RISK Alert   #924     Hollywood Nursing Home Deaths            

Dateline,   September 14, 2017,  Fort Lauderdale, FL


The impact of Hurricane Irma on healthcare care organizations in Florida came home yesterday when it was discovered that 8 elderly patients died in a nursing home just north of Miami, in Hollywood, Florida.  Florida Gov. Rick Scott called the situation “unfathomable,” promising to “aggressively demand answers on how this tragic event took place.”

Hollywood police launched a criminal investigation, and agents from the state attorney general’s office and the state Agency for Health Care Administration were on the scene, authorities said. State officials closed the
facil Wednesday night and barred it from admitting new patients.

“This was a terrible incident. The scene was chaotic when I arrived,” said Dr. Randy Katz, medical director for emergency services at Memorial Healthcare System, where about a dozen of the 158 people who were evacuated from the facility were admitted for respiratory distress, dehydration and heat-related issues.

Katz said so many patients needed assistance that his hospital, which is just down the street, called in more than 50 doctors, nurses and other staffers under a mass casualty protocol.

Fire crews were first called to the Hollywood Hills facility at 3 a.m. ET for a report of a cardiac arrest. More fire and emergency response crews were sent when a second call came in at 4 a.m. for a patient having breathing issues, she said. Three people were found dead on the second floor, and by 6:15 a.m., a full-scale evacuation of the facility was underway.

The new CMS Final Rule on Emergency Preparedness stresses the Dr. Donald Miller, an ER doctor, added, “Nursing home patients are generally more frail than the normal population and we need to have controls in place to guard their safety in a crisis situation, like Hurricane Irma.”

Lessons Learned:

1.  Nursing homes need to be on a first name basis with other providers so they can shift patients to safer facilities during severe weather emergencies like Irma and Harvey.  The new CMS Final Rule on Emergency Preparedness spells like the procedures for these emergencies.

2.  The November 15, 2017 Deadline for 17 Healthcare Providers to finish their All-Hazards Facility Risk  Assessments is fast approaching.  Emergency Communication plans need to be finalized, in addition to staff training and community drills precisely to PREVENT THESE INCIDENTS IN THE FUTURE.

RISKAlerts is a
publication of Risk & Security LLC

Write to info@riskandsecurityllc.com for more information on the new CMS Emergency Preparedness Program, including All Hazards Facility Risk Assessments

#NursingHomeDeaths                    #CMSFinalRule             #nursinghome  

RISK Alert March 31, 2016 Patient Dies After Falling from Hospital Room

RISKAlert   No. 843, March 31, 2016

A Maine patient, hospitalized with a severe brain injury after a motorcycle accident, climbed out of a 6th floor window in the hospital and fell to his death at 5:10 pm on March 29th.

Paul Cady, 43, from Hollis, Maine, had entered the hospital on March 9th, after a motorcycle accident, and had been in a medically-induced coma for a period of time following the accident.  His family emphatically stated he was not trying to commit suicide, but that he was only trying to get home to his family.
Portland, Maine -- 03/30/16 -- Paul Cady, as seen in an undated photo provided by his daughter, Miranda Cady. Paul Cady died Tuesday evening after falling from his sixth story window at Maine Medical Center in Portland. Courtesy photo

Recently, hospitals have recognized the value of fresh air and ventilation, but as a Life Safety issue, the amount that the window opens has been regulated by CMS, the Centers for Medicare and Medicaid.  Studies that shown that windows provide a positive effect on both healing and on patient satisfaction, whether the windows can be opened or not.

Registered Architect Gene Wells of Marshall Erdman & Associates, a leading national health care design and construction firm, offers the following: “In today’s hospital, huge efforts are being made to create a healing environment for patients and their families. A non-institutional approach lessens the stress level for people who already have too much stress and leads to better outcomes. Patient’s rooms, in particular, are often designed to reflect local culture, connect with nature or create a hotel-like environment. Operable windows can be an integral part of this atmosphere.

Lessons Learned:

1.  Patient falls from hospital windows are extremely rare in the United States.
2.  This type of incident can create a potential liability issue for healthcare organizations.

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RISKAlert Case Study #841 – Physician Shot & Killed in Metairie

Dateline:  March 25, 2016 – New Orleans, Louisiana

A local Doctor was shot and killed by a patient while he treated others in his office near East Jefferson General Hospital in New Orleans yesterday.

The 73-year old shooter walked into the doctor’s office, and killed the doctor with a single shot to the head.  He then ran out of the office and into a Wendy’s restaurant.  Jefferson Parish Sheriff’s Office deputies were nearby and they responded and chased the shooter into a nearby Wendy’s restaurant, where the shooter killed himself by putting the gun in his mouth and pulling the trigger.

The doctor, 75-year old Dr. Elbert Goodier, a urologist,  was treating patients at the time of the shooting.  Colleagues said that Dr. Goodier was a very kind and popular physician.  The shooter’s family said that the shooter had been treated by Dr. Goodier in the past.  While the shooter did not have a criminal background, his family said that he had suffered from mental illness in the past.

Dr. Goodier had practiced for 50 years in the New Orleans area, according to East Jefferson General Hospital.

According to Wendy’s employees, a woman was placing her order when the shooter pulled the trigger as the deputies advanced on him.   The man’s body remained inside of Wendy’s more than an hour after the shootings. Yellow police tape cordoned off the parking lot and the hospital’s exit lanes. Some workers and patrons were also still in the building as of 4 p.m., speaking with investigators. Outside, other workers, concerned relatives and onlookers watched.


This type of shooting, the Baby Boomer Shooter, is the second attack on a urologist, and one in an increasing number of seniors who attack their physicians.  Another shooter killed his urologist in Reno, Nevada and injured two others before taking his own life. The shooter said had struggled for 3 years with ailments resulting from a botched vasectomy, according to messages he posted on an online support group and a law enforcement investigation.

Lesson Learned :

While doctors have not been a target in the past, they have been shot and killed recently by patients unhappy with medical results.  All hospitals and medical offices should review their access controls systems, based on the increasing, and alarming rate of attacks on healthcare workers.

                    Stay Alert and make sure to subscribe to RISKAlerts
Sign Up at: caroline@riskandsecurityllc.com

ED Visitor in Guelph General Hospital is Shot and Killed by Hospital Police

RiskAlert LogoCase Study # 714 – Guelph, Canada

Date:  June 1, 2015

Emergency Department Patient in Canadian
Hospital is Shot and Killed by Hospital Police.

Dateline:  May 21, 2015

In a rare hospital shooting, a Guelph General Hospital’s emergency department became a crime scene when a woman, covered with blood, ran out of the hospital screaming that her boyfriend was shooting.

Minutes later, two Guelph police officers shot and killed the man accused of shooting his girlfriend.  Witnesses at the scene said that they screaming.  A witness on the scene reported, “All I heard was gunshots, the chick’s  just like, ‘Help, my boyfriend’s shooting at me,’ and she comes running out,”

Guelph General Hospital President Marianne Walker praised the hospital staff, saying “They put the patients first, and thought of themselves second.”

Few details were released, pending investigation, but a source reported that the “boyfriend” had been at the hospital many times before, according to a source who did not want to be identified.

Homewood Health, one of Canada’s largest addiction and mental health centres, is located near the hospital.  Some of the bystanders suspected it might be a case of domestic violence. 

President Walker said the hospital was providing counseling and other services (Psychological First Aid) for the hospital staff who was very upset over the event.   “All our staff will get as much time off as they need, and as much support as they require,” she said, ““We really want to make sure that they’re OK.”

Lessons Learned

1.   Staff members who are not used to violent incidents may be shaken up by
shooter events.  New requirements for hospitals emphasize the importance of having support  available immediately after an event to counsel employees.

2.   Support for hospital staff who witness violence are prime candidates for a program  that FEMA has called “Psychological First Aid.

                   RISKAlert® is a publication of Risk & Security LLC

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Biggest Risks for Baby Boomers – Obesity & Diabetes

Lots of people I know are afraid to get on a plane…  Lots of others worry about catching Ebola, or finding a single germ on their kitchen counters.

HEY – at Holiday Time this year, the greatest threat to people over 40 are the twin terrors of Obesity and Diabetes.

I look at other people’s shopping carts in the store and see they are all buying soda, and white bread, and processed food – like chips, etc.  You can see why the produce department only takes up less than 10% of the store.  People eat junk. Junk means
you are eating what your body cannot recognize as real food!  It has to look like –
an apple, or a banana, or lettuce, or even a chicken leg.  But look at a cheerio – you can’t tell it’s original form…. it’s plastic food.

But food is only half the story — if you want to heal yourself and live better – Start moving. 

I have a new theory of how your cells renew themselves by oxygenating themselves. Cells fresh with oxygen don’t rust, don’t get stuck and don’t let cancer or diabetes come into through the cell wall.

It’s easy to get started – walk, or run, as fast or slow as you can, do yoga, or just
aerobic breathing.  Roll around the floor — do pushups, or jump rope, or swim, lift weights or dance!  Buy yourself a small trampoline for Christmas and jump on it- it’s full and it bounces your whole body full of oxygen.

Holiday and New Year’s resolutions should be 1. GET MOVING – however you can, wherever you can, whether you are already in shape, whether you are bedridden, whether you are 23 and 83. You can start today and in 3 days, you’ll feel 300% better.

OBESITY, DIABETES, CANCER are risks you can avoid!! Try it.


Second Ebola Patient in the US Confirmed by CDC

As the media is reporting incessantly, a healthcare worker at Texas Presbyterian Hospital in Dallas has been diagnosed with Ebola.  The transmission mechanism hasn’t been announced, but again, it looks like it may be related to taking OFF the protective

Obviously only 2 cases is not a country-wide epidemic, and 99% of the people who read this are hundreds of times more likely to be hit by lighting, or drown in the bathtub, than they are to ever catch Ebola.


However, healthcare workers are more at risk.  I have heard journalists continue to report that all hospitals are READY – THEY ARE NOT!  They report on the New York
City hospitals, but HEY, the first and second cases were in DALLAS, TEXAS!

What can an average person do at this point?  Call up your local hospital and ask them if they have prepared an isolation treatment area, ask them if they have full protective
gear available right now – today.  Ask if they have updated their infection control
procedures in the last 30 days.

The squeaky wheel forces organizations to pay attention to things like EBOLA preparation, enhanced staff training, additional investments in Protective Suits,
temporary barriers, better hazmat disposal, and lots more.

Preparedness is the ONLY THING that can stop Ebola from spreading and safeguard
everyone from a killer disease!

How Mental Health Problems Directly Affect Hospital Security

Reprinted with permission from www.SecurityInfoWatch.com



Healthcare’s failure to address link between mental illness and violence putting lives in jeopardy. Pennsylvania hospital shooting highlights ineffectiveness of the industry in treating high-risk patients

Richard Plotts, the man who allegedly murdered a 53-year old caseworker at a suburban Philadelphia hospital last week by shooting her in the face, was formally charged with murder on Saturday following surgery to remove bullets in his torso.

According to Delaware County District Attorney Jack Whelan, police in Upper Darby, Pa., where Plotts lived, were aware of at least three mental health commitments, including once after he cut his wrists and once when he threatened suicide — but said such stays can last just one to three days. Whelan also noted in his press conference that Plotts had also spent time in a mental health facility.

Every week brings a new story in the media about murder-suicides, patients killing healthcare workers, random shootings and assaults.   We can read the new polls like the article on U.S. shootings in healthcare, as well as the recent healthcare crime study by the International Association of Healthcare Security and Safety IAHSS) that routinely reports that violence in healthcare is soaring.

Not only in healthcare, but throughout the U.S., these random active shooter trends are increasing.  To see how much of this violence is related to severe mental health problems, we only have to look as far as these high profile incidents:

  • June 14, 2012 – Buffalo, N.Y., trauma surgeon shooting
  • July 20, 2012 – Aurora, Colo., movie theater shooting
  • Sept. 16, 2013 – Washington Navy Yard shooting
  • Dec. 17, 2013 – Reno, Nev. urology clinic shooting
  • Jan. 22, 2014 – LAX active shooter incident
  • April 2, 2014 – Fort Hood (2nd) active shooter incident

None of these incidents were related to poor performance review, losing a job, and only one of these could be called “domestic violence,” but what they all have in common is that the perpetrators were all severely mentally ill.

Guns scare me.  Guns kill people by accident and on purpose. I never let my children play with guns.  However, as I analyze the elements of these shootings and dozens more, my bias is changing.  I think it’s less about guns and more about mental illness.

Healthcare and hospitals would be the one industry where you would think that people would be concerned about the state of mental health of their patients and staff. Instead, it seems like mental health problems are walled off by society, treated ineffectively, and violent tendencies (which sometimes make their way onto patients’ Facebook pages) are largely ignored and unreported by the clinicians treating them.

So it’s left to the security and law enforcement community to deal with these individuals who are paranoid, depressed, angry, frustrated, disappointed, hurt, confused, and, ultimately, violent.

Now that mental health has been re-classified as another medical problem, the money is flowing to the treatment centers and it’s covered by Medicare. But progress doesn’t seem to be either easy or effective.

Dr. Graham C.L. Davey, Ph.D. writing in Psychology Today in January said: “Many of those health professionals (GPs and family physicians) at the first point of contact with people suffering mental health problems are poorly trained to identify psychological problems in their patients, and have little time available to devote to dealing with these types of problems. This increasingly makes medication prescription an attractive option for doctors whose time-per-patient is limited—an outcome which will have all the potential negative effects of medicalizing the problem into a “disease.”

And that’s exactly what we see, patients who don’t take their meds because of the negative side effects and so they become isolated and increasingly violent.  The side effects are clearly pointed out in TV commercials, that you’ve probably watched.

For example, one medicine has side effects that include sexual side effects, convulsions, brain shrinkage, stroke, death, suicide, violent thoughts, psychosis and delusional thinking.

The increase in hospitals adding seclusion rooms, expanding the number of beds for psych patients, and the time spent by both law enforcement and security professionals  in dealing with these troubled individuals, may account for one-quarter to one-third of an organization’s security budget.

Many of the security risk assessments we do are focused on handling mobile mental patients, including the baby boomers suffering from Alzheimer’s and dementia.

As violent incidents continue to increases in our society, our workplaces, and in our hospitals, we need to spend more time looking for, and demanding treatments that work and that are sustainable by the patients so they can lead happier lives and we can protect the rest of society, and our healthcare facilities, from their potentially violent behavior.


Author: Caroline Ramsey Hamilton

Since 1988, Caroline Ramsey-Hamilton has been a Thought Leader in All Aspects of Active Shooter and Security Risk Assessment in both Public and Private companies and organizations. Specializing in Hospital and Healthcare Security. Hamilton is Certified in Homeland Security (CHS-III), Anti-Terrorism (ATAB) and Security Risk Assessment. As President of Risk & Security (www.riskandsecurityllc.com) she works with many hospital clients, and develops affordable risk-based apps for improving security risk assessments, and publishes the RISKAlert security awareness program. She lives in south Florida with one beagle, a rescued kitty and (on weekends), 4-year old twins.