Mental patient was put at risk

Man was strapped to bed face-down

RALEIGH -- Internal records show workers at a state mental hospital in Butner strapped a patient to a bed face-down for more than an hour this week, violating proper procedures and endangering the patient.

A spokesman for the state Department and Health and Human Services said Friday that an extensive investigation has been started.

The incident occurred early Wednesday morning at Central Regional Hospital after a 24-year-old man resisted having his blood drawn for tests and made verbal threats, according to a staff report.

At least five health care technicians, working under the supervision of a nurse, responded by carrying the patient to a restraint room, placing him face down on a bed with his arms and legs strapped to the sides.

It is not clear from the report why he was placed face-down, rather than on his back as the staff at state mental facilities is trained to do.

The practice can cause panic in the person being strapped down, whose vision would be limited. It can also make it harder for a patient to breathe and can exacerbate the risk of heart problems.

"It's a life-threatening position," said Barbara Gardner, a retired state mental health administrator who helped run Dorothea Dix Hospital in Raleigh. "It's the most dangerous position you could have a patient in because of the difficulty breathing when the patient is face-down.

"It's an absolute no-no. You never restrain anyone face-down."

According to an internal hospital record, the patient was left restrained face-down from 6:20 a.m. until 7:25 a.m., though handwritten notes indicate he was calm, cooperative and asking to be let up for much of that time. The staff is supposed to release a patient as soon as he is no longer acting aggressively.

The staff's notes also indicate the restrained patient asked for a bandage for a bleeding finger, though an electronic record entered into the hospital's computer system indicates there was no injury.

The revelation comes at a delicate time for Central Regional. The $138 million hospital opened partially in July after repeated delays due to design flaws and safety concerns. It has not yet been accredited.

A team of state inspectors working on behalf of the federal Centers for Medicare and Medicaid Services has been at the facility all week, reviewing the hospital's operations.

It is not clear whether administrators at Central Regional immediately informed the regulators of the improper restraint. DHHS spokesman Tom Lawrence said Friday the inspectors would meet with the hospital's leaders about the issue.

There are security cameras in the restraint rooms at the new hospital, so the incident should have been recorded.

Lawrence said he could not confirm whether a tape was made. But if one was, the recording will be used to help sort out what happened, he said.

"Once the investigation is complete, any disciplinary actions will be taken," Lawrence said via e-mail. "No further comment will be made until the investigation is complete."

New hospital

At stake is the state's plan to close Dix Hospital in Raleigh and transfer the patients and staff to the new facility in Butner. That plan has been stymied by regulatory hurdles and a court challenge from the advocacy group Disability Rights North Carolina.

A Superior Court judge issued a temporary order in September that bars the state from moving Dix's patients. That order is still in place.

Central Regional opened amid the closure of John Umstead Hospital, less than a mile away. That older facility, the staff of which was transferred to the new hospital, was cited by federal regulators in December after three workers beat a mentally ill woman who was strapped to a bed.