Probe Criticizes Procedures Used at State Hospital : Behavior: Auditor general says some children at Camarillo were physically restrained without required approval.

Camarillo State Hospital uses physical restraints on mentally retarded children more than any other California institution, according to an investigation by the state Auditor General’s office.

Of 44 children in the hospital’s Developmental Center last year, 27 were restrained--either with straps, mittens, helmets or drugs--to modify behavior problems, said Acting Auditor General Kurt Sjoberg.

A random sampling of six children revealed that three had been restrained without approval from their parents or a hospital behavior modification board, in violation of their civil rights, Sjoberg said.

Top officials at Camarillo State Hospital could not be reached for comment. But a patient rights advocate employed there said he is unaware of the problems listed in the state audit.

“I think we are doing a reasonably good job,” said Bob Hentley.

According to state law, hospitals are allowed to use restraints on some patients, especially when they are in danger of harming themselves or others.

But Sjoberg said state investigators were alarmed to find that Camarillo--as well as five other state hospitals for the mentally disabled--have failed to obtain proper approval before using the restraints. In some cases, the children are believed to have been confined longer than necessary because procedures were not followed, Sjoberg said.

For example, the audit found, Camarillo staff placed a child in specially designed restraining mittens and a helmet five times between August, 1989, and April, 1990, without recording either how long the client was kept in restraints or assessing the child’s condition at least every 30 minutes, as required by law.

The audit was requested more than a year ago by the state Legislature after reports, which originated at Sonoma State Hospital, that mentally retarded children in the state’s hospitals were being abused. Several investigators spent about a month interviewing staff and patients and studying documents at Camarillo State Hospital.

Sjoberg said the auditor general’s office is recommending that the hospitals follow guidelines more closely before using restraints on children.

“Overmedicating or tying a child to a chair can have devastating effects on a young life,” Sjoberg said. “One would certainly hope (the hospitals) would be working toward making that life as positive as possible.”

Hentley, citing a need for restraints, said mentally retarded children housed at Camarillo tend to be more mobile and aggressive than the youngsters at other state facilities.

While the Camarillo staff failed to obtain permission to use restraints on three of the six children surveyed by investigators, two other state facilities were found to be worse in failing to secure consent for restraints, Sjoberg said.

At Stockton Developmental Center in Stockton, hospital staff did not obtain permission to restrain 83% of the children surveyed there last year. And at Lanterman Developmental Center in Pomona, permission was not obtained in 70% of the restraint incidents checked by the state.

Carole Hood, the deputy director of the state Department of Developmental Services, acknowledged the situations at the hospitals.

“In some cases the procedures were not followed,” Hood said. “Oftentimes the behavior of the clients is aggressive and there is a very real threat of them injuring themselves or the staff. . . . While the staff was trying to make reasonable decisions to protect the health of the patients, unfortunately that meant that they did not follow the policies.

“We now need to make some changes.”

Hood said hospital officials have been made aware of the problems and have agreed to ensure that patients’ rights are protected.

Peggy Collins, consultant to the state Senate Special Committee on Developmental Disabilities and Mental Health, said she believes the use of restraints should be eliminated at the state facilities.

“It is just inappropriate,” Collins said. “It is ghastly, shocking and of grave concern to us.”

Collins, an aide to state Sen. Dan McCorquodale (D-San Jose), said she plans to take the issue up with lawmakers.