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Is Protecting Yourself a Joint Commission Violation?

There are a lot of bonehead stories about the Joint Commission in the news lately. I just had to post this one.

CMS and JCAHO are now investigating Lehigh Valley Hospital in Pennsylvania for using stun guns on unruly patients.

In one instance, a patient was using an IV pole as a pugil stick before security guards used a TASER to put him to the ground. In two other instances, patients were beating on security guards when they were “tazed.”

Protecting yourself is apparently a “violation of state and federal health rules.” As a result of the stun gun incidents, the hospital was ordered to retrain certain staffers in responding to behavioral emergencies. Security and emergency department staff had to be trained in comprehensive crisis management. The hospitals also had to establish a task force to track “incidents” and ensure that staffers had used the “least restrictive measures” when restraining a patient.

When are you guys going to learn? When a patient is choking the life out of you, you HAVE to offer them milk and cookies then tell them to go to a secluded room before you try to defend yourself. Those are the rules. If they have their hands around your windpipe and you can’t breathe, then just point emphatically to the secluded area.

Wouldn’t it be … interesting … to watch an “unruly patient” attack a CMS investigator and then watch hospital staff utilize mandatory CMS protocols to intervene?

Sir. SIR! How about you stop disarticulating that man’s elbow. Really now. Would you like some juice instead? We have apple, grape, and cranberry. Maybe some nice Saltines and peanut butter? No? Hey! Now if you don’t stop poking your fingers in that man’s eyes, we’re going to have to bring you to a secluded area. I’m not kidding, Mister. And you, Mr. Investigator – stop trying to fend off his attack with your clipboard. Don’t you know the patient could injure his knuckles if he hits that clipboard instead of your face? OK, Mister. I see the Investigator’s blood dripping all over the place. Someone might slip and get hurt. You are officially creating a patient safety hazard. NOW you’re getting CITED! SECURITY!

That should calm those unruly patients.


  1. I would appreciate any covered entity deciding to sue CMS and JCAHO if a regulation resulted in an injury to staff or other patients. They are guideline makers. They have a duty to do no harm by their guideline making. If they breach that duty, and they have notice of harm from their regulation, they should be subject to exemplary damages.

    In case law, a pool builders association was held liable for a diving injury due to defective guidelines, even though the builder did not belong to it, did not use their faulty guideline, and it was promulgated after the injury. The legal reasoning would apply to all guideline makers, including informal ones. An example of a informal guideline maker would be an expert for the plaintiff in a medmal case. He would be bossing all the clinicians of the state by testifying to his subjective opinion of the standard of care.

  2. This will go over well. Once again, the unruly, out of control patients have more rights than the staff trying to do their job! Honestly, when will these entities pull head out of tail and see that patients are getting more violent, there are more of them period, and staff will continue to get hurt. Having security staff on hand to assist with gaining control of dangerous patients is paramount to everyone’s safety- including the patient!

  3. The ‘Smoke a Joint’ Commission should really be glad that there are compliance modalities such as the TASER available today. A few years ago, the security/officers would probably be resorting to good, old fashioned bullets to subdue rampaging individuals… But hey, let’s just ignore /that/ one.

    Honestly, I agree with the above poster, the stakeholders need to figure out a good way to sue the pants off TJC and put them out of business for good. At some point, all this safety is going to backfire.

  4. This bodes well for the future of medical care. Between hospitals and doctors not getting reimbursed by the government for government-backed “insurance,” insurance premiums through the roof, and staff being disallowed from any kind of real defense… yup, I bet there are people beating down the door at medical schools and nursing schools across the country!

  5. I think the key here is “Joint Commission”. Too many blunts, perhaps?

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