Guarding prisoner patients in Texas

[Antipas]

Is there some sort of general protocol found in the Texas Code of Criminal Procedure or in the Texas Penal Code governing the duties of law enforecement officers who are assigned to guard prisoners who have to be taken to a hospital for medical treatment? Or would such duties be spelled out in the General Orders of the particular agency?

I ask because I work at a medical center whose official policy spells out the duties of officers assigned to guard prisoner patients, and the references listed for the policy are "Texas Code of Criminal Procedure" and "Texas Penal Code," with no citations of particular sections from those codes. I've attempted to find something in both of these codes dealing with the subject but have had no luck. Am I overlooking something, or do these codes simply not deal with the subject? I can't ask the composers of the policy for clarification because they are no longer employed at the medical center.

[TEXASCOP]

My agency has a policy and it also depends on the severity of the offense the patient committed. Could you be more specific. Are you talking about if the patient gets out of control or attempts to harm someone? Is the patient already in jail but require medical attention that cannot be provided at the jail? If I arrest someone that needs medical attention I standby at the hospital and keep an eye on them till the doctor stitches them up, there really isn't anything special about it. If the person is dangerous or combative we may restrain them more than just handcuffs to protect the doctors and nurses. If I have arrested someone they are still in my custody (although possibly not handcuffed) while they are at the hospital. I follow my agency policy, not the hospitals policy.

[Antipas]

Thanks for the reply. I'm asking about general procedure for guarding an inmate who had to be brought to a hospital to receive medical treatment that could not be provided at the jail. What, for example, does your policy say about the proximity that must be maintained in relation to the prisoner?

Here's a direct quote from my medical center's policy:

"If the officer on duty is requested to leave the room by the physician or other health care provider, the officer will maintain visual contact with the prisoner, but of sufficient distance to protect the prisoner's right to confidentiality."

I did a search on this passage and got a hit on a similar passage from another hospital's policy, but no hits from the Texas Code of Criminal Procedure or the Texas Penal Code. My concern here is that if some agency has a more restrictive policy that prohibits the officer from leaving the patient's room under any circumstances, some overzealous medical center employee might end up interfering with the officer's performance of his duties as mandated by his agency's General Orders.

[TEXASCOP]

Yeah I don't believe there is anything in the Texas statutes that stipulates a prisoners rights to medical confidentiality. When I take someone I have arrested to the hospital. I normally keep a close enough proximity to intervene in case he attempts to assault the hospital staff. Safety for the hospital staff is more important than the prisoners confidentiality. I also don't go blabbing to everyone about the prisoners medical condition. I have never had a doctor/nurse ask me to leave the room. In fact It always seems they make sure I'm in the room with them. Your hospitals policy is only for protection of civil liability. Bottom line if the prisoner is dangerous I'm not going to give him the opportunity to injure a innocent hospital employee. If the employee refuses to treat unless I leave the room, then I guess he goes untreated. But you never know the guy could be completely compliant and next thing you know he goes nuts (i have seen it happen)

[Antipas]

Your hospitals policy is only for protection of civil liability.

How so? It would appear to me that if an officer with restrictive general orders that forbid him from leaving the forensic patient's room acquiesces to hospital policy and leaves the room, it could actually increase the hospital's liability. For example, suppose the patient attacks the health care worker and inflicts severe injury. The injury would have been much less severe--or might not have occurred at all--had the officer remained close by in the room instead of having to respond from outside the room.

[McNulty]

I'm concerned about your motives for obtaining this information. I have a funny feeling that you're probably going to use it to jam up a cop.

[Antipas]

I'm concerned about your motives for obtaining this information. I have a funny feeling that you're probably going to use it to jam up a cop.

On the contrary, I'm trying to make sure that some cop doesn't get "jammed up." My point is that LEOs are legally bound to carry out their general orders regarding prisoner patients, and if they deviate away from their general orders to follow some medical center policy, it could get them and the medical center into trouble. In short, I am of the opinion that a medical center has no business telling an on duty LEO how to deal with the prisoner patient in his custody. I am troubled by the fact the medical center where I work does exactly that and then cites the Texas Penal Code and the Texas Code of Criminal Procedure as "references" for its policy. I have as yet not been able to find anything in the Texas Penal Code or the Texas Code of Criminal Procedure that governs how LEOs are to handle prisoner patients.

[Samuel]

Just wondering why this bothers you so much?

[TEXASCOP]

How so? It would appear to me that if an officer with restrictive general orders that forbid him from leaving the forensic patient's room acquiesces to hospital policy and leaves the room, it could actually increase the hospital's liability. For example, suppose the patient attacks the health care worker and inflicts severe injury. The injury would have been much less severe--or might not have occurred at all--had the officer remained close by in the room instead of having to respond from outside the room.

1.Ok, I noticed you used a term that would indicate you are talking about a patient who suffers from some type of mental health issue. Correct me if I'm wrong but doesn't forensic patient pertain people who suffer from some type of mental health issue? The type of patient doesn't really matter but I was just pointing that out.

2. I was agreeing with you, businesses and organizations generally have policies to protect them from getting sued. For some reason your hospital's policy makers felt that protecting a patient's medical information was more important than the staff members safety (witch I don't agree with). There is noting in the Texas Statues that says a doctor or nurse may order an officer to leave the patient's room under the color of patient confidentiality. Like I said before that person is my prisoner and I will keep close proximity to him no matter what. The police officers duties supersede the hospital's policy.

3. The law's sometimes get changed or altered at each legislative session which is every 2 years (maybe their was a statute regarding this at one time but I doubt it). I think the person that originally wrote your policy was confused regarding this circumstance.

4. Of all the hospitals that I have brought prisoners to, I have never had anyone ask me to leave the room. On the contrary I have always got the impression that the hospital staff preferred I stay in the room.

5. I'm not a hospital administrator therefore I can't tell you why your hospital chose to write your policy in such a way. In my opinion it was an attempt to protect the hospital against a lawsuit brought on by a patient, subsequently endangering the hospital staff. I agree that your hospital could end up getting sued by one of the staff members that's injured after the officer is asked to leave the room.

6. I don't know how you can go about resolving the situation, maybe speaking with your administration staff?

[McNulty]

On the contrary, I'm trying to make sure that some cop doesn't get "jammed up." My point is that LEOs are legally bound to carry out their general orders regarding prisoner patients, and if they deviate away from their general orders to follow some medical center policy, it could get them and the medical center into trouble. In short, I am of the opinion that a medical center has no business telling an on duty LEO how to deal with the prisoner patient in his custody. I am troubled by the fact the medical center where I work does exactly that and then cites the Texas Penal Code and the Texas Code of Criminal Procedure as "references" for its policy. I have as yet not been able to find anything in the Texas Penal Code or the Texas Code of Criminal Procedure that governs how LEOs are to handle prisoner patients.

In my particular case, we have very specific department policies about prisoner control and transportation. Some of the hospitals we go to require us to do various things, such as sign in with security, get an ID badge, etc. One actually gives us a copy of their policy to read and sign each time. I do whatever they want, as long as it doesn't contradict our policy. My employer pays my bills, the hospital doesn't.

[MountainMan]

I can't speak for Texas but most States aren't going to mandate much in the way of how a prisoner is guarded at a medical facility with a few exceptions. For the most part an officer is going to allow medical staff to do what they need to do. The only issues is a few Dr's or other staff members that don't understand that many times it was a fight to get people into cuffs and I'm damn sure not going to release them without a very compelling reason.

Interference with a Law Enforcement official may result in obstruction charges. Hospital Policy doesn't trump Law Enforecements authority to conduct business.

I have had a few Dr's that "ordered" me to remove a cuff and I simply explain that it took several of us to get him in those cuffs and I'm not releasing them. If they insist I explain that if the prisoner attacks them its on them. I also explain that if an escape attempt is made they will be charged and going to jail for aiding escape. Simple, they understand the consequences and take the liability for their own poor choices. It keeps it to medically necessary. Usually its not an issue. People being taken from a detention facility would be under similar guidelines. But they may or may not be restrained depending on their classification in the detention facility.

[Antipas]

Just wondering why this bothers you so much?

It bothers me because my department--Safety/Security--is charged with the responsibility of getting LEOs to sign off on a policy supposedly justified by the Texas Penal Code and the Texas Code of Criminal Procedure when in fact it is not.

[G35 Mass]

It bothers me because my department--Safety/Security--is charged with the responsibility of getting LEOs to sign off on a policy supposedly justified by the Texas Penal Code and the Texas Code of Criminal Procedure when in fact it is not.

I would (probably not so politely) tell you to shove your form. I don't answer to hospitals. Not once, not never.

[Antipas]

Correct me if I'm wrong but doesn't forensic patient pertain people who suffer from some type of mental health issue?

"Forensic patient" is simply a euphemism for "prisoner patient." So yes, a person brought in on a mental health warrant is a "forensic patient," but so is the gangbanger who got shanked at the county jail. At our medical center, psychiatric patients under warrant are kept in a locked mental health unit and don't require a LEO to sit on them. Our policy refers to prisoners who are brought in with medical issues.

There is noting in the Texas Statues that says a doctor or nurse may order an officer to leave the patient's room under the color of patient confidentiality.

So the medical center's policy shouldn't be citing Texas Statutes as a reference.

I think the person that originally wrote your policy was confused regarding this circumstance.

Very confused.

4. Of all the hospitals that I have brought prisoners to, I have never had anyone ask me to leave the room. On the contrary I have always got the impression that the hospital staff preferred I stay in the room.

Are you ready for this? After the part where it says that the LEO is to leave the patient's room when requested, there is a later section where it says that the LEO "is not to leave the patient's room under any circumstances." I believe the compiler of the policy pastiched different policies together totally oblivious to this glaring contradiction.

In my opinion it was an attempt to protect the hospital against a lawsuit brought on by a patient, subsequently endangering the hospital staff.

My subsequent research showed that the leaving the room bit to protect patient confidentiality was plagiarized from a medical school police department policy. The medical school PD offered the LEOs who could not agree to the policy the option of taking their patient somewhere else for treatment; my medical center's policy omits this very important qualification and "requires" the LEO to sign off on the policy.

I don't know how you can go about resolving the situation, maybe speaking with your administration staff?

I'm gathering information for a report on the deficiencies of the policy that I will submit to administration.

[Antipas]

I do whatever they want, as long as it doesn't contradict our policy.

A part of the sign off policy states that the LEO agrees to obey all policies of the medical center. Of course, without knowing what all the policies are, the LEO may very well be signing off on something that may violate his general orders.