Shoring up security at San Mateo Medical Center 

After two high-profile sexual criminal incidents involving San Mateo Medical Center psychiatric patients, increased security and additional attempts to keep patients safe have been instituted — but bureaucratic red tape may be the biggest culprit in both incidents.

On March 30, Ronald Sunwo O’Brien, a 27-year-old patient with an extensive criminal and psychiatric history, walked into a 23-year-old female psychiatric patient’s room and attacked her, according to the District Attorney’s Office. After the attack, he allegedly threatened her into not telling anyone. O’Brien’s facing a slew of charges, including felony rape.

How and why a patient with a violent and troubled past would be allowed to interact with other patients and staff is one of the core issues that county and hospital officials are attempting to resolve.

And it’s not the first time such an incident occurred.

In February, Daniel Brickman, a 47-year-old man with decades of psychiatric problems, was taken to the county medical center’s psychiatric ward. For weeks, Brickman allegedly exposed himself to staff and patients and forcibly groped three nurses. The situation culminated with Brickman sexually assaulting a 20-year-old female patient in front of staff members, resulting in them forcibly prying him off the woman, according to the District Attorney’s Office. He’s charged with two felony counts of false imprisonment and 11 misdemeanor charges.

After the March 30 incident involving O’Brien, an additional security guard and registered nurse were added to the overnight staff, according to Dr. Susan Ehrlich, chief of the San Mateo Medical Center.

“What happened on March 30 was a variety of things [going] wrong all at the same time,” Ehrlich said. “Typical [of] what happens in these kinds of cases is we delve in deeper [and] fix things, which we’re doing.”

O’Brien had many interactions with several county departments prior to the incident, according to Ehrlich. The lack of communication between the departments was highlighted by the incident.

“A key issue is that San Mateo County [departments] and the Health System [county hospital and health and human services] are not islands,” Ehrlich said. “Individuals who commit violent acts and who are mentally ill are many times managed by many different organizations in the community, including police and court and other different community agencies. We feel it is important to have a clear way to manage these very, very vulnerable individuals.”

That new management, Ehrlich said, is taking shape through a task force that will create a line of communication between departments and prevent future violence on psychiatric wards.

But despite the focus on safety, requests for police services to the hospital increased in May, with 25 calls. Roughly 35 calls were placed between January and April, according to San Mateo Police Department statistics.

The county Medical Center, a 509-bed facility with a staff of 1,094 full-time employees, is within San Mateo city limits, but it falls under the responsibility of the Sheriff’s Department because it’s a county institution. The law enforcement agency contracts out security services.

An estimated five security guards work at the center 24 hours a day, seven days a week, Ehrlich said.

From her meetings with staff and patients, Ehrlich said many have expressed an increased feeling of safety.

Liz Jacobs, spokeswoman for the California Nurses Association — the union that represents the Medical Center’s registered nurses — said the safety of patients and staff is always a concern.

“We always have to take into account the level of care, the illness that a patient has and level of nursing care that is required,” Jacobs said.

She was unable to comment specifically on O’Brien because she didn’t know all the details of the case, but Jacobs did say there’s an increase in violence in psychiatric wards and emergency rooms nationwide.

“People are frustrated,” she said. “They’re not getting care, they’re out of work, they don’t have health insurance. Tensions are building.”

Though changes are being made for staff and security to be more proactive, Ehrlich said it’s nearly impossible to reduce all risk.

“No matter what you’re doing when you have individuals, especially who are so vulnerable in psychiatric units, in any way can you eliminate all risk,” she said. “However, because we’ve done this comprehensive investigation, we feel like we’ve minimized as much as possible.”

Two Medical Center cases called rare for prosecutors

Incidents where the San Mateo County District Attorney’s Office needs to investigate claims at the San Mateo Medical Center are rare.

Chief Deputy District Attorney Steve Wagstaffe said rare and serious cases are the only ones often prosecuted. However, two such cases involving patients and staff were in court this week.

“It’s not often,” he said. “We get more misdemeanors when a patient punches a nurse, for instance. But this has been highlighted because of the serious charge.”

Ronald Sunwo O’Brien, 27, was charged with felony rape, forcible digital penetration, assault with the intent to rape and residential burglary. He faces life in prison.

A mental-competency hearing was held Tuesday, and it was determined that he’s not fit to stand trial. A hearing will be held Aug. 2 to determine which hospital he will be transferred to.

Daniel Brickman was accused of groping three nurses and exposing himself in February and sexually battering a fellow patient. Also Tuesday, he pleaded no contest to one felony count of false imprisonment, one count of false imprisonment of an elder and 11 misdemeanors. He will be sentenced today.

Wagstaffe said mental competency is evaluated and reviewed by two doctors in order to decide if the accused can stand trial. If not, the defendant is sent to the state mental hospital until they are fit to stand trial, which can take roughly four months.

Wagstaffe said a defendant can usually stand trial once they are properly medicated.

O’Brien and Brickman are being housed at San Mateo County Jail until their respective court dates, Wagstaffe said. They will remain there unless they have psychiatric breaks, in which case they would be transferred to Santa Clara County Jail.

Wagstaffe said San Mateo does not have a jail psychiatric ward.

“We used to have one, then someone decided it was too expensive,” he said. “We now rent two beds a month from Santa Clara for $1 million a year.”

— Andrea Koskey

Policy change

Recommendations and changes at the San Mateo Medical Center following an investigation into an March 30 incident include:

  • Additional security guard during overnight shift
  • Additional registered nurse during overnight shift
  • Improved patient observation
  • Increase staff training to react to patient behavior change
  • Create a systemwide task force for facilities

Source: San Mateo County Medical Center

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