Hospital shooting leaves two dead, physician injured

In the latest act of violence committed at a U.S. hospital, a man on Thursday shot and wounded a Johns Hopkins Hospital physician, later turning the gun on his mother and himself, the Baltimore Sun reports.

The man on Thursday morning received a briefing about the health condition of his 84-year-old mother—who was admitted for surgery related to cancer treatment—after which he became "emotionally distraught" and "overwhelmed," according to investigators. The man then shot his mother's physician, investigators said. The physician—an orthopedic surgeon—underwent treatment Thursday and is expected to survive.

While the incident is the latest to raise questions about safety at U.S. hospitals, security experts say imposing new restrictions is difficult and specifically adding metal detectors is "impossible." According to Harry Koffenberger, Johns Hopkins' VP of corporate security, the hospital receives more than 80,000 patients and visitors per week, who access the facility through more than 80 different entry points. To add metal detectors and armed staff to every door is not feasible, Koffenberger said at a news conference yesterday.

Meanwhile, Johns Hopkins is staffed by a 400-person security force, and guards verify every visitor and patient before admitting them to the facility. The staff do search and "wand" patients and guests in high-risk areas, such as the ED. Johns Hopkins officials also had prepared for a violent situation in the wake of a 2007 shooting at Virginia Tech, and their emergency plan yesterday to communicate with and protect staff, patients and visitors was executed as designed, Koffenberger said.

RISING VIOLENCE, LOW-LEVEL ABUSE RAISE CONCERNS

Officials warn that the number of violent crimes committed at U.S. health care facilities continues to grow, Modern Healthcare reports. There have been several other well-publicized violent incidents in U.S. hospitals across the past year, including shooting incidents at facilities in Connecticut, Massachusetts, North Carolina, Tennessee and West Virginia.

In a Sentinel Event Alert issued in June, the Joint Commission found an increase in reports of homicides, rapes and "other assaults" against patients or visitors by staff, visitors, patients or intruders at U.S. health care facilities since 2004. To curb the rise in violent incidents the commission recommended that hospitals collaborate with security departments to evaluate safety protocol, increase security in EDs and provide training for staff on how to respond to agitated patients or family members, among other suggestions.

Meanwhile, an assistant professor at the University of Maryland School of Nursing cautioned that while the most-violent acts at hospitals make headlines, caregivers face low-level violence and verbal abuse every day as patients and visitors are frustrated and worried about the care they receive and potential delays in treatment (Calvert et al., Baltimore Sun, 9/17; Fenton et al., Baltimore Sun, 9/16; White, Washington Post, 9/17 [registration required]; Carlson, Modern Healthcare, 9/16 [subscription required]).