Risk and Security LLC

Risk Assessments, Training and More

This content shows Simple View

Hospital Security

Former Nurse Commits Suicide in Hospital Bathroom at Valley View Hospital

RISKALERT INCIDENT REPORT # 574 – Suicide in the Hospital Bathroom

August 6, 2014

Former Nurse Commits Suicide, Fires A Single Shot to the Head, Locked in a Public Restroom at Valley View Hospital, Glenwood Springs, Colorado.

A hospital staff member reported Eric Knurr dead in a bathroom stall a round 11:30 a.m. Monday, morning, August 4, after maintenance had to be called to unlock the door to the men’s restroom off the emergency department. The former male nurse had been formally admonished by state regulators for brushing a patient’s teeth until they bled, and also slapping the patient, who was in restraints at the time of the incident in 2005. He had applied for a job at Valley View Hospital in 2012, but was not hired.  In similar incidents:

  • In January, 2014, a man locked himself in the hospital bathroom at Cherokee Medical Center in Iowa, and committed suicide.
  • In August, 2013,   62-year-old man committed suicide in a public bathroom at the Veterans Affairs hospital campus at Fort Harrison, Montana, after locking the bathroom door and killing himself with a single shot.
  • In August, 2012, a similar incident happened at an Oklahoma hospital when a Oklahoma State University employee committed suicide in a public restroom off the emergency room.


(1.)  Hospital staff should IMMEDIATELY report any locked bathroom door in a public restroom.  In several of the incidents, housekeepingdidn’t want to bother securitywhen they found the bathroom door locked, so they waited another two hours before reporting the problem, and by then it was too late.

(2.)  Not having any form of metal detection allows people to bring guns into hospitals, lock themselves in bathroom, and commit suicide.  Metal detectors or wand detectors can prevent a tragedy.

     In December, 2010, The Joint Commission Issued a Sentinel Event Alert on Suicide Risk Outside Psych Units in Hospitals, including medical units, surgical units, and emergency departments.  (http://www.jointcommission.org/assets/1/18/SEA_46.pdf).

“It is noteworthy that many patients who kill themselves in general hospital inpatient units do not have a psychiatric history or a history of suicide attempt – they are “unknown at risk” for suicide.   Compared to the psychiatric hospital and unit, the general hospital setting also presents more access to items that can be used to attempt suicide – items that are either already in or may be brought into the facility – and more opportunities for the patient to be alone to attempt or re-attempt suicide.

“This Alert presents strategies that can be used and suggested actions that can be taken by general hospitals to help better prepare their staffs and their facilities for suicidal patients and to care for both their physical and mental needs. Suicide has ranked in the top five most frequently reported events to The Joint Commission since 1995. The Sentinel Event Database includes 827 reports of inpatient suicides.  Of these events,  14.25 percent occurred in the non-behavioral health units of general hospitals (e.g., medical or surgical units, ICU, oncology, telemetry),  8.02 percent occurred in the emergency department of general hospitals and 2.45 percent occurred in other non-psychiatric settings.”              

           Stay Alert and Encourage Hospital Employee Awareness!

RISKAlert® is a publication of Risk & Security LLC at www.riskandsecurity.com

Get Management’s Attention for Security – Shooter Kills the Hospital Administrator

Every Security Officer I’ve ever met has mentioned how difficult it can be to get funding for additional security!  It is a never-ending mission, to get the budget for a security program that will truly protect an organization.

Hospitals are no exception.  They have suffered their own financial problems and because security is not seen as a ‘clinical’ or ‘patient care’ issue, it is easy to take money from security and put it somewhere else.

But there’s one sure way to get management’s attention for Security — having a security incident.  And if you don’t have one at your organization, high profile security incidents at other facilities will all grab management’s attention.

In my Risk-Pro Security Incident Report today, a shooter killed four, wounded three, and then killed himself.   What was unusual about this incident was that the shooter went to the Hospital Administrator’s house and shot the administrator dead, and then shot his wife who was taken to an area hospital.





Most executives and administrators think about security as sort of an abstract concept, that doesn’t directly affect them.  But it might, and by sending your management a copy of our Risk-Pro Incident Report, you’ll get their attention this time!

(Subscribe to the Risk-Pro Incident Report program by sending an email with the word SUBSCRIBE on it to info@riskandsecurityllc.com)

Wondering Which Security Controls Offer the Highest Protection for Less Money?

Security Controls can be incredibly cost effective or astronomically expensive.  And when you’re faced with a facility or a school campus, or a system that has to be secured, but you also have a budget to keep in mind – what do you do?

The simple answer is ROI – Return on Investment.  This simple calculation compares the Cost of the Proposed Control to the Protection is Provides and that creates the magic ROI Number.

Here’s an example:   A hospital near the New Jersey shore wants to create a new emergency ops center.  They have the space,
but it would cost about $250,000 to build it out.  Here’s what we look at – how often would they use an emergency ops center?

Threat data shows that they would need to use it about 3-6

Operations Center (OPS)
Operations Center (OPS)

times a year, including severe storms, thunderstorms and hurricanes.

(After Hurricane Sandy, the hospital was closed for two days because they were not able to resume service right away.  As a result, the hospital lost about $2,000,000 per day because it could not bill for any services, none could be provided.)  

So we take that lost $2,000,000 per day and say that if we could keep the facility open because we had a better operational center, we could easily save 2 days of revenue which is $4,000,000 for the 2 days, and if it cost us only $ 250,000, and saves us $ 4,000,000, that’s a Return on Investment of SIXTEEN to ONE, 16:1.

Say it saved us 3 days of revenue a year – that’s a ROI of TWENTY-FOUR to ONE, 24:1!

You can get more info by writing to me directly at caroline@riskandsecurityllc.com and requesting a webinar invitation,
or a copy of the video.


Man Wants to Commit Suicide at Hospital to Donate his Organs!

Suicidal Man Triggers an Evacuation in Denton, Texas.

The emergency department at Texas Health Presbyterian Hospital was evacuated after an armed man threatened to shoot himself in the hospital’s parking lot, as reported in a newspaper article. The man had sent suicidal messages to his ex-wife. She contacted police, who in turn began tracking the man’s cell phone. He was found in his vehicle, which was parked in front of the hospital’s ED. Police cleared the ED while they negotiated with him for about 45 minutes. The man told police he chose the hospital because he wanted to donate his organs after he killed himsel

17-year old imposter does CPR on patient in Kissimee, FL

Security measures in place are being questioned in Kissimmee, Florida at Osceola Regional Medical Center after clerk passes as a physicians assistant!

Hospital security procedures, including staff screening practices at Osceola Regional Medical Center, are getting a second look after a 17-year-old passed himself off as a physician’s assistant and took part in several exams and procedures, including doing CPR on a patient. The Orlando Sentinel reported that hospital management is reviewing its practices to ensure a similar incident doesn’t occur. The youth was able to secure a hospital ID badge from the human resources department by claiming to need a new one because the surgical practice at which he worked had changed names. In fact, the youth was employed part time as a billing clerk at a doctor’s office. When confronted by staff, the youth said he was working undercover for the sheriff’s department, so they would be unable to check his employment records

The REAL VALUE of a Hospital Security Program

Violence in hospitals and against healthcare staff has been steadily increasing since 2004. A recent article in the Journal of the American Medical Association (JAMA), cited the National Institute for Occupational Safety and Health, NIOSH publication 2002-101, which indicated that healthcare workers face four times the violence potential as other occupations.

If you add in the many domestic violence cases that play out in our hospitals, you can double or triple that figure. For reporting purposes, OSHA does not count domestic incidents (like murders) that take place in hospitals as officially “workplace violence incidents”.

Anecdotal incidents such as the shooting of a physician at Johns Hopkins Hospital in Baltimore, Maryland in September, 2010, and the January 1st, 2011 stabbing murder of an engineer at Suburban Hospital in Maryland by an employee angry because he didn’t get a good performance evaluation, keep the issue on the front pages, and cause hospital staff to worry about their personal safety.

The Joint Commission issued a Sentinel Event Alert in June 2010, on violence in hospitals and how it can affect both staff and the patients themselves. Nurses are on the front lines, and they are the most likely to be attacked, a fact which has not been lost on the nurse’s associations who are actively lobbying for safer working conditions.

Workplace violence issues were traditionally something handled in the Department of Human Resources, but security departments are increasingly involved in violent incidents and are critical to safeguarding hospitals.

Why Violence in Hospitals is Increasing

Violence is not a concept that people usually associate with hospitals. For years, hospitals have been seen as almost a sanctuary of care for the sick and wounded in our society. However, the perception of hospitals has been changing over the last fifteen years due to a variety of factors.

1. Doctors are no longer thought of as “Gods”. This means they are
are more easily blamed when a patient’s condition deteriorates.

2. Hospitals are now regarded as businesses. This perception has been
been aggravated by television in shows like a recent “60 Minutes”, as well as
by the effects of the recession on jobs and the loss of health insurance.

3. Lack of respect and resources (funding) for hospital security departments
. Rather than being seen as a crucial protection for the hospital staff and
patients, many security departments are chronically underfunded and used
for a variety of non- security functions, such as making bank deposits for
the hospital gift shop.

4. Resistance to Visitor Management programs in many hospitals. Again,
because of the unsettling effect of the recession, violent solutions are
becoming more common in the United States in general, for example, the
recent Tucson tragedy.

The federal government issued a guidance document for dealing with violence issues in healthcare,
OSHA 3148.01R, 2004, Guidelines for Preventing Workplace Violence for Health Care & Social Service Workers

The Evolution of the Hospital Security Program

Even as recently as five years ago, many hospitals didn’t have a Security Director, instead they used the Safety Officer to double up and handle security. However, the Joint Commission and many professional hospital organizations recommend the formation of the Security Director position.

Now every almost every hospital has a Security Director who oversees the various security functions at the hospital. These cover a wide range of duties including managing either a contract security force, or developing and managing a proprietary security force; managing violent patients in the Emergency Department; managing incidents regarding kidnapping, infant abduction, cash handling, helicopter coordination, handling admission of prisoners, monitoring visitors, managing hundreds of cars and garages, dealing with harassment, sexual assaults and domestic violence issues which end up at the hospital.

As the Security Director has assumed responsibility for an expanded list of duties, the security budget has not always kept pace with the expansion of the security function.

Assessing the Value of Security to the Functioning of the Hospital

When we start to assess the value of the security program to a hospital, we have to start with the total value of the hospital.

One of the greatest surprises we find in conducting risk assessments on hospitals, is that they possess tremendous value but because they are so large, and perform so many different functions, individuals can’t always see the hospital as a whole.

To make it easy to understand, we can breakdown the value of a hospital into its component parts:

1. The value of the Facility – this is the current replacement value of the building, usually over 50 million dollars.

2. The value of the hospital Staff, including both administrative and medical staff members (use the value of their salaries for a year).

3. The value of specialized medical equipment, including all
the IT systems, X-rays, Cat scans, MRIs, and medical lasers, photon knives, etc.

4. The value of the actual revenue from the patients.

5. The value of the patient’s safety and their health information.

You can see that when we add up these asset values, and add another 10-12 categories, the hospital usually ends up with a value of $100 million to $500 million, or often higher. That is the total of the assets that are potentially ‘at risk’.

That is the value that the security function protects. Each of these asset categories can potentially experience a loss that would interrupt their operations, either for a limited time (like a gang fight in the lobby; or a theft of pharmaceuticals), or permanently (for example, a catastrophic fire).

The next step in the analysis is the see what kinds of controls are already in place to protect all these assets. Controls are mandated by a variety of federal, state and local laws, as well as best practices from insurance companies, and standards created by industry associations such as the Joint Commission, the Center for Missing and Endangered Children, the International Association of Hospital Security and Safety.