Yesterday I was shocked to read a very disturbing article in the Sunday New York Times. An internet version of the story can be read at http://www.nytimes.com/2016/02/14/us/hospital-guns-mental-health.html. The article, by reporter Elisabeth Rosenthal, was entitled “When the Hospital Fires the Bullet”. On August 26th, 2015, Alan Pean, a 26 year old student had been admitted to a Houston hospital. Alan, who had a presumptive diagnosis of bipolar psychosis, drove himself to the hospital seeking treatment. As he approached the hospital, he crashed his car and was seen in the emergency ward. He is reported to have been screaming I’m manic…I’m manic, as he was ushered into the E.R. to assess his injuries from the car crash. Mr. Pean was admitted to a surgical ward with the diagnoses of hand abrasion, substance abuse (blood tests showed positivity for THC), and motor vehicle accident. During his period of observation on the surgical ward, it is reported that Mr. Pean became difficult to control. The clinical staff called security to assist with the issue. According to the Times report, the security guards who responded were two Houston police officers who were moonlighting as hospital security personnel that evening. The exact details of what happened next are a bit vague, but it is reported that Mr. Pean was violent and out of control and struck the officer who was trying to subdue him. Apparently, in an effort to gain control of the situation, Mr. Pean was first Tasered by the security officer and then, when the Taser was insufficient to subdue Mr. Pean, he was shot in the chest. Mr. Pean survived the bullet wound to his chest, was ultimately discharged from the hospital, and is currently being treated for his psychiatric condition. Mr. Pean, is now being charged with two counts of felony assault of a police officer, including the use of four “deadly weapons”, “an unspecified piece of furniture, a wall fixture, a tray table and his hands”, according to the Rosenthal article. He was released from the hospital, after a four-day stay, on $60,000 bail. Mr. Pean’s X-ray, taken several days after he was shot, showing bruised lungs and bullet fragments scattered through his chest. As a Canadian physician who has worked the better part of my life in a hospital, I must say I was stunned. First, I, like most other physicians who have worked in an acute care institution, have been involved in difficult situations where we have had to restrain patients. I certainly remember deploying strategies that included attempts at calming down the patient verbally, the use of physical restraints, and the use of sedatives. In reading the article I couldn’t ever imagine that one of the techniques that might be used to deal with the situation of a psychotic patient being out of control would include the use of a Taser, or the use of a firearm. In fact, not having ever thought about it, I didn’t process that there might be guns in the hospital. Apparently not. Rosenthal, in her article, quotes that according to a 2014 U.S. national survey, 52% of medical centers reported that their security personnel carried handguns and 47% said they used Tasers. Apparently, the incident has caused public outrage. This has included a petition campaign against gun use in hospitals. “I think there is no circumstance under which it is acceptable for a Taser or gun to be used to subdue a patient seeking care,” said Sonya Shadravan, a Los Angeles-based resident physician in psychiatry who signed the petition in support of Pean, in a report by Alma Almendrala and Erin Schumaker of the Huffington Post. The issue, however, may not be as straight forward as it might seem. In an article in Canadian Security a report from the IHSSF, the International Healthcare Security and Safety Foundation, it was stated that “while the debate continues about whether the availability and utilization of weapons by security personnel in the hospital setting is wise, especially the use of TASERS®, this study shows a lower risk of physical assaults in hospitals in which TASERS® (or similar devices) were available to security personnel, which suggests these devices may be useful tools for de-escalating and controlling potentially violent (or already violent) situations.” All that said, Alan Pean was quoted in the Times article as saying ”I thought of the hospital as a beacon, a safe haven. I can’t quite believe I ended up being shot”. If you have any thoughts about this issue, respond the the blog, or better yet…please stop by the Macklem House, my door is always open. Source
What weapons did the patient have? A stapler perhaps like Djiekanski? Who knows if he was in pain and scared after the accident, and this made his condition worse?
