2023 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.