Hospitals Must Balance Between Security, Access

Orange County hospital officials are reevaluating security needs in light of Tuesday’s fatal rampage in Anaheim, but they remain reluctant to use metal detectors and armed guards as found in some major cities.

Hospitals must strike a balance, they said, between safety and access for their employees and thousands of patients and visitors.

“This is not airport security,” said Bob Fraschetti, chief executive officer of St. Jude Medical Center in Fullerton. “People are coming here to see and treat patients, so you do the best you can with what you are dealing with. Hospitals are supposed to be a place of healing; they are not supposed to be fortresses.”

Moreover, security officials said it is just impractical to use metal detectors unless the circumstances warrant extreme measures, and armed guards present training and liability issues.

“Metal detectors are cost prohibitive and they are employee-intensive,” said Anthony Person of American Protective Services, a company that provides security at 58 hospitals nationwide, including three in Orange County. “Someone has to screen the people, and you have to figure out what to do with weapons when you confiscate. It is too extreme.”

Some hospitals in Los Angeles and other major cities, however, pay that price. They use metal detectors, especially in emergency room areas, where patients and visitors include the distraught, gunshot victims and gang members, said several officials.

Six years ago, a disgruntled patient shot up the emergency waiting room at Los Angeles County-USC Medical Center, critically wounding three doctors, forcing the evacuation of dozens of employees and sending hundreds of patients running for their lives.

The incident led to a state law that required hospitals to step up safety measures in emergency wards.

It also led to increased security at County-USC, where only two entrances are now open.

“All the others have been closed off, and everyone entering is subject to search and screened with a metal detector,” spokeswoman Adelaida De LaCerda said. Employees are admitted only with an ID, and visitors must specify where they are going and get a colored badge signifying the ward, she said. Similar measures were taken at all six hospitals run by the county, spokeswoman Sharon Wanglin said.

Orange County hospitals rely on measures ranging from receptionists in the lobby to unarmed security guards posted near the door, officials said. In many cases, security is tightest in emergency room areas with a locked access to the treatment areas to comply with the new state law, officials said.

“Security ranges across a spectrum depending on what the facility believes they need to have based on past experience and the area they are located,” said Jon Gilwee, vice president of the Healthcare Assn. of Southern California, a hospital trade group.

Guards are trained to deal with the difficult emotional environment unique to the health care setting, according to security and hospital officials. This sensitivity training prepares them for dealing with patients or stressed family members.

Other security measures include installing visible surveillance cameras, an ID system for visitors and employees, and sensitivity training for nonmedical personnel who come into contact with patients and families.

Hospitals also react to problems. West Anaheim Medical Center installed bulletproof glass in its emergency room after a patient brandished a gun there in 1998, said Dr. Robert McCauley, former chief of staff.

Gilwee and others said the killings Tuesday would probably lead to a reassessment of security at hospitals throughout the county, though he did not predict changes would follow. “These are tragic incidents when they occur and cause everyone to focus on and reevaluate their security,” he said.

Steve Geidt, senior vice president at Saddleback Memorial Medical Center, acknowledged that hospitals are in a difficult position: Some patients die, and family members can react with violence.

“The uniqueness of hospitals is it is not just employees [who can be disgruntled] but it is also patients, who are under our care. Perhaps that creates an added need for security.”

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Recent Hospital Shootings

1999

* Sept. 14--West Anaheim Medical Center, Anaheim: Man on a shooting rampage kills three hospital staffers.

* March 7--Mount Zion Medical Center, San Francisco: Man shoots and kills his elderly father, wounds a janitor in hospital lobby.

1998

* June 22--Beaumont Convalescent Hospital, Riverside County: Man shoots and kills his elderly wife, then kills himself.

* June 20--Fairchild Air Force Base hospital, Spokane, Wash.: Military man assigned to the base sprays random gunfire from an AK-47. Kills four people and wounds 19 others before being killed by military police.

* Feb. 5--Washington Cancer Institute, Washington, D.C.: Gunman kills one and wounds five.

1993

* Feb. 8--Los Angeles County-USC Medical Center, Los Angeles: Disgruntled patient opens fire in emergency waiting room, critically injuring three doctors. Incident leads to state law requiring emergency ward safety measures.

* June 20--Daniel Freeman Memorial Hospital, Inglewood: Teenager shot while waiting for treatment in emergency ward. Incident believed gang-related.

* Oct. 20--Crestwood Hospital, Huntsville, Ala.: Housekeeping employee shoots and kills co-worker after an argument.

* Feb. 13--Loma Linda University Medical Center, Loma Linda: Woman shot and killed outside hospital emergency room in a domestic dispute.

1992

* Dec. 24--San Bernardino County Medical Center, San Bernardino: Suspected gang member wounded earlier in a drive-by shooting is shot to death in his hospital bed.

1991

* Oct. 12--White Memorial Medical Center, Los Angeles: Gang members spray emergency room entrance with bullets, injuring one bystander.

* Sept. 29--Fairview Developmental Center, Costa Mesa: Alienated employee opens fire, killing one and wounding two.

* Sept. 21--Alta View Hospital, Sandy, Utah: Man carrying dynamite and two guns shoots and kills a nurse after holding maternity ward patients and employees hostage for 17 hours.

1990

* Oct. 16--Los Angeles County-USC Medical Center, Los Angeles: Teenager shot in the face during an altercation between rival gang members visiting patients.

* April 14--Mission Bay Hospital, San Diego: Man distraught over the death of his father earlier in the day returns with a handgun and sprays the emergency room with bullets. Two killed, two wounded.

* Feb. 19--UCLA Medical Center, Los Angeles: Gunman enters an office, kills one employee and wounds another.

1988

* July 25--Childrens Hospital of Los Angeles: Police shoot and kill armed man who led them on a chase through the hallways.

Source: Times reports; Researched by JANICE JONES DODDS / Los Angeles Times

Los Angeles Times