Infant abduction raises questions about health care security and vigilance

Latest kidnapping shows familiar weaknesses and flaws in system

The community of Lubbock, TX, was shocked last year when a newborn baby was stolen from its mother, who had come to trust the accused kidnapper because she appeared to be on staff at the hospital. It would seem the community's hospitals would be on high alert for infant abduction after having seen firsthand how the crime can happen if staff is not vigilant.

But another Lubbock hospital recently was reminded that staff can never, ever let their guard down in the nursery unit.

The latest infant abduction occurred across town from another hospital that experienced a very similar incident in 2006. In that crime, a woman ingratiated herself with a mother by posing as a hospital employee and wearing scrubs that gave her the right look, and then she kidnapped the baby soon after the mother and child left the hospital. The baby was recovered unharmed.

The most recent incident occurred across town in a very similar manner. On March 10, 2007, a woman posing as a medical worker walked out of Covenant Lakeside Hospital in Lubbock with a 3-day-old baby in her purse. The newborn was found a day later unharmed in Clovis, NM, about 100 miles away, after a tip from someone who thought the woman matched the description of the abductor. Federal authorities charged her with kidnapping.

Similar strategy as other incidents

According to reports from the Lubbock Police Department, the kidnaper's strategy was virtually identical to the incident a year earlier in Lubbock and to many other incidents of infant abduction: A woman entered the nursery unit wearing surgical scrubs that gave her the appearance of being on staff at the hospital. She visited the mother's room several times looking for an opportunity, convinced the woman that the baby needed to be taken for tests, and then walked out of the hospital with the infant hidden in a large purse.

The infant was wearing a security tag on an ankle, but security cameras showed the woman exiting the hospital without being challenged. Gwen Stafford, a senior vice president at Covenant Health Systems, told the Lubbock Avalanche-Journal that the hospital's security measures did not malfunction, but she declined to say how the abductor beat the system. John B. Rabun, executive vice president and chief operating officer of The National Center for Missing and Exploited Children (NCMEC) in Alexandria, VA, has investigated the incident and tells Healthcare Risk Management that the abductor removed the security tag before exiting the building. (See box below for more on the limitations of infant security tags.)

Group issues warning on infant security tags

The National Center for Missing and Exploited Children (NCMEC) in Alexandria, VA, has issued a special warning about infant abduction security tags: Don't rely on them too much, and act quickly if the alarm sounds, the group says.

The latest abduction in Lubbock, TX, is just another example of how security tags do not always thwart infant abduction, says John B. Rabun, executive vice president and chief operating officer of NCMEC. Rabun says the group's data show that there have been 10 infant abduction cases from health care arising from the criminal misuse of the attaching bands used with electronic tags. All types of attaching mechanisms have been involved in the 10 recorded cases, he says.

"The electronic tags and support systems themselves do not seem to be an issue. However, with the critical mass of these cases wherein the separation of the bands were successfully used in commission of the felony abduction of newborn babies, we feel it is time for a cautionary use advisory," he says.

The NCMEC released this advisory:

"No matter what form of attachment bands (or clamps) continue in use with the electronic tagging of infants, health care facilities should be very careful to ensure there is NEVER ANY DELAY in activation of the alarm function upon separation and perform frequent, ongoing testing in support of that guideline. Staff should be trained to respond IMMEDIATELY so there is no delay between detection of the alarm condition and generation of the alarm notification."

Rabun says the woman took the infant out of the room in a bassinet and wheeled it past an unoccupied nurses' station to a utility closet at the end of the hall. She then removed the security tag, which was attached with Velcro. The abductor replaced the hospital's baby blanket with one she had brought and then took the baby down an elevator that is out of the line of sight of the nurses' station in the unit.

Removing the ankle bracelet activated it, Rabun says, but apparently the hospital programmed the bracelets with a delay timer so that the Velcro attachment could be adjusted without setting off the alarm. After a delay, the ankle bracelet set off the infant abduction alarm, but by then the woman had taken the baby downstairs to a building exit.

Rabun says the delay timers on the bracelets are a problem. He doesn't know how long the delay was set on this bracelet, but he says he has seen some set as long as three minutes — which gives an abductor a lot of time to escape with the child.

"There's also the question of whether everyone understood the system. Some hospital leaders have said they thought the alarm would automatically lock down the hospital, which it clearly did not," Rabun says. "The risk manager at that hospital has to get in there big time and say, 'What happened here?'"

A relative of the accused woman, Rayshaun Parson, told the Associated Press that the woman had recently experienced her second miscarriage. Since being arrested, Parson has tried to kill herself several times, according to a statement from her attorney.

Healthcare Risk Management sought comment from the risk manager and other officials at Covenant Lakeside Hospital, but they declined. A hospital spokesman indicated that the officials were busy, not surprisingly, with a survey by The Joint Commission. It is common for The Joint Commission to immediately conduct a focused survey after such a sentinel event.

Infant abductions are not common, but they still occur with alarming frequency. Since 1983, there have been 248 infant abductions, according to the National Center for Missing and Exploited Children (NCMEC), in Alexandria, VA. This number includes abductions by nonfamily members from health care facilities, private homes, and other places. Of that number, 121 abductions, or 49%, were from health care facilities.

The Lubbock incident pushes Texas into a tie with California for the most infant abductions since 1983. Each state has 33.

Every infant abduction is frightening, but the latest Texas incident is disturbing in a different way, says Barry Mangels, CPHRM, director of risk management and compliance at Good Samaritan Hospital in Los Angeles. With each abduction that garners significant media attention and analysis within the health care industry, one would expect providers to take note and learn from the hardship of others, he says. But the publicly disclosed facts of the Covenant Lakeside abduction raise questions about whether risk managers really are taking the lessons to heart.

First, Mangels says, let's give credit to the hospital for having done some things right. The hospital did have an electronic monitoring system to alert staff when a baby is taken from the newborn area, and it had security cameras that captured good images of the woman leaving the hospital with the infant. But Mangels notes that the security camera footage shows the woman calmly walking out the hospital exit without being stopped.

"I'm just baffled that the woman could get to the floor and get the baby out," he says. "It makes me wonder how much they depended on the alarm itself to stop the abduction, and whether everyone knew what to do when that alarm sounded." The alarm doesn't stop anything, he points out. "It just tells you that people need to spring into action," he says.

Mangels also is troubled by reports that the abductor was on the unit for some time before taking the baby and went into the patient's room several times, without being challenged by hospital staff. That strategy is standard for these crimes, he says: The abductor hangs around looking for an opportunity and getting friendly with the parents. "The question is, 'Why didn't the staff challenge this person?'" he says. "She didn't have proper identification, so someone — everyone — should have been asking who she was."

Hospital will suffer financially

A. Kevin Troutman, JD, an attorney with the law firm of Fisher & Phillips in New Orleans who assists hospitals with risk management projects, says he also was surprised by the videotape showing the woman walking out of the hospital with the baby. The incident is a reminder that infant abduction is a problem that requires constant attention, he says. Setting up a few safeguards and then thinking you've solved the problem isn't enough, he says.

The hospital could be sued by the parents for emotional distress and related claims, Troutman says. Mangels agrees, and he adds that the consequences for the hospital could be severe even if the parents do not file a lawsuit. "I would expect the hospital to suffer financially, not necessarily from a litigated claim, but from the people who say maybe they don't want to deliver their babies there," Mangels says. "Loss of good will is a huge risk factor for hospitals, and I guarantee you every single person in Lubbock, TX, knows there was a baby abducted from that hospital."

The negative publicity also can make the target a hospital for completely unrelated lawsuits in the future, Troutman says. The hospital's quality and attention to patient safety has been questioned, so that questioning may make people look at future incidents more skeptically and critically, he says. The negative image stemming from the abduction can spill over into unrelated cases, he explains.

Publicity surrounding the previous Lubbock incident may have spurred this latest attempt, and the current attention may prompt another abduction, Troutman says. People who are desperate for a child may hear about the incident and get the idea that such an abduction can be successful," he notes. This incident shows that these incidents continue no matter how much you prepare, but you can take steps to stop it all before the baby is gone," Troutman says. "There will be more of these, so the question is whether you're prepared and respond appropriately, or you're the next hospital that has to figure out what went wrong."

For more information on the Texas infant abduction, contact:

Sources:

  • Barry Mangels, CPHRM, Director of Risk Management and Compliance, Good Samaritan Hospital in Los Angeles, 1225 Wilshire Blvd., Los Angeles, CA 90017. Telephone: (213) 977-2121. E-mail: bmangels@goodsam.org.
  • John B. Rabun, EVP & COO, National Center for Missing & Exploited Children, Charles B. Wang International Children's Building, 699 Prince St., Alexandria, VA 22314-3175. Telephone: (703) 837-6216. E-mail: jrabun@ncmec.org.
  • A. Kevin Troutman, Fisher & Phillips, Suite 3710, 201 St. Charles Ave., New Orleans, LA 70170. Telephone: (504) 529-3856. E-mail: ktroutman@laborlawyers.com.

Scrubs again play role in infant abduction

Scrubs were an issue in the latest Lubbock abduction, just as they were in the 2006 Lubbock incident and in other abductions nationwide. A simple of pair of scrubs can be purchased cheaply and easily by anyone, and they can be a surprisingly effective disguise, says Barry Mangels, CPHRM, director of risk management and compliance at Good Samaritan Hospital in Los Angeles.

Scrubs are the de facto "uniform" of many hospital staff, so anyone walking through the facility in scrubs automatically looks appropriate. "It's a simple but a very effective way to blend in, and that's what these people want. They want to blend in with all the other staff so no one questions them, including the parents," Mangels says. "It's like if anyone could buy a police uniform and have people just assume you're a police officer. But unlike police uniforms, anyone can buy a set of scrubs."

Curtailing the wearing of scrubs would be best, but that can be difficult to execute, Mangels notes. Some hospitals require staff in their newborn units to wear a distinctive color of scrubs or other uniform to make it clear that they are authorized to handle an infant, which Mangels says can be a good start. His facility uses a different color of scrubs and a distinctive-looking name badge for staff in the newborn unit.

Another possibility is to refuse entry to the hospital for anyone wearing scrubs but not showing staff identification — in effect, saying that only staff can wear scrubs. That would help avoid the problem of parents, if not staff, assuming that the scrubs mean a person is on staff even if the identification is not visible. "It's a good solution, but most risk managers will find it hard to implement," Mangels says. "With scrubs so common, you're going to turn away a lot of people. If you're in a big medical complex where people from other offices might be coming to the facility but aren't on staff, that would cause a lot of problems."