In September 2010, police say a man went to 918-bed Johns Hopkins Hospital in Baltimore, apparently despairing over a poor medical outcome his mother had received during cancer care. The perpetrator shot and killed his 84-year-old mother in her hospital room, shot her physician (who survived the attack), and then committed suicide.
The Johns Hopkins shooter—Paul Warren Pardus—lived in Virginia, was 50 years old, and had a license to carry a gun, according to news accounts.
Like most of the 10 hospitals contacted by Modern Healthcare for interviews after incidents of violence, officials with Johns Hopkins declined to be interviewed.
David Banks, CEO of the 1,067-bed Florida Hospital in Orlando, described feelings of failure and vulnerability after a patient specifically targeted Dr. Dmitriy Nikitin for assassination on the sprawling hospital campus, killing the transplant surgeon in a parking garage.
“Even though you see it on the news and you have your security in place, you just don't think it's going to happen to you,” Banks said. “I think we'd all be better served to give a little more forethought to what you would do if that kind of event takes place.”
After the shooting, the hospital stepped up its use of video monitoring and security personnel, both uniformed and undercover, Banks said.
But in the wake of publicity about hospital violence, news accounts show that the public often clamors for visible signs of safety precautions, particularly metal detectors, though hospital officials have mixed opinions on that topic.
A 2008 article in the journal Academic Emergency Medicine found that about 14% of respondents said their hospitals used metal detectors to screen for weapons.
Dr. Melissa Barton said concerns about public image did not hurt her push for more metal detectors at her hospital in Detroit, the 316-bed Sinai-Grace Hospital, which she said has the distinction of being the closest trauma center to Detroit's infamous 8 Mile area.
The hospital already had metal detectors at the emergency department entrance, but Barton said she was one of the people who successfully pushed to have them installed at the hospital's front door as well.
“It's a balance between having patients and facilities and visitors feel welcome and that we want them to come and see their loved ones, versus also offering safety and a feeling of security for those same people,” she said.
The security enhancement also included more training for security officers and the development of a no-tolerance policy for violent behavior in the hospital.
But neither the Joint Commission nor professional associations for emergency nurses or emergency physicians specifically recommends metal detectors, saying each hospital's needs and communities are different. Critics say that in addition to the cost of labor to staff the detectors, the equipment is powerless against the more common type of patient who is violent without using a weapon that would be detected and confiscated at the door.