Taser use on father stuns some experts

A recent incident in which police officers used a stun gun to stop a man who was trying to leave a hospital with his own child has prompted concern among health care professionals who wonder if the action was justified, especially because the man was holding the infant at the time he was stunned. The media mostly portrayed the incident as an overreaction that could have harmed the child, and hospital security experts tell Healthcare Risk Management that they agree.

The case can be seen as an example of what can go wrong when a well-intended effort to stop infant abductions and to prevent violence in the hospital goes awry, suggests Tony York, CHPA, CPP, president of the International Association for Healthcare Security & Safety (IAHSS) in Glendale Heights, IL, the professional association for security professionals in health care. York also is senior vice president of Hospital Shared Services in Denver, which provides security to many Colorado hospitals.

Based on what he has learned from media reports of the incident, York says the stun gun use was "an inappropriate use of the device." (For the background on the Houston incident, see article below.) "The officers used the Taser when they had control over the father," he explains. "It seems to me they pulled that Taser out because he was not cooperating with them, and they had not thought through this situation fully to think what they would do if someone was trying to leave with an infant."

Father stopped by wristband system

A surveillance videotape of the April 2007 incident at Woman's Hospital of Texas in Houston shows two police officers trying to stop a 30-year-old man, who was reportedly acting belligerent. Another patient and her husband told local reporters that they overheard the man threatening to create a hostage situation if the staff did not allow him to leave with the child.

Although the man was a custodial parent, the staff were trying to stop him because he was taking the baby without following hospital procedure. The staff summoned security, and two Houston police officers who had been in the building on other business arrived. The man was trying to leave via the elevator, but the infant's wristband caused the elevator to shut down. When he refused to comply with orders to calm down and hand over the baby, one of the officers used a stun gun on him, which caused him to fall to the ground. (Editor's note: The surveillance video can be seen at http://abclocal.go.com/ktrk/story?section=local&id=5572678. The video has no sound, and the father is mostly out of the frame when the guard uses the stun gun on him.)

When the man fell, the second officer picked up the baby and handed her to the mother. The father, William Lewis, told reporters that he was trying to leave with the baby because he and his wife felt mistreated by hospital staff. He says the girl landed on her head and suffered head injuries, but a medical examination revealed no harm.

The baby is in the custody of the local child welfare agency because of a history of domestic violence between Lewis and his wife. Lewis was charged with child endangerment, but a grand jury did not indict him. Healthcare Risk Management sought comment from Woman's Hospital of Texas, but our calls were not returned.

York says the incident illustrates a common dilemma that can occur when staff must confront people trying to take a baby. How far do you want them to go in trying to stop the person? A physical alteration must be avoided if at all possible because of the risk to the child, he says. But staff must be provided with practical guidelines for how to respond. (See article below for more on training staff.)

Staff often don't know how to stop people

Even with drills on infant abductions and a heightened awareness of the risk with young patients, health care staff often don't know what to do when it appears someone is leaving with a child, says Tony York, CHPA, CPP, president of the International Association for Healthcare Security & Safety (IAHSS) in Glendale Heights, IL.

For instance, infant abduction drills usually involve sending staff members to designated exits to watch for someone who might be leaving with a child. The instruction usually is along the lines of "stop anyone who might have an infant." But York says his experience with hundreds of drills shows that when that moment comes, people freeze. "They see the person, but they don't know quite what to do. Many of the hospital policies don't clearly articulate what we want them to do," he says.

The policy should state that the staff member should not make physical contact unless there is imminent danger to the infant, York says. But at the same time, the policy should not just be "observe and report." Simply watching the person leave and then reporting to authorities is not enough. "We want the staff to engage that person. Talk to him or her," he says. "Get in the universal position that says 'stop,' with the hands up and palms out, and at the same time calling for assistance. There is strength in numbers."

A stranger trying to take an infant is not likely to be prone to violence, York notes. The profile of an infant abductor is a person with mental issues, but they do not typically have a record of violent crime. A parent trying to take a child in a custody dispute may be somewhat more prone to violence, but still the risk is low unless the staff escalates the situation with a physical intervention, York says.

When a staff member summons help, the hospital administration must be ready to respond with not just security guards, but others who might be able to end the crisis peacefully. Good candidates are nurse managers, the hospital chaplain, and other trained counselors, York says.

"The last thing you want is a violent fight over the baby," he says. "We witnessed this in a drill one time in which a nurse actually got into a tug-of-war with the doll representing the baby and the person playing the abductor. It was a wake-up call to us that we have to train people in crisis intervention if we're going to ask them to intervene."

York says a physical intervention — whether it is the use of a stun gun or wrestling with the person — poses too much risk to the baby and therefore must be avoided unless necessary to stop immediate harm to the child. In most instances, the person is not harming the child, and staff can take time to talk and diffuse the situation, he says.

The key to understanding the Houston incident may be the fact that the stun gun was used by local law enforcement, not security guards employed by the hospital. "Nonhealth care law enforcement will readily admit to you that they don't understand infant abductions," York says. "They think of kidnapping, someone trying to do harm to a child, and they figure they have to do everything to stop and arrest that person. We know that it's more about someone trying to have a vicarious birth or a custody issue, and that has to be handled differently."

Evelyn Meserve, CHPA, president-elect of the IAHSS and director of security and safety services at CaroMont Health in Gastonia, NC, agrees that health care security professionals probably would have handled this situation differently. She agrees with York that the stun gun was unnecessary and dangerous, but she understands why the police officers were more prone to use that solution rather than de-escalating the situation. Police officers are obligated to intervene in the way they see appropriate, and their perspective can be very different from that of security professionals who are oriented toward a health care environment, she says.

"I would want our security professionals to intervene very differently, with nonphysical interventions," she says. "This scenario might have played out very differently if hospital security had arrived on the scene before the local police officers."

The fact that the person trying to leave with the baby was the father further complicates the issue, Meserve says. Unless the hospital is aware of a custody dispute or verifiable risk to the child, there is little legal basis for stopping a parent from taking the child out of the hospital, she says. (For more on the dilemma with parents, see article, below.)

'Patience is a virtue'

Meserve and York concede that in some extreme cases, physical intervention can be necessary. If the person is harming the child or threatening to do so, the risk from physically intervening could be justified. But they emphasize that in most cases of infant abduction, the person is not likely to intentionally harm the child. "Patience is a virtue. Time is on your side in these cases," York says. "There's no harm in just talking, keeping the person there in the elevator lobby, talking as long as it takes to get that person to hand over the baby calmly and safely."

Sources

For more on the use of physical intervention in health care, contact:

  • Evelyn Meserve, CHPA, Director of Security and Safety Services, CaroMont Health, P.O. Box 1747, Gastonia, NC 28053. Telephone: (704) 834-3575. E-mail: Meservee@gmh.org.
  • Tony W. York, CHPA, CPP, Senior Vice President, Hospital Shared Services, 1395 S. Platte River Drive, Denver, CO 80223. Telephone: (303) 603-3101. E-mail: tyork@hss-us.com.

Hard to stop parents leaving with child

Infant abduction systems can help stop strangers from kidnapping a child and they also can slow down a parent trying to take a child against medical advice. But ultimately if the parent wants to leave with a child, there may be little you can do to stop them, says Tony York, CHPA, CPP, president of the International Association for Healthcare Security & Safety (IAHSS) in Glendale Heights, IL.

The recent case in Houston was just such a scenario. York says the hospital's infant tagging system worked properly by shutting down the elevator, which slowed the father down long enough for an intervention. Staff and security can talk to the parent in such a situation, but ultimately might have to let the person leave with the child, explains Evelyn Meserve, CHPA, president-elect of the IAHSS and director of security and safety services at CaroMont Health in Gastonia, NC.

"I would expect my officers to get physical in the sense of blocking the path of egress to slow the person down, to allow more time for a nonphysical intervention," Meserve says. "But I would not want to see a physical takedown, not knowing where the baby is going to end up in that pile, even if this is not a parent taking the child."

Without knowledge of imminent harm or legal disputes, hospital security probably does not have the authority to stop the parent from leaving, Meserve says. If the parent insists on leaving, staff should be trained to gather the same information they would if it were a stranger taking the child: a description of the person and the car, and the direction of travel. That information can be useful if it later turns out that there is concern over the child's welfare.

York and Meserve note that, even if the mother and father are in dispute, the hospital may have no authority to intervene. "There is not much we can do to stop parents from leaving unless we've been warned that there is a security risk or a restraining order against the other parent, for instance," York says. "If the parent just wants to go and the doctor doesn't want him to, we may not be able to stop him."