Assaults at Hawaii hospital for criminally insane prompts Senate investigation

 PRESSING THE ISSUE: Psychiatric technician Emelinda Yarte with Senate Judiciary and Labor Chair Clayton Hee at the Hawaii State Capitol.

by Malia Zimmerman, Watchdog.org, November 21, 2013 

HONOLULU — Assaults on workers at the Hawaii State Hospital are all too common, and taxpayers are picking up the tab for the cost of treatment and workers compensation.

Records show that the mentally ill patients at the hospital assault an employee on average once every three days, causing injured staff to miss months, or even years, of work.

The situation has prompted two state senators, Dr. Josh Green, chair of the Senate Health Committee, and Clayton Hee, chair of the Senate Judiciary and Labor Committee, plan to hold a series of investigative hearings before Christmas. Hospital management and staff and other related parties will testify about overcrowding, understaffing, dangerous working conditions and treatment of injured workers.

The senators met with media at the state Capitol on Wednesday, where they introduced several state hospital employees who had been injured on the job.

The $52 million operation under the supervision of the state Department of Health houses Hawaii’s most volatile and sadistic criminals — murders, rapists and child predators — who have avoided prison by successfully arguing an insanity defense.

One of the workers, nurse Josh Akeo, said employees have no protective gear or weapons to shield themselves from aggressive prisoners who may relentlessly attempt to bite, spit, punch, kick or body slam staff members once released from their restraints.

Akeo lost consciousness when he tried to break apart two patients having a physical altercation, and was knocked to the ground and repeatedly kicked in the head by one of them. Akeo awoke to the news he suffered a concussion and other injuries, but had no memory of the event.

His doctor, Scott Miscovich, said Akeo, who is on leave and receiving workers compensation, suffers from severe headaches and memory loss, and won’t be authorized to return to work at this point because it’s too dangerous.

 HEAR OUR PLEA: Hawaii State Hospital workers Ryan Oyama, Josh Akeo and Kalfred Keanu with Dr. Scott Miscovich standing behind them.

Psychiatric technician Emelinda Yarte stands just 4’11” tall, but she intervened in a 2009 attack on her fellow employee by a patient with mixed martial arts training because there was no other employee on the floor. Yarte was severely injured, suffering blows to her head, spine and jaw.

“I know I got assaulted because there was a lack of staff on that day,” Yarte said.

The mother of two burst into tears as she told her story, saying the beating has caused her to be out of work for four years. Yarte is still in pain, depressed and suffers flashbacks. The criminal case against her attacker was dismissed because of court delays.

“I cannot sleep. I do not want to go out knowing that the patient is outside. I don’t know what is going to happen. Was I going to see him? I got so scared,” Yarte said.

Yarte’s attacker is now back in the hospital, and other workers confirmed he subsequently beat other employees.

Ryan Oyama, another psychiatric technician, said he has been attacked more than 60 times in 10 years, resulting in a concussion, knee injury and other problems.

 INVESTIGATION NEEDED: Senators Clayton Hee and Josh Green said they will get to the bottom of the violence against workers and patients at the state hospital.

Psychiatric technician Kalfred Keanu was assaulted by a patient who had hit another patient two days earlier. The injuries to his head were so severe he was out of work for 10 months.

“That changed by life dramatically,” Keanu said.

Keanu was unable to get his workers compensation payments or medical treatment on time, and as a result, could not pay his bills, child support or rent, and lost his home.

Keanu returned to work, even though he was in pain, to climb out of his financial hole, but he was assaulted again and injured severely enough to be put back on workers compensation.

“If we’re getting assaulted, who is going to keep the patients safe? Keanu asked. “And that is the big concern, is the patients.”

The state Department of Health said there were 132 assaults on workers in 2011, 120 in 2012 and 90 so far this year.

Meanwhile, there were 135 reports of assault of patients by other patients in 2012 and 126 so far in 2013.

Thirteen worker compensation claims totaling $146,000 have been filed by hospital staff so far this year. In 2012, there were 33 claims totaling $350,000.

Oyama said many more assaults go unreported because staffers are encouraged by supervisors not to report them and “take one for the team.”

Mark Fridovich, head of the Adult Mental Health Division for the Department of Health, maintained the administration is dedicated to ensuring the safety of patients and staff and argued the facility is not overcrowded or understaffed.

“We acknowledge there is risk working with an unpredictable population that requires intensive around the clock care and supervision,” Fridovich said. “We take immediate action when an injury occurs at the hospital.  We want to prevent every injury.”

Workers involved with direct care of patients must undergo conflict prevention training every six months, and self-defense training is a component of that, Fridovich said.

There are unarmed private security patrolling the premises, but there aren’t police or armed guards in the intake area and other areas where dangerous criminals are kept.

Hawaii State Hospital “is a hospital, which is different from a prison,” Fridovich said. “…we treat patients with challenging behaviors, we follow best practices and national standards. Hospitals do not allow armed guards on staff. Hospital staff ensure quality treatment.”

The four workers were critical of the hospital management’s use of the psychiatric intensive care unit where the most dangerous criminals are supposed to be held. The unit cost the state $530,000, but isn’t used for its original purpose since a staff member was severely beaten there.

“We want to use the unit for dangerous patients, but not until policy and other issues are worked out to maximize safety,” Fridovich said.

He said state lawmakers have been briefed on the hospital’s needs and are “working together on resources, to continually improve safety and enhance the effectiveness of treatment and patient care.”

Green, an emergency room doctor on the island of Hawaii who handles mentally ill patients, disagrees that legislators have all the facts.

“We will be addressing and investigating the number of assaults, the severity of them and what we have to do make them totally accountable at the state hospital,” he said.

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