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Abstract
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On June 1, 2022, an active shooter incident left five people dead at the Saint Francis Hospital in Tulsa, Oklahoma. The perpetrator, a disgruntled patient armed with an AR-15-style rifle purchased just hours earlier, proceeded to gun down four individuals before turning the gun on himself. The intended target of the assailant was Preston J. Phillips, MD, 59, an orthopedic surgeon whom the gunman held responsible for persistent back pain following a recent surgical intervention. Additional victims included sports medicine physician Stephanie J. Husen, 48, nurse Amanda Glenn, 40, and visiting spouse Mr. William Love, 73.1
That very week, three other U.S. hospitals were the site of violent incidents. The Miami Valley Hospital in Dayton Ohio was in the grip of a county jail inmate in need of care who overpowered and fatally shot a private security guard before killing himself. The Encino Hospital Medical Center in Los Angeles California, for its part, witnessed a patient in the emergency department stabbing a physician and two staff nurses. Finally, the Wayne UNC Hospital in Goldsboro North Carolina endured an active shooter incident that injured a female visitor. In this Commentary we consider the ever-growing violence in U.S. healthcare settings and explore potential measures intent on the curtailment thereof.
The ever-escalating U.S. death toll of gun violence, the byproduct of permissive gun laws, shows no sign of abatement. According to the independent non-profit Gun Violence Archive, the annual number of deaths attributable to gun violence in the U.S. increased from 12,352 to 45,034 over the 2014-2021 interval. Healthcare professionals have hardly been spared. Kelen at al. enumerated a total of 154 active shooter incidents in U.S. hospitals over the 2000-2011 interval. The high case fatality rate (55%) observed was ascribed to the close proximity and determination of the perpetrator, the surprise factor, and the frailty of hospitalized victims. A subsequent report of the Government Accountability Office, for its part, concluded that rates of violence against workers in healthcare facilities were substantially higher as compared to workers overall. A more recent report by Zamore et al. concluded that the frequency with which U.S. physicians are injured or killed in hospital-based active shooter incidents has more than tripled during the past two decades.5
Close to 20% of the incidents in question appear to have been motivated by a grudge held against a physician for a healthcare outcome.
Hospitals, not unlike schools, or houses of worship, are not designed to guard against the threat of a determined gunman. In fact, hospitals, whether publicly or privately owned, are universally viewed as a communal resource that is (or should be) accessible to the local populace at virtually all hours of the day. Ongoing efforts to preserve this highly prized accessibility have heretofore all but precluded any attempts at target hardening. Instead, hospitals have come to rely on guidance materials, procedural protocols, and regularly scheduled drills in the hope of enhancing their state of readiness in the event of an active shooter incident...
Language: en |