NY Ment Hygiene L § 33.04 (2021)
2021 New York Laws MHY - Mental Hygiene Title E - General Provisions Article 33 - Rights of Patients 33.04 - Restraint of Patients.

§ 33.04 Restraint of patients.  (a) As used in this section, "restraint" means the use of an apparatus on  a patient which prevents the free movement of both arms or both legs or which totally immobilizes such patient,  and  which  the  patient  is unable to remove easily.  (b)  Restraint  shall  be  employed  only  when necessary to prevent a patient from seriously injuring himself or others.  It  may  be  applied only  if  less restrictive techniques have been clinically determined to be inappropriate or insufficient to avoid such injury.  It  may  not  be employed as punishment, for the convenience of staff, or as a substitute for treatment programs.  (c)  The  "camisole"  and  the "full or partial restraining sheet", or such other less restrictive restraints authorized by  the  commissioner, shall be the only permissible forms of restraint.  (d)  Restraint  shall be effected only by written order of a physician after a personal examination of  the  patient  except  in  an  emergency situation,  as  provided  by  subdivision (e) of this section. The order shall set forth the facts justifying the restraint and shall specify the nature  of  the  restraint  and  any  conditions  for  maintaining   the restraint.  The order shall also set forth the time of expiration of the authorization,  with  such  order  to apply for a period of no more than four hours, provided, however, that any such  order  imposing  restraint after  nine  o'clock p.m. may extend until nine o'clock a.m. of the next day.   A full record  of  restraint,  including  all  signed  orders  of physicians,  shall be kept in the patient's file and shall be subject to inspection by authorized persons.  (e) If an emergency situation exists in which the patient is  engaging in activity that presents an immediate danger to himself or others and a physician  is  not immediately available, restraint may be effected only to the extent necessary to prevent the patient from injuring himself  or others  at  the  direction  of  the  senior  member  of the staff who is present.   The senior  staff  member  shall  cause  a  physician  to  be immediately  summoned  and  shall  record  the  time of the call and the person contacted.  Pending the arrival of a physician, the patient shall be kept under constant supervision.  If  a  physician  does  not  arrive within  thirty  minutes of being summoned, the senior staff member shall record any such delay in the patient's clinical record  and  also  place into  the  patient's  clinical record a written description of the facts justifying the emergency restraint which shall specify the nature of the restraint and any conditions for maintaining  the  restraint  until  the arrival  of  a  physician,  the  reasons  why  less restrictive forms of restraint were not used, and a description of the steps taken to  assure that  the  patient's  needs, comfort and safety were properly cared for. Such physician shall place in the clinical record an explanation for any such delay.  (f) During the time that a  patient  is  in  restraint,  he  shall  be monitored  to  see  that  his  physical  needs,  comfort, and safety are properly cared for. An assessment of the patient's  condition  shall  be made at least once every thirty minutes or at more frequent intervals as directed  by a physician. The assessment shall be recorded and placed in the patient's file. A  patient  in  restraint  shall  be  released  from restraint at least every two hours, except when asleep. If at any time a patient  upon being released from restraint makes no overt gestures that would threaten serious harm or injury to himself  or  others,  restraint shall  not  be  reimposed and a physician shall be immediately notified. Restraint shall not  be  reimposed  in  such  situation  unless  in  the physician's  professional  judgment  release  would  be  harmful  to the patient or others.  (g) A record of all restraints shall be kept by the  director  of  the facility.  (h)  Nothing  in  this  section  shall  prevent  the use of mechanical supports necessary to keep an infirm or disabled patient in  a  safe  or comfortable  position  or to provide stability necessary for therapeutic measures  such  as  immobilization  of  fractures,   administration   of intravenous or other medically necessary procedures.