Case Study: East Security

During interview Ms. Stoker was alert, aware of surroundings, and answered all questions appropriately and independently. During the visit Ms. Stoker dry heaved into a garbage bucket, and visited the restroom once. The worker was at the residence for about 2 hours. Initially Ms. Stoker was shaking uncontrollable to the point of shaking the entire bed. At the end of the visit the shaking had stopped and Ms. Stoker was smiling and interaction with worker while talking about DELETEbeing a wife and mother. During visit Ms. Stoker received a call from Alacare Home Health. She informed them she was out of her pain medicine but did not inform them she was out of all medicine. Alacare called the pharmacy and was informed she did

In light of the recent events, the most stated issue staff had was lack of communication throughout the entire facility among other staff members as well the referring provider’s offices. There was also a concern for the lack of policy regarding the check-in and discharge process for the safety of our pediatric patients. A few staff felt as if they had too many duties to be worried about any more and it should be the responsibility of other staff members to be concerned with the discharging of a pediatric patient. By not properly putting policies in place for a thorough patient in-take and patient discharge process, it not only jeopardizes the well being of the patient, but it poses a legal liability on us for many privacy violations. These barriers fail to promote proper communication with appropriate departments and leaves each department to make inconsistent judgment in situations such as the most current sentinel event. Of all the employees interviewed during the said event, most stated that they had no way of knowing they were making the wrong judgment. For instance, verifying patient’s parents upon arrival as well as approval of who is allowed to have access to the

On 08/27/15 Mrs. Pruitt contacted DHS to request someone pick Jakyah up. Jakyah has been diagnosed with severe behavior issues and she’s been prescribed medication for D.I.D. Between 08/26/15-08/27/15 Jakyah had noticeable changes in her behavior; Jakyah began showing out and ran out into the road. Jakyah had homicidal ideation and threatened to cut others. Ms. Brown picked the child up from the Pruitt home and Jakyah was taken to the county office. While at the office Jakyah’s bags were checked and medication bottles were found in the child’s possession filled with her prescription. One bottle had 14 pills init and a second bottle had 28 pills in it. Before leaving the home, a worker asked Mrs. Pruitt if Jakyah had her medications that day

In March 2015, RP overheard one of the caregivers state that one of the residents had scabies but facility never notified the families. RP stated that an order for Benadryl was made for the resident on 7/12/16 but the resident never received the medication because it was reported that the order was not signed. Staff never contact the physician to request a signed order so the resident was without the medication for 16 days. Resident's husband contacted RP on 9/9/16 and said that he had a confirmed case of scabies. On 9/10/16, RP spoke with administrator who disclosed that there has been confirmed cases of scabies. Administrator stated that due to the resident and resident's family members contracting scabies, Terminex was at the facility on 9/12/16 to treat residents room. RP also mentioned that on one occassion she visited the resident and the room "reeked" of urine and the resident's Depends was on the floor. RP stated that there is not enough staff to handle the amount of residents in the facility. RP stated that on one of her visitis, there were residents sitting in the living room for over 2 hours before anyone was able to check on

On Wednesday 01/04/2017 at about 2227 hours, FHEO Security Officers were dispatched to the Children's Emergency Department (CEC) room #5 for a Signal (42T) Threats/Intimidation Against Employee. Security Supervisor Steven Evans along with Officers Corey Ritchie, and Omar Alonso, responded at 2229 hours and met with Doctor Yaron Ivan and Assistant Nurse Manager Kimberly Brooks. They both stated to us that the father of the Baker Act patient in CEC#5, Kiana Hughes (DOB: 07/04/2002-FIN #86674239), whose name is Finas Hughes, was creating an issue of safety concerning the transport of the patient from here to her assigned Psychiatric Facility. The father felt that because he was a Homeland Security Federal Marshal, that it was his right to be able

On 10/28/15 at approximately 1930 an ICS was activated at Higbee for an offender McDonald OID 200046 who was unresponsive . Upon arrival offfender was lying in bed, but was not responding to command. Officers entered the cell cuffed up offender and assited her to the sitting position. At that point offender started talking to staff. Offender was in no medical stress and denied any health concerns. She stated that she was tired. Vital signs were normal. Offender was advised to let staff know if she has any health concerns.

Shydae was talking to staff about an incident that happened early today with Jessica. Shydae became agitated with Jessica when she began to bang her head on the wall. Staff attempted to redirect Shydae several times. Shydae went into her bedroom and grab a weighted vest and removed a weight from it and throw the weight at Jessica . Staff encourages Jessica to go to her room but she refused and return to the milieu. Shydae became aggressive towards Jessica ; staff intervenes quickly to avoid any physical altercations. Shydae became combative and aggressive towards staff. Staff called for additional staff for support. Shydae was placed into a standing to seated restrain (6:40 pm to 7:05 pm). Shydae was able to return to baseline ,nursing was

On Friday 12/16/2016 at about 0135 hours, Security Staff was dispatched to the Special Care Unit, ED. room #37 for a code (51D) Disorderly Patient in E.D. Security Officers Miguel Pagan, Corey Rithchie, Omar Alonso, and Supervisor Steven Evans arrived at 0136 hours and met with Patient Care Tech Cathy Negron who was standing just outside of the patient's room. We observed, the patient, Krystal FernandezRivera (DOB: 09/15/65 - FIN #86594670) in her bed inside the room talking to her Nurse, Cindy Rodriguez, who was attempting to get the patient to change into a blue scrub Hospital gown. Nurse Rodriguez walked outside the room and informed us that the patient had been Baker Acted by ER Doctors and she refused to hand over her belongings and changed

Issue: While performing her Charge Nurse duties, noted patient crying in the hallway and stating he wanted to go home and see his family; she noted he was confused and very tearful. Action: After calming the patient down using therapeutic communication, she guided the patient back into his room, turned the bed alarm on, notified his nurse, and requested a Patient Safety Aide for this patient from the Off Tour Coordinator for his safety. Outcome: When reassessing the patient, he seemed to be more cheerful and calm with a Patient Safety Aide at the bedside to reorient him and to prevent his feelings of loneliness.

At approximately 0910 hours, on 07-Aug-15, the writer and S/O A.Sayeedi responded to a dispatch from POC to attend ATU 2. Upon arrival the officers met with the clinical staff, who informed the officers that the one of the patient has been really agitated and has not been co-operating with the clinical staff since morning. The officers were told that the clinical staff will get verbally engaged with the patient and will inform her that she will be going to Seclusion room in ATU1. The clinical staff also mentioned that the patient will not be co-operative to walk to Seclusion room, so the officers have to physically escort her there.

Rebecca was threatening to hurt herself and also get loud to wake other clients if she was not given the phone to call her guardians. She started hitting the window, waking other client in the process. Staff tried to redirect her to keep the unit safe, but to no avail. The unit nurse, Peninah Gitonga, RN, obtained orders from the on-call provider, Kat McNeil, NP, to administer IM medication. Rebecca refused to take the medication willingly so she was on physical hold for medication administration. CRU policy and procedures were followed to ensure clients' and staff safety.

On July 5, around 3:10 PM Client P, F said she was feeling dizzy and shaky and wanted to go to the E.D. because she thought that she has an iron deficiency. Ariel told her that since shifts were in the middle of changing we would have to talk first and figure out what was going on and whether we would be able to take her to the E.D. Client CR decided that it would taking too long and called 9-1-1 to have them pick her up to the ER. Client was verbally abusive to Ariel and me, cussing at us and saying that we were not doing our jobs and not trying to help her and because she did not plan to come back she wanted to take her medication with her. When paramedics came @ 3:20 PM she said them that her blood sugar was low. According to the paramedics

I was asked to meet with Administrative Nurse Supervisor Debra Reilly. I, Steven Evans conferred with the Nurse Supervisor about what transpired in room #401 and what was reported to her. Nurse Supervisor Reilly felt that the problem was a grave security concern for the patient’s nurse and the entire medical staff. She advised the problem should be reported. She contacted the (CFRC) Central office and spoke to a Correctional Supervisor about the issue. I did not make contact with the inmate patient’s Nurse in room #401 and was therefore unable to obtain a written witness statement from her. This report was generated, pending further investigation. No further information is available at this

On Thursday, December 22, 2016 at approximately 2147 hours, Security Operations Center (SOC) notified FHEO Security in reference to a signal 54B (Missing or Eloped Baker Act Patient), from the East Tower room #502. Security Officers Omar Alonso (420) and Christopher Paz (408), responded to the scene. While enroute, SOC advised Security staff that the Baker Act Patient, who was later identified as Daniel GonzalezRamos (DOB: 11/04/1987 – Fin #86614786), was exiting the building from the South wing, stairway A, located in 5 East. As Officer Alonso and Paz ran towards stairway A and attempt to stop the patient from leaving, Assistant Nurse Manager (ANM) Tonya Smith rushed in the Emergency Department triage stating that the patient had ran towards the main lobby, west tower. Alonso and Paz conducted a search of the area until they observed a Hispanic male with black hair, wearing paper blue scrubs standing next to a visitor, later identified as Maurice, talking on a cellphone. Both Officers approached Patient, GonzalezRamos and advised him that he had to return to his room. Mr. GonzalezRamos was very uncooperative and refused to go back to his room. As Paz attempted to walk closer to him, he bolted into Lake Underhill Road. Officer Paz extended his right arm and attempted to pull the patient from going into incoming traffic, as he grabbed the back of his blue scrub shirt, the shirt ripped off. The patient

On June 10th, 2016 at approximately 2205 hours, FHEO Security was notified by clinical staff in reference to an incoming (51D) Disorderly Patient in E.D., located in the EMS offload. Upon arrival, Security staff made contact with Orange County Fire Rescue (OCFR) Engine #83 and restrained patient James Patrick Hogg (DOB: 03/26/1968 - FIN: 85758458). OCFR staff stated patient, Hogg is Altered Mental Status (AMS) and was uncooperative with rescue personnel. Security staff escorted OCFR and patient, Hogg to the Special Care Unit (SCU) room #37. Patient Hogg agreed to remain calm and be cooperative during his care at the hospital. Clinical staff removed the soft restraints off of Mr. Hogg without incident. All cleared, the final call disposition