Beth Israel Medical Center
Statement of Deficiency – Tag 154; Event ID 2WH611- Inspection release October
30, 2015
Based on interview and review of document, it was determined the facility failed to
ensure patient's rights to care in a safe setting. Specifically, the facility permitted the use
of handcuffs, a law enforcement restraint device that are unsafe to be used by hospital
personnel for the restraint of patients. This finding was noted in 4 of 20 security incident
reports reviewed.
Findings include:
Incident #1 dated 9/17/15 notes, Security Staff B was called to 8 Bernstein (Psych unit)
because Patient #3 refused to hang up the phone. Security Staff #B and Staff C
escorted the patient to the seclusion room but the patient refused to go into the room.
The patient was restrained by the wrist by the two security staff while the registered
nurse administered medication. Security Staff B notes, "patient continued to struggle.
He had to be handcuff."
Incident #2 dated 6/21/15 and authored by Security Staff D notes, "I had to use my
handcuffs as well as Staff E's to keep Patient #4 restrained to the wheelchair during his
transport to 8 Bernstein. Staff D reported the patient was handcuffed because he was
very unruly and very combative with the nursing staff and security guards on the scene.
Incident #3 dated 4/30/15, Security Staff F reported Patient #5 had assaulted a doctor in
the Emergency Department and threatened other staff members. The patient was
handcuffed with the help of several other security staff pending the arrival of police
officers who arrested the patient.
Incident #4 dated 4/1/15, Security Staff G notes Patient #6 was disruptive in the
Ambulance triage area because he could not visit his friend in the Emergency
Department and he began to trash the nurse's station. Staff G notes, "Patient #6 was
placed in handcuffs until New York Police Department officers arrived."
The review of facility's policy (Policy #241) titled, "Use of Force", last revised in 2010
notes, "Handcuffs cannot be used as a form of restraints. Handcuffs can be used to
prevent criminal behavior, including but not limited to assault, in persons who are
considered a danger to themselves and others." The policy indicates security officers
may arrest another person for any offense when the offense was committed in their
presence.

 The policy further notes, "Handcuffs are hospital property provided for officers
protection, and are part of Security uniform."
At interview with Security officers regarding the use of handcuffs, Staff H, on 10/21/15 at
2:30 PM stated, handcuff is used as a last resort to apprehend patients who are
disruptive and combative and who are deemed a danger to self and others.
Security Staff I on 10/21/15 at 2:27 PM, stated handcuff is used temporary to restrain a
patient who is unruly, and a threat to staff, until the patient is moved to a location where
hospital restraints can be safely applied by clinical staff.
Security Staff J on 10/21/15 at 2:35 PM, stated that a patient who has committed a
crime in the hospital could be handcuffed pending the arrival of the New York Police
Department.
At interview on 10/21/15 at 12:45 PM, Staff K (Director of Security), acknowledged the
use of handcuffs by security staff and reported handcuffs are used only in immediate life
threatening situations. He added that security staff members are not peace officers and
can only make a citizen arrest.