying the restraint and shall specify the\nnature of the restraint and any conditions for maintaining the\nrestraint.  The order shall also set forth the time of expiration of the\nauthorization, with such order to apply for a period of no more than\nfour hours, provided, however, that any such order imposing restraint\nafter nine o'clock p.m. may extend until nine o'clock a.m. of the next\nday.  A full record of restraint, including all signed orders of\nphysicians, shall be kept in the patient's file and shall be subject to\ninspection by authorized persons.\n  (e) If an emergency situation exists in which the patient is engaging\nin activity that presents an immediate danger to himself or others and a\nphysician is not immediately available, restraint may be effected only\nto the extent necessary to prevent the patient from injuring himself or\nothers at the direction of the senior member of the staff who is\npresent.  The senior staff member shall cause a physician to be\nimmediately summoned and shall record the time of the call and the\nperson contacted.  Pending the arrival of a physician, the patient shall\nbe kept under constant supervision. If a physician does not arrive\nwithin thirty minutes of being summoned, the senior staff member shall\nrecord any such delay in the patient's clinical record and also place\ninto the patient's clinical record a written description of the facts\njustifying the emergency restraint which shall specify the nature of the\nrestraint and any conditions for maintaining the restraint until the\narrival of a physician, the reasons why less restrictive forms of\nrestraint were not used, and a description of the steps taken to assure\nthat the patient's needs, comfort and safety were properly cared for.\nSuch physician shall place in the clinical record an explanation for any\nsuch delay.\n  (f) During the time that a patient is in restraint, he shall be\nmonitored to see that his physical needs, comfort, and safety are\nproperly cared for. An assessment of the patient's condition shall be\nmade at least once every thirty minutes or at more frequent intervals as\ndirected by a physician. The assessment shall be recorded and placed in\nthe patient's file. A patient in restraint shall be released from\nrestraint at least every two hours, except when asleep. If at any time a\npatient upon being released from restraint makes no overt gestures that\nwould threaten serious harm or injury to himself or others, restraint\nshall not be reimposed and a physician shall be immediately notified.\nRestraint shall not be reimposed in such situation unless in the\nphysician's professional judgment release would be harmful to the\npatient or others.\n  (g) A record of all restraints shall be kept by the director of the\nfacility.\n  (h) Nothing in this section shall prevent the use of mechanical\nsupports necessary to keep an infirm or disabled patient in a safe or\ncomfortable position or to provide stability necessary for therapeutic\nmeasures such as immobilization of fractures, administration of\nintravenous or other medically necessary procedures.\n