The prisoner's transport from the local jail to the hospital emergency department seemed no different from the countless number of trips the sheriff's deputies had experienced in the past. Charged with armed robbery, departmental policy mandated that leg irons and handcuffs be securely fastened around the convict's extremities.
Unfortunately, the experienced deputy had no way of knowing that his prisoner had earlier made a statement to a fellow inmate revealing his intent to escape. Typical of most inmates, the prisoner's complaint of arm and leg pain was not discernible by the jail's medical staff. As a result, policy required that the inmate be taken to the local hospital's emergency department for further evaluation.
Upon arrival at the hospital the prisoner, now termed a forensic patient, was placed in an ED treatment cubical where he was immediately examined by a physician. After a quick examination the doctor ordered the inmate's shackles removed from the prisoner's right side so X-rays could be taken of the alleged injury. While waiting unshackled for his test results, the prisoner requested permission to go to the bathroom. After using the bathroom the inmate called for the deputy's assistance. As the officer peered into the bathroom the inmate feigned having difficulty pulling up his orange jump suit. In an attempt to help the inmate, the deputy bent over exposing his gun side to the inmate. The deputy was struck in the head with an object later identified as the metal tube from the center of a toilet paper dispenser. The desperate prisoner grabbed the dazed deputy's gun from his holster as the injured officer fell to the floor.
The Emergency department immediately initiated a lockdown of the unit, not knowing the prisoner had taken possession of the deputy's handgun. Having heard the commotion, one of the hospital's security officers immediately responded to the ED in an attempt to gain access through the locked glass door. As the guard pushed on the locked door, a shot, fired from the deputy's gun, penetrated the glass striking the guard, mortally wounding him.
During his escape, the fleeing felon shot and killed an approaching deputy, as well as forcing a state college to shutdown on their first day of school. An entire community would be thrown into a massive panic before the escaping felon could finally be captured.
The above isn't a tale of fiction; it's the reality from late August 2006, when an inmate, sent for treatment to a hospital in Blacksburg, Va., managed to overpower his accompanying deputy. In his escape, the suspect, William Morva, left a hospital security officer dead, as well as a pursuing deputy. You can see the full story here.
This incident, in security terms, is the result of an unbroken chain of events that led to a tragic sentinel event -- an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof.
Examining the Root Cause
A shooting death on hospital grounds invariably draws close scrutiny from Federal and state regulatory agencies. Litigation exposure moves to the forefront and the hospital's order of the day typically becomes 'damage control', notwithstanding the pending wrath of the Joint Commission, which is a virtual certainty. Still, many hospitals and healthcare facilities across the country continue to accept this type of incident as a "necessary evil" in the treatment of forensic patients in their emergency department setting.