S.F. General worker had reported a woman in stairwell He stepped over her 1 week before victim was found

An undated photo provided by David Perry & Associates, shows Lynne Spalding. Officials confirmed Tuesday Oct. 9, 2013, the identity of the body discovered in a rarely used stairwell at San Francisco General Hospital more than two weeks ago as that of Lynne Spalding, 57, a native of England. Spalding was being treated for an infection at the hospital when she disappeared from her room on Sept. 21, 2013. (AP Photo/Courtesy of David Perry & Associates) less An undated photo provided by David Perry & Associates, shows Lynne Spalding. Officials confirmed Tuesday Oct. 9, 2013, the identity of the body discovered in a rarely used stairwell at San Francisco ... more Photo: Associated Press Photo: Associated Press Image 1 of / 3 Caption Close S.F. General worker had reported a woman in stairwell 1 / 3 Back to Gallery

A worker at San Francisco General Hospital reported seeing an unconscious woman in a fire-escape stairwell one week before the body of a missing patient was found in the same spot, according to sources familiar with the investigation into the patient's death.

Lynne Spalding, 57, disappeared from her room on the hospital's fifth floor Sept. 21, two days after she was admitted for treatment of an infection. Her body was found Oct. 8 on the fourth-floor landing of the locked stairwell.

The cause of death has not been determined, but police believe Spalding had been dead for several days and was not the victim of foul play, said the sources, who have knowledge of the police investigation but are not authorized to speak publicly.

According to the sources, a hospital orderly told a nurse Oct. 1 that he had seen a woman, apparently passed out, on the fourth floor of the stairwell. The orderly said he had stepped over the prone woman twice, once going downstairs and again when he returned to the fifth-floor door that he had used to enter the stairwell.

The nurse contacted the Sheriff's Department, the sources said. Sheriff's deputies provide security at San Francisco General.

Response unclear

Such a call should have prompted the sheriff's dispatcher to send a deputy to check the stairwell. But police have not been able to determine how the department responded Oct. 1, the sources said. It's possible no deputy responded to the stairwell, they said, or that a deputy was dispatched to the wrong location.

It is also unclear whether the woman was still alive when the orderly found her. There was nothing in the nurse's call to the Sheriff's Department, however, that indicated the woman might have been dead, the sources said.

Spalding's family reported her missing on the day she vanished, believing she might have wandered out of the hospital, confused because of her medication. Within a few days, the family went public with its concerns.

"We the family, until we get an official report, there is nothing more we can do but wait. It's all horrifying," David Perry, a spokesman for the family, said Friday. "If this story could get any more horrifying, it just did."

Authorities have not said how they believe Spalding got into the stairwell, which had alarms on the doors. Her body was found by a building engineer who was conducting a routine quarterly check on the alarms.

The hospital's apparent handling of the report of the unconscious woman followed standard practices, said Stephen La Plante, former chief of public safety for the city Public Health Department, which formerly oversaw security at San Francisco General. He retired this year as the city's emergency medical services administrator.

Reviewing security

"It's the deputies who go check, who perform the well-being check for anyone found outside a hospital ward," La Plante said. "That is just the standard of practice in American hospitals. I would never expect a nurse to go outside the ward, down a hallway and into a fire escape stairwell. That is automatically the purview of the security force."

Susan Fahey, a spokeswoman for the Sheriff's Department, said the department "will not leave any stone unturned" in its investigation of Spalding's death. She would not comment on whether the hospital had contacted a sheriff's dispatcher about a woman in the stairwell Oct. 1.

Rachael Kagan, spokeswoman for the hospital, also declined to comment.

The medical examiner's office performed an autopsy on Spalding but said a cause of death might not be known for several weeks.

Mayor Ed Lee said last week that the UCSF Medical Center will review the hospital's safety and security protocols.