Healthcare News & Insights

Patient’s visitor killed by hospital staff — what went wrong?

A Massachusetts hospital faces a state inquest after a patient’s husband was restrained by security staff, fell into a coma and died.

Daniel Ryan, a 35-year-old father of two, arrived at Cape Cod Hospital on October 9th, to visit his wife as she recovered from surgery. According to multiple sources, Ryan attracted security’s attention for speeding and driving erratically in the hospital parking lot.

Details of the rest of the day are sketchy, and vary depending on the source.

According to the hospital, Ryan began to act “irrationally,” although to date, no further description of his behavior has been given. (The Ryan family denies he was a threat to anyone at the hospital.)

At some point, police were called to deal with Ryan. After the police left, hospital workers sent Ryan to the emergency department to wait for a psychiatric evaluation.

Ryan slipped out of the ED and began to run through the halls of the hospital as security gave chase and restrained him while waiting for the police to return.

His wife claims Ryan was caught and put in a chokehold.

According to the Boston Globe, a state official who reviewed surveillance video says Ryan tripped on a sheet that had been put over his head. Ryan fell, bringing the security guard down with him. The guard then turned Ryan over and sat on his chest.

Hospital officials deny a chokehold or other improper restraint techniques were used.

What is known is that Ryan fell unconscious while still restrained, was admitted to the hospital and eventually had to be put on life support. He died three weeks later.

The inquest

Ryan’s death was ruled a homicide, meaning that his death occurred as a result of human actions. The state’s inquest will determine if those actions amounted to a crime.

The inquest will take place in June and be closed to the general public. The results of the inquest may be made public. However, even if evidence of criminal wrongdoing is found, it’s still up to the prosecutor to decide whether or not to take the case to the grand jury.

Cape Cod Hospital denies wrongdoing in the case, but has taken steps to improve security procedures and increase training for security staff.

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Comments

  1. Gebrehana W. Zebro says:

    It is a very unfortunate incident. My Condolences to his wife and the rest of his family. I call on everybody to show maximum restraint and not be lead by emotion. Hospital staff need to have a better training in handling this kind of situation with out endangering the wellbeing or life of human being. What has happened can not unhappen but we should take this opportunity to learn very crucial lesson . It is a sobering experience for all of us invlolved in patient care .
    Thanks,
    Gebrhehan W.Zebro ,MD FACP

  2. Pedro Westernman says:

    When you feel like driving dangerously and the running the halls of a hospital like a nut putting people in danger stay home. Or if you just have to get out to endanger others go down to the police station and run their halls. They know how to take care of people like this. I have no sympathy for him, he was putting already ill people in serious danger. The hospital personal did the best they could.

    He was taking staff away from patients who were ill and needed their attention. Again if he wanted professional nut case handling he needed to go to a police station where they have mace, stun guns, billy clubs and handcuffs.

  3. Charles Marley, D.O. FACEP says:

    Several facts are missing in this article, including the autopsy results which would determine the exact cause of death. This man’s erratic behavior apparently had a cause and it is impossible to determine from this account whether or not the cause for the erratic behavior was possibly a major contributor to the death (e.g. intracranial bleed, intoxicants, hypoglycemia, etc.).
    Rather than blaming a security response that seemed typical and not extraordinary based upon the way this gentleman was acting, it seems appropriate to also look at this from a different angle. In a Just Culture, it certainly was not the intent of the security guards to cause harm to this patient, but to prevent him from causing further harm to himself or others. There was no intent of malice and to pursue that seems ludicrous.

    • Carol Katarsky says:

      Not all of the facts are in, hence the inquest. No one has claimed malicious intent on the part of the staff.

      I don’t think it’s in any way “ludicrous” to ask questions about a death that has been determined by the state to be a homicide. Obviously, something, somewhere went horribly wrong in this case. Closing our eyes to it is not a solution.

  4. Robbin RN says:

    This is a very sad incident, but hospital employees encounter all sorts of irrational patients and visitors that put our safety at risk. I would love to know if this visitor has a hx of mental illness or drug dependency. In our culture today, both of these problems are very prevalent. As people become more anxious and crazy, for lack of a better word, I wish all hospitals would change from civillian security to armed police officers.

  5. Phillip says:

    Definitely lacking information here. Sounds like the guy was not in his right frame of mind for whatever reason, be it drugs, alcohol, or maybe a mental malady. Either way, however, there must be better training for security guards in subduing unruly patients other than sitting on their chest until they pass out. Yes, perhaps there no intent of malice by the SG but obviously poor judgement was exercised and a serious lack of training. Whether or not the patient died due to the restraint or some other condition that caused the erratic behavior the guard should not have been sitting on his chest. A sheet should not have been placed over his head either….

  6. How did the patient exit the E.D.? was Security watching him in the first place or was he placed in the room on the honor system, after he had run the halls erratically? No the sheet should not have placed on his head and at no time should someone sit on someone’s chest as a form of restraint. Once the Police assisted and the patient was placed in the E.D. he should have been watched by Security to assure safety of the patient and staff.

  7. Carrie Anne Johnson says:

    Wait, so you mean a person who’s wife is in surgery and you’re not there doesn’t constitute a reason for a husband with two children to do everything to arrive as quickly as possible? This article doesn’t detail the specific surgery she had, but any surgery can pose complications. Isn’t it plausible that the “mental state” he was in was just a result of normal feelings of anxiety and concern for his family at that moment? Why does everything have to be so complicated and divided in the culture of western medicine?

    Instead of tackling him – with a SHEET for goodness sake? – couldn’t someone ASSUME he’s there to visit someone in critical care and escort him there quickly? And while Charles Marley, D.O., FACEP suggested that an underlying condition caused his erratic behavior, isn’t it more likely that being tackled by security with a sheet over your head and being put in a chokehold could *trigger* an underlying condition, in which case, that condition would not have revealed itself were it not for the reckless behavior of our security culture. I don’t question that security thought they were doing there jobs, but I question the terror-mindset of our culture and the lack of humanity applied in their jobs.

  8. Pedro Westernman says:

    Woulda, coulda, shoulda…….. He’s dead, better him than some innocent staff member, security officer, hospital patient, or visitor (maybe a child). When your feeling like a nut stay away from hospitals unless you go there to check yourself into the mental ward. Maybe the next nut will take a lesson from this and maybe go to a baseball game to run down on the field and run amuck. There are nice policeman there with mace, clubs and guns that would be happy to chase you down.

  9. What I see is that it is problematic is to have a security guard sitting on a person covered with a sheet. How could the security guard know where he was sitting on this person and how much weight is safe for that part of his body? He couldn’t see his face to see what condition he was in before and during his restraint.

  10. Michelle RN says:

    I have worked in health care for over 35 years and I have seen police officers and security guards lie to cover up bad behavior. What we have here is a debate over their side of the story without any facts from the autopsy, any video footage, or the ability of this man to give his side of the events. It is common practice to park people the cops don’t like in the ER until they can decide what to do with them. Again, we don’t know a lot of facts. Perhaps he was driving hurriedly (erratically?) in the parking lot because he had gotten a call from the OR staff or maybe he was running late getting to the hospital after dropping off kids at school. Maybe he argued with the cops. Some police officers are so arrogant that just arguing with them will land you in the ER. Having worked in an ER, I have seen this first hand.

    Recall that there was similar incident in which police detained a family in the parking lot as their mother lay dying in the ICU. The situation was similar–they were detained for driving fast in the parking lot. Luckily, all of it was caught on film–the cop taking his sweet time to write a traffic ticket, other officers roughing up and detaining the woman passenger as she tried to run into the hospital. In the end, this family missed being with their loved one when she died, over an ignorant cop serving a traffic ticket. This case went national only because the husband is an NFL player and video obtained by their lawyer proved everything they said happened. Up to that point, police were using the line that the family was “driving erratically” and “acting irrational.” See any parallels?

  11. There are not enough facts in this article to warrant any claims that oppose (or even support) the actions of the security officers. The article states that “at some point, police were called to deal with Ryan.” If the hospital staff contacted law enforcement, then Mr. Ryan’s behavior probably wasn’t simply “irrational.” I suspect that there was a perceived threat of some sort. What was he doing? How can readers judge the response to someone’s behavior without knowing any details about that behavior? According to the article, Ryan was restrained while security officers were “waiting for police to return.” If the police were contacted again (or already planned to return) for Mr. Ryan, then his actions must have been worse than we are led to believe. This article does little more than inspire debate, without providing the most important information.

    • Carol Katarsky says:

      Jason, we provided as much information as is currently available. If you have more details from a credible source, I encourage you to share them. The lack of information — and discrepancies in what information is available is precisely why the state has instituted an inquest.

  12. All the details of the incident were not included in this article. There are too many “what ifs” and obviously two different sides to the situation. There is the medical side and the security side, both of which play different roles in the medical field. A medical professional’s job is to render aid to anyone needing it; as a Security Officer’s role is to protect staff members, patients, and visitors. There is a fine line between a patient and a criminal and once that line is crossed it is the Security Officer’s job to handle the situation at whatever cost to protect the lives of others.

    Some of you mention “maybe he was in a rush to get to the OR to see his wife”, that does not mean you have the right to break the speed limit laws because your wife in the OR is more important than my child walking through the parking lot to see his/her sick grandmother in ICU. There is no excuse for his irrational behavior and regardless if he arrived at the hospital when he did, or 20 minutes later, his wife was receiving the best care possible in the OR and him being there/not being there would not have changed anything.

    In the end, Security should have had the proper equipment to handle a situation like this along with the proper training (whether they did or did not is unknown). Also, before publishing a story like this the media needs to get all the facts straight and none of this “he said, she said” stuff.

  13. I have been a hospital police officer for over 10 years and 8 years of municipal law enforcement. The problem with this situation is where is the medical staff. CMS is very clear on patient restraint and monitoring of patients. Police and security is not part of the medical staff and therefore they do not meet the qualification for watching, sitting, or providing medical care. Our (police/security) job in the hospital is to support and protect the staff, patients, and visitors. Medical staff (not all) sits back and let the situation get out of control then expect security and police to handle the problem. Then when it goes bad, blame the cops and security. I have worked for two hospital systems and have found this type of behavior in both. Medical staff operates from a “feels right” perspective and police operate from a “legal” perspective. The two often conflict. As to the “parallels” of the stories, stupidity often runs along the same line no matter where or when, and that is not the problem of the police.

    As I read the responses, I see that there is still confusion out there on roles and responsibilities between security, police and medical staff. CMS and Joint Commission need to look at regulating hospital security and hospital police and defining their role better for the medical staff that cannot seem to grasp the concepts. The lines are often blurred and tough to distinguish. The answer lies in respect and teamwork. Medical staff has to get over the “medical god” complex, and security has to get over “I am always right” complex. RN/MD do not tell me how to my job, and I will not tell you how to do yours. If we do not work together for the good of the patient, then incidents like these will occur.

  14. Heather Munoz says:

    This reply is to Pedro who obviously has no empathy for anyone and has no idea what he is talking about. As a nurse I would have tried to find out without violence what was going on with the man and the security gaurds should have had training on how to restrain without injuring someone.

  15. I appreciate your response, Carol; and I understand that some important details are not currently available. But, in the absence of such important information, the content of this article (and its title) seem to be intended to fuel outrage and stir up controversy. The text states that Mr. Ryan “slipped out of the ED and began to run through the halls of the hospital.” Based on that description, a reader might infer that Mr. Ryan’s actions were harmless, or at least non-threatening. The statement is very misleading. The truth is, we don’t know what Daniel Ryan was doing outside of the Emergency Room. As the article points out, details vary depending on the source; and a complete description of Ryan’s behavior was not given. If the text had included even a brief description of dangerous or threatening behavior, then it would paint a very different picture of Mr. Ryan. Would an article titled, “Dangerous psych. patient dies while being restrained by hospital staff — what went wrong?” have the same shock value? Obviously, an article can’t contain information that is not known. But, why present the available information in a way that encourages people to jump to conclusions? The police were called (probably twice) to respond to something that Daniel Ryan was doing. The information given to the involved officers (by the dispatcher) is most-likely available to the public. Why is there no information detailing the involvement of law enforcement? The police weren’t called because someone was simply being irrational.

  16. I am interested to see what the inquest will bring out. I work security in a hospital myself and we have strick training and policies in place in how to properly restrain individuals. I am also interested in seeing if the “use of force” will be brought out in the inquest.

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