King/Drew Medical Center Could Lose Federal Funding Over Use of Tasers on Some Psychiatric Patients

CMS inspectors said Thursday that Martin Luther King Jr./Drew Medical Center could lose federal funding if it does not develop within 23 days new policies to subdue aggressive psychiatric patients that reduce the use of Taser stun guns, the Los Angeles Times reports. State inspectors two years ago cited King/Drew for allowing county police to use Tasers to subdue such psychiatric patients without instituting formal guidelines for their use. King/Drew officials prohibited the use of Tasers following that citation, but Los Angeles County officials in March 2003 reversed that ban after finding that Tasers could be a "useful tool, but that police needed additional training," the Times reports. Medicare and Medicaid funding account for more than half of King/Drew's $350 million annual budget, according to the Times. Steven Chickering, a manager for the San Francisco CMS office, said that King/Drew staff used county police to subdue aggressive psychiatric patients with jolts of electricity and handcuffs too often, instead of trying less extreme methods. Chickering said that although using Tasers in hospital settings is uncommon, eight patients have been shocked with the stun guns at King/Drew since March 2003, and some have been injured as a result, the Times reports. According to the Times, most hospitals use specially trained medical personnel to calm aggressive psychiatric patients or subdue them with medication or minimal force rather than using Tasers, which fire two darts connected to electrical wires up to 21 feet and deliver as much as 50,000 volts of electricity over five seconds to immobilize a person and cause him or her to fall down.

Los Angeles County Department of Health Services officials Thursday night instructed police at King/Drew not to use force to restrain patients unless they were being arrested. However, King/Drew officials said that they were concerned that banning Tasers could compromise employees' safety. They added that they hoped to reach a compromise that would allow police to use Tasers and hand cuffs in extreme cases. County DHS Director Thomas Garthwaite said that some psychiatric patients at King/Drew may be difficult for well-trained medical staff members to control, adding, "I think [CMS is] saying that they would like to see an additional step before the police get involved. I'm not against that. Our goal is to increase the safety margin for our employees and our patients." CMS' recent warning marks the second time in three months that the agency has threatened to cut off King/Drew's funding. CMS officials said that it is "extremely uncommon for two warnings to be made in such close succession," the Times reports.

Taser International spokesperson Steve Tuttle said, "[W]here [Tasers] have been used quite a bit is with violent, combative subjects who have been putting personnel at the hospital at risk." He added that people are usually calmed by just the sight of the gun. However, Mary Cesare-Murphy, executive director of behavioral health accreditation at the Joint Commission on Accreditation of Healthcare Organizations, said, "I'm very surprised" about the use of Tasers, adding, "If anything, there's been so much emphasis on the reduced use of any kind of restraining device, even the more traditional restraining devices," such as seclusion or soft wrist restraints. Edward Jackson, a spokesperson for Washington, D.C.-based Amnesty International, which is against use of Tasers, said, "It's disturbing and alarming to hear that hospitals -- places that are supposed to be safe for people with illnesses and people with mental health problems -- are using electric-shock weapons on their patients" (Ornstein/Weber, Los Angeles Times, 6/5).