Hospital took adequate steps to protect employees from assault

An administrative law judge vacated a citation levied against a behavioral health hospital holding that the U.S. Secretary of Labor failed to show that the hospital violated the general duty clause.

In Secretary of Labor v. HRI Hospital Inc. d/b/a Arbour-HRI Hospital, the judge held Friday that HRI Hospital Inc., based in Brookline, Massachusetts, provided sufficient evidence that it took steps to adequately protect its employees from being physically assaulted by patients and dismissed the Occupational Safety and Health Commission’s citation.

HRI is a 62-bed inpatient behavioral health hospital. Patients are referred to the facility if they are unable to be treated in a less restrictive setting.

OSHA received a complaint about aggressive actions taken by patients against staff, and a compliance officer visited the worksite in August 2016 and January 2017. OSHA determined that HRI failed to adequately protect its employees from the hazard of patient assaults in violation of the general duty clause.

OSHA charged that nurses and mental health workers had been attacked by patients who punched, kicked and scratched, and said employees sustained injuries when they were hit by soda bottles and a drawer that a patient removed from a dresser. OSHA said as a result, HRI failed to “furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm.”

Although HRI did not deny that its employees experienced violence and that the hazard of patient-on-staff violence remained at the facility despite its abatement efforts, the administrative law judge found that the Secretary of Labor did not show that HRI failed to adopt feasible abatement measures.

The judge noted that HRI documented, tracked and trended incidents of violence against staff and had training and written policies to ensure employees recognized the hazard of patient-on-staff violence. The judge also found that HRI’s training include personal defense tactics, a system to enable staff to call for immediate additional assistance when they could not manage a patient's aggression by themselves and handheld emergency communication devices.

Although the secretary argued that HRI should have employed security staff, the judge found that the secretary failed to make clear what was meant by “security staff” and noted that the hospital took immediate steps to remove hazards — like replacing all dressers with cubbies — after the drawer incident.

The judge held the fact that incidents occurred “does not establish that HRI failed to adopt feasible means of abatement.”

HRI declined to comment and its attorney did not immediately return a call for comment.