Sometime on July 16, a week after his 33rd birthday, Stefan Ballard went to Harborview Medical Center and killed himself. Authorities are unsure why. He had been to the hospital atop First Hill only once as a patient, five years ago, for a sore throat. This time his illness was fatal, and solitary: Ballard lay dead and unnoticed for 12 hours in an East Wing rest room, wearing earphones attached to a portable MP3 music player, its batteries exhausted. He died around 9 p.m. and wasn't found until 9 the next morning, a loaded .357 magnum at his side. He shot himself in the head, but he could have done serious harm to others, having brought a 50-round box of ammunition with him. The only potential security barrier, an emergency-room metal detector, is used mostly at night. Ballard apparently entered before the detector went on at 8 p.m. or found another way in. No one, including security officers, knew his corpse was in the hospital until a locksmith opened the rest room door. Startled officials promptly announced a thorough review of safety procedures at the crowded trauma center and teaching/research hospital, where security is a balancing act between public safety and an open-door policy. Visitors and patients can readily breeze into the public facility, whose mission, unlike private hospitals, is to turn away no one, regardless of means to pay. It was founded in 1877 as the county welfare hospital. Today, Harborview's priority patients—usually uninsured—are jail inmates, the mentally ill, drug abusers, and victims of burns, trauma, domestic violence, and sexual assault.
Unfortunately, not everyone comes unarmed. Last year, thanks mostly to the nightly metal-detecting, security officers confiscated 32 guns and almost 2,000 knives, sprays, and assorted makeshift weapons, with untold others carried in during the day. By its very nature, the 351-bed hospital attracts violence: Its all-comers emergency room—with an average of 220 patients every day—often is packed with victims and perpetrators, who might be followed through the door by angry friends or family, revenge seekers, or gang members. Ballard's well-armed intrusion was an indication of how unsafe Harborview has become.
Yet more than two months later, there are no new security measures. "At some times of day, they could just walk in, yes," concedes community-relations director Tina Mankowski. For that matter, Ballard's armed entry wasn't unpredictable. Officials were well aware of Harborview's security flaws, the staff's fear, and growing crime in and around the hospital. There were more than 1,500 incidents last year, including 130 thefts, 42 assaults, five robberies, and four rapes. Back in 1995, a man named Bill Ingram, 32, committed suicide in a hospital stairwell. (Stabbed deeply in the chest, he might have been murdered, but investigators were undecided.) More than 500 Harborview workers signed a petition seeking better security back then, and the administration promised to deliver. More video cameras, panic buttons, key-card access, and security officers were added. But according to officers, medical workers, and public documents, hospital administrators continued to downplay the dangers and have not taken meaningful steps to ensure a higher level of safety.
HARBORVIEW HAS FAILED to properly train its security force, it cut back on hiring armed off-duty police, and it reassigned the hospital's security chief to work at home with full pay, leaving it without a permanent on-site chief for more than a year. The state Department of Labor and Industries is completing an investigation into workplace-safety complaints by security officers who feel present policies could get them killed. As part of that probe, investigators examined a case of death threats made by one of the officers against his bosses and co-workers. Though the officer boasted about his violent side and vowed to bring a shotgun from home and blast fellow workers, the hospital kept him on duty. In a complaint to Labor and Industries, a security commander warned, "This type of incident has the potential to involve everyone being at risk in the facility."
Security officials and administrators also have been battling over how best to patrol the public hospital. The 50 officers, equipped only with collapsible batons, want to be armed and trained as police, because, they argue, they handle more dangerous incidents than many police departments in the state. The hospital wants them to remain a public-safety force, specializing in security and sometimes assisting in patient restraint (7,300 last year, mostly in the emergency room and psychiatric ward). "We've always used a public-safety model here," says spokesperson Mankowski. "Look across the country—we're right in line with other major trauma centers," she says. "We want officers to just promote and maintain safety within the hospital, and use Seattle police as a backup." In complaints to Labor and Industries, security officers beseeched the state to force Harborview to train and arm them, saying they, other staff, and patients are at risk. "There will be a fatality, it's just a matter of time," wrote one officer in a complaint. "Sooner or later," said another, "there will be a lawsuit."
The state sided at least in part with the officers and is proposing a $2,800 penalty because "training was not implemented to improve the skill, awareness, and competency of all the employees as it relates to occupational safety." The hospital and the state are still working on a settlement, which includes the promise by Harborview to train its officers further. But the county-owned hospital and its operator, the University of Washington (which has its own police force), passed on the option to have officers schooled at little cost at the state police academy. The academy, says Mankowski, was not a good fit because it specializes in turning out cops. So Harborview has contracted with an Arizona company, the Taylor Group, for a $300,000 course in public-safety tactics. Including officer salaries, the total cost will be $700,000 when training is finished, perhaps by next year.
MANKOWSKI WOULDN'T comment on the Labor and Industries probe, other than to offer a copy of the findings. Additional documents obtained by the Weekly from Labor and Industries note that some officers feared for their lives when a fellow officer, who was a gun collector, threatened to shoot several sergeants and another officer. He was eventually placed on administrative leave pending an investigation. For unexplained reasons, he was returned to duty. The hospital sought to keep news of these events quiet, an officer claims. Co-workers were forced to alert outside investigators after the man bragged about his threats, calling himself "Mr. Workplace Violence" and composing songs that included death threats. Eventually, the officer left to take a security job with the city community-college system. Now "he's someone else's problem," says a former officer.
Some of these conflicts unfolded at a time when the hospital had not one but two security directors. A year ago, an interim chief was on the job while the permanent chief, Anthony Potter, was at home—but being paid about $35,000—for more than five months. Potter, now in private business, won't comment, apparently bound by a legal agreement. Harborview officials "do not discuss confidential personnel issues," says Mankowski. But one former hospital official with direct knowledge of events says Potter was sort of "let go in installments" to settle legal issues. Hired in October 1999 and eventually making about $70,000 a year, Potter and Harborview agreed to a split due to philosophical differences. He was allowed to work at home as a consultant. But from August 2001 until early this year, "they never called once," says the official who knows of the deal. Some projects on Potter's to-do list, such as completion of a hospital security access-control system, were actually done by other consultants at additional cost, the official says.
Potter was elbowed out because he was "too much cop, not enough door-knob rattler," says the official. One of his run-ins was over a crime report he compiled for Harborview's board of trustees last year, showing a rising incident rate. Some figures were downsized by an administrator who "picked new numbers out of the blue," says the knowledgeable official. Some crimes were downgraded or shifted to lesser categories; 89 assaults became 42 assaults and 197 thefts became 130, the official says. Spokesperson Mankowski concedes that some changes were made but says it was because "it appeared that some of the incidents may have been counted multiple times." Potter, she says, "agreed to clarify the disposition of the 1,052 incidents so that the numbers were meaningful," and a "second," revised report was issued.
The hospital promises safer, saner days ahead. Thirteen months after Potter left office, Harborview has hired Warren Walls, a former security official at St. John's Mercy in St. Louis, as its new security director. He's been on the job about a month. Has he decided on any changes, such as 24-hour weapons screening? "He is currently assessing the medical center's public-safety program," says Mankowski. "At this time, it's premature to speculate on what changes he may make."