Violence in Healthcare

Doctor Shot and Killed in Grudge Shooting Over “Mom”

Posted on January 25, 2015 9:53 am by Caroline Ramsey-Hamilton Comment

RISKAlert- Active Shooter No. 625, January 21, 2015, Boston, Mass.

Middle-Aged Shooter kills Cardiologist at Brigham and Women’s Hospital, and then Kills
Himself, in an apparent Grudge Shooting Because the Doctor had Operated on his Mother.

On Tuesday morning on Jan. 21, at 11 am, Stephen Pasceri, 55, walked into the Shapiro Center
at Brigham and Women’s Hospital, and asked to see cardiologist, Dr. Michael J. Davidson. When
he saw Dr. Davidson, outside of an exam, he shot him twice, critically injuring him.

Dr. Davidson later died from his injuries. Pasceri then went to the 2^nd floor and killed himself with a gunshot
to the head. Later, it was discovered that Dr. Davidson had operated on Pasceri’s mother, Marguerite, and
she had died on November 15, 2014. Pasceri’s sister was quoted as saying, “He loved his mom, and he
loved her very much. He appeared to be handling her death well,” the sister said of her brother.

“Everything seemed to be going really well. I have no idea why he snapped like this.
He was a great guy. He took care of his family, he had a beautiful house and he has four
beautiful children. He was an upstanding citizen.”

The hospital locked down and rushed Dr. Davidson into surgery, but he died during the night from his injuries.
Brigham and Women’s Hospital’s COO said the hospital was one of the first to institute an active shooter
training program. The hospital does not use metal detectors.

Lessons Learned : “A is for Access Control”

1. Metal Detectors can be are a reliable tool to Prevent In-Hospital Shootings.

2. Active Shooter Drills are NOT ENOUGH as these incidents unfold in just a few minutes.

3. Installing ‘NO WEAPONS’ Signage at Entrances can be a deterrent to these first time shooters.

Despite having a good job, family, and a beautiful home, when confronted with a mid-life crisis, his mother’s
death, another middle-aged shooter goes to a hospital and shoots the doctor, in a scenario that resembles
the Johns Hopkins shooting in 2010. To protect staff and patients, hospitals will have to increase their
security protective measures, including use of metal detectors, no weapons signage and
situational awareness of the staff.

RISKAlerts is a publication of Risk & Security LLC.
To subscribe, write to: info@riskandsecurityllc.com

Healthcare’s failure to address link between mental illness and violence putting lives in jeopardy

Posted on July 29, 2014 9:50 am by Caroline Ramsey-Hamilton Comment

DATELINE: JULY 28, 2014

Richard Plotts, the man who allegedly murdered a 53-year old caseworker at a suburban Philadelphia hospital last week by shooting her in the face, was formally charged with murder on Saturday following surgery to remove bullets in his torso.

According to Delaware County District Attorney Jack Whelan, police in Upper Darby, Pa., where Plotts lived, were aware of at least three mental health commitments, including once after he cut his wrists and once when he threatened suicide — but said such stays can last just one to three days. Whelan also noted in his press conference that Plotts had also spent time in a mental health facility.

Every week brings a new story in the media about murder-suicides, patients killing healthcare workers, random shootings and assaults. We can read the new polls like the article on U.S. shootings in healthcare, as well as the recent healthcare crime study by the International Association of Healthcare Security and Safety (IAHSS) that routinely reports that violence in healthcare is soaring.

Not only in healthcare, but throughout the U.S., these random active shooter trends are increasing. To see how much of this violence is related to severe mental health problems, we only have to look as far as these high profile incidents:

June 14, 2012 – Buffalo, N.Y., trauma surgeon shooting
July 20, 2012 – Aurora, Colo., movie theater shooting
Sept. 16, 2013 – Washington Navy Yard shooting
Dec. 17, 2013 – Reno, Nev. urology clinic shooting
Jan. 22, 2014 – LAX active shooter incident
April 2, 2014 – Fort Hood (2nd) active shooter incident

None of these incidents were related to poor performance review, losing a job, and only one of these could be called “domestic violence,” but what they all have in common is that the perpetrators were all severely mentally ill.

Guns scare me. Guns kill people by accident and on purpose. I never let my children play with guns. However, as I analyze the elements of these shootings and dozens more, my bias is changing. I think it’s less about guns and more about mental illness.

Healthcare and hospitals would be the one industry where you would think that people would be concerned about the state of mental health of their patients and staff. Instead, it seems like mental health problems are walled off by society, treated ineffectively, and violent tendencies (which sometimes make their way onto patients’ Facebook pages) are largely ignored and unreported by the clinicians treating them.

So it’s left to the security and law enforcement community to deal with these individuals who are paranoid, depressed, angry, frustrated, disappointed, hurt, confused, and, ultimately, violent.

Now that mental health has been re-classified as another medical problem, the money is flowing to the treatment centers and it’s covered by Medicare. But progress doesn’t seem to be either easy or effective.

Dr. Graham C.L. Davey, Ph.D. writing in Psychology Today in January said: “Many of those health professionals (GPs and family physicians) at the first point of contact with people suffering mental health problems are poorly trained to identify psychological problems in their patients, and have little time available to devote to dealing with these types of problems. This increasingly makes medication prescription an attractive option for doctors whose time-per-patient is limited—an outcome which will have all the potential negative effects of medicalizing the problem into a “disease.”

And that’s exactly what we see, patients who don’t take their meds because of the negative side effects and so they become isolated and increasingly violent. The side effects are clearly pointed out in TV commercials, that you’ve probably watched.

For example, one medicine has side effects that include sexual side effects, convulsions, brain shrinkage, stroke, death, suicide, violent thoughts, psychosis and delusional thinking.

The increase in hospitals adding seclusion rooms, expanding the number of beds for psych patients, and the time spent by both law enforcement and security professionals in dealing with these troubled individuals, may account for one-quarter to one-third of an organization’s security budget.

Many of the security risk assessments we do are focused on handling mobile mental patients, including the baby boomers suffering from Alzheimer’s and dementia.

As violent incidents continue to increases in our society, our workplaces, and in our hospitals, we need to spend more time looking for, and demanding treatments that work and that are sustainable by the patients so they can lead happier lives and we can protect the rest of society, and our healthcare facilities, from their potentially violent behavior.

http://www.securityinfowatch.com/blog/11598089/healthcares-failure-to-address-link-between-mental-illness-and-violence-putting-lives-in-jeopardy

Author: Caroline Ramsey Hamilton

Since 1988, Caroline Ramsey-Hamilton has been a Thought Leader in All Aspects of Active Shooter and Security Risk Assessment in both Public and Private companies and organizations. Specializing in Hospital and Healthcare Security. Hamilton is Certified in Homeland Security (CHS-III), Anti-Terrorism (ATAB) and Security Risk Assessment. As President of Risk & Security (www.riskandsecurityllc.com) she works with many hospital clients, and develops affordable risk-based apps for improving security risk assessments, and publishes the RISKAlert security awareness program. She lives in south Florida with two beagles, a rescued kitty and (on weekends), 4-year old twins.

Reprinted with permission from www.SecurityInfoWatch.com

Psychiatrist Shoots Mental Patient who Killed His Caseworker at Mercy Fitzgerald Hospital

Posted on July 25, 2014 7:07 pm by Caroline Ramsey-Hamilton Comment

Psychiatrist Draws Gun in Mercy Fitzgerald Hospital and Shoots the Mental Health Patient who Killed his Caseworker by Shooting Her in the Face. Witnesses near the scene reported hearing screaming and gunfire, as suspect and mental health patient Richard Plotts confronted his caseworker, Theresa Hunt, and then drew his gun, and killed her. Another bullet grazed a doctor, adjacent to the scene, but the doctor had a gun of his own, and he shot Plotts 3 times in the torso.

The doctor, identified as Lee Silverman, was treated was treated for a head wound and released after being taken to the Hospital of the University of Pennsylvania. The shooter, Richard Plotts, of Upper Darby, Pennsylvania, who had a long criminal record, was undergoing surgery Thursday night at the Hospital of the University of Pennsylvania. If he survives, he will be charged Friday with murder, said Delaware County District Attorney Jack Whelan.

There is a Lesson Here — KEEP POTENTIAL SHOOTERS WITH WEAPONS OUT OF HOSPITALS.

A is for Access Control! Once a potential shooter brings a weapon into a hospital, everything is much more difficult to control. Keep them out.

Weapons should be checked at the hospital entry points and no-weapons signage should clearly indicate that weapons are not allowed, and that should be followed up with either stand-alone, or wand metal detectors which give staff members a initial level of protection.

usa-shooting-pennsylvania

Bernice Ho, a spokeswoman for Mercy Fitzgerald Hospital, said Thursday it was against hospital policy for anyone other than security guards to carry weapons, so there are questions about why this doctor disregarded the policy, although Donald Molineux, chief of the Yeadon Police Department, said “If Silverman returned fire and wounded Plotts, he without a doubt saved lives.”

District Attorney Whelan described how the meeting among Plotts, Silverman, and Hunt abruptly took a violent turn. Plotts and Hunt went to Silverman’s third-floor office shortly before 2:30 p.m., Whelan said. Plotts was apparently armed, and people near the room soon heard shouting.

Concerned, a hospital employee “actually opened the door, saw him pointing a gun at the doctor,” Whelan said. The worker shut the door quietly and immediately called 911. Plotts then opened fire. According to Whelan, he shot Hunt two times in the face. The psychiatrist then ducked under his desk, retrieved his gun, and came up shooting, striking Plotts three times.

Keep Weapons Out of the Hospital to Dramatically Reduce Violent Incidents!

Aventura Hospital Patient Strangled in his Room on July 1st,, 2014

Posted on July 2, 2014 4:09 pm by Caroline Ramsey-Hamilton Comment

RiskAlert INCIDENT REPORT 565 –

Patient Strangled in Aventura Hospital, Florida

32-year old Behavioral Health Patient found Strangled to Death
in his Hospital Room

32-year old Alex Paloumbis diagnosed with bipolar disorder and schizophrenia at a
young age, had been in the hospital for two weeks. He was on the fourth-floor psychiatric
ward when he was attacked by the patient in the next bed.

The other patient in the room, identified by police as Alexander T. Jackson, 31, was
charged with first-degree murder and remained in Miami-Dade County Jail on Monday
with no bond. Jackson, who is homeless, was admitted to the hospital around 10 a.m
Thursday, the day of the murder, which occurred about 3 p.m. the same day. He was
put in the same room with Rios, according to the arrest report.

LESSONS LEARNED:

Behavioral health patients require extra controls including
live, continual camera monitoring, use of appropriate
medication and possible use of restraints.

Patients may pose a danger to others, as they did in this tragedy,
and should be under continuous supervision.

Rios was last seen alive at about 2:45 p.m. Thursday. At 3:36., a hospital
housekeeper found him face down on the floor. “The defendant admitted
to killing the victim by strangling him with his hands and a bedsheet,”
according to the report.

While administrators declined to comment on the security procedures at the
hospital, IAHSS (the International Association for Healthcare Security & Safety)
President Marilyn Hollier said psychiatric floors generally have lock-down
procedures, metal detectors, seclusion rooms and cameras at the access
points. It is not known whether any of these security controls existed at the
hospital. Hollier also stressed that security officers need specialized
training to deal with behavioral health patients.

Aventura Hospital, located near I-95 north of Miami, Florida, has a large
behavioral health unit with 46 beds. The victim’s mother said her son was
never violent. “He never, never, never raised his voice,” Paloumbis said.
The mother was summoned to the hospital Thursday. She was told come
quickly and then was ushered into a room where police officers and detectives
were waiting. Though she had limited English skills, she understood that
her son was dead and initially thought that he may have died from a heart attack
or other natural causes.

Stay Situationally Aware and Continuously Monitor Behavioral Health Patients!

RISKAlert® is a publication of Risk & Security LLC at www.riskandsecurity.com

How Risk-Based Security Can Reduce Violence in Healthcare

Posted on May 23, 2014 9:54 am by Caroline Ramsey-Hamilton Comment

reprinted with permission from www.securityinfowatch.com

Using Risk-Based Security to Stem the Tide of Violence
in Hospitals and Healthcare

Created by: Caroline Ramsey Hamilton

Date: May 22, 2014

Hospital and healthcare security is experiencing a major increase in violence,
instigated by patients, patient families and even healthcare staff. Just last year,
there was an active shooter incident in Reno, Nev., in which two physicians were
shot, and in Houma, La., a hospital administrator was shot to death by a terminated
nurse. As recently as Easter Sunday in California, two nurses were stabbed at the
hospitals, where they worked. One was stabbed in both the upper and lower torso
and is in critical condition. These two incidents add to the more than 100 violent
incidents in 2013 and the first half of 2014.

Since 2010, violence in healthcare has skyrocketed. As a result, the Joint Commission has
issued a “Sentinel Event Alert” on the issue and contributed to numerous articles on shootings
in U.S. hospitals. The Department of Homeland Security and a consortium of state and local
hospitals recently released a standard for active shooters in healthcare. These all point to the
conclusion that the current law enforcement-based hospital security model is not working.

Changes in Healthcare
The changes in healthcare, including the increase in insured Medicaid patients and increased
traffic to emergency departments, highlights the fact that very well-intentioned people are
working with an outdated security model that hasn’t evolved to address a changing healthcare
environment. The change in billing and reimbursements for healthcare organizations, such as
tracking of readmission rates, has squeezed hospital profits causing reductions in funding in many
security departments at a time when violent events are steadily increasing.

A new risk-based model for hospital security is emerging that is less linear and more cyclical.
It uses technology to a greater extent, employs forecasting and statistical models to predict the
likelihood of future incidents, and is proactive instead of reactive, focusing money and energy on
preventing events instead of simply responding to them. This model also uses risk assessment
formulas to quickly assess the current security profile of a hospital, clinic, hospice, or behavioral
health facility, factoring in heightened threat-risk environment, not only for the facility in question,
but also adding in the wealth of healthcare data that’s now available.

Risk –Based Security Focuses on Continual Assessment
A major focus of this model is the continual assessment and evaluation of preventive security
controls, which are reviewed quarterly, semi-annually, or annually to discover gaps in controls,
and to fix gaps as soon as they are identified. This dovetails nicely into the assessment models
already required by the Joint Commission, OSHA and new CMS standards.

Looking at recent high-profile security events that took in place in hospitals shows that incidents
happen because of exploited gaps in the existing security of the healthcare facility. In the past,
security officers successfully worked hard to reduce response time so that often officers could
arrive in under two minutes, but it’s still too long. In the Reno shooting, response time was under
two minutes, but that was long enough to kill two doctors.

Focusing on prevention makes sense for healthcare, much in the way the Joint Commission
focuses on patient safety, by continually assessing controls, reducing discovered gaps in controls,
and mitigating gaps by reassessing and tightening security, which creates a cycle of continual
improvement in the healthcare security environment.

Taking Advantage of Technology
The healthcare risk-based security model takes advantage of technology. Instead of waiting
for manual recording of security incidents every day, software programs allow hospital security
officers to enter data at the end of each shift, and that means security directors can map what’s
happening in the hospital or facility on a daily, weekly, monthly and yearly basis. This can go a long
way to identifying trends early and help facilities make appropriate changes in controls so that
negative trends can be reversed quickly and both patient and staff security is increased.

In addition to automating incident collection and analysis, the healthcare security risk assessments
must be automated too. Risk assessments are too time-consuming and labor intensive to be done
annually. By the time the risk assessment is over, the environment has changed again. By
automating the risk assessments, including environment of care and hazard vulnerability,
it produces data that can be used instantly to analyze and recommend the most cost-effective
controls, and rank them by their return-on-investment (ROI).

The role of security in hospital and healthcare organizations is changing too. Security organizations
should no longer be isolated without intensive interaction with others in the organization, including
the human resources department, the facilities managers, safety managers, and the emergency
management staff.

New DHS Guidelines for Active Shooters in Healthcare
With DHS issuing new guidelines for active shooters in healthcare, hospital emergency managers
are now required to prepare for active shooter incidents, as well as storms, hurricanes, tornadoes,
power interruptions and other events related to natural or man-made disasters. This creates a
natural partnership between the emergency management staff and the security program,
because the skills of both functions are needed to properly prepare an organization for any disaster.

Instead of existing in a vacuum, healthcare security directors and managers should cheer at
this development because it expands the importance of security inside the hospital or healthcare
facility, and underscores its value in protecting the organizational assets – the physical facility,
patients, visitors and staff – to proprietary information, including the HIPAA mandated PHI
(Protected Health Information), vehicles, security systems, high-value healthcare equipment
and the healthcare provider’s reputation.

Security budgets have always suffered because security costs are seen as operating
expenses, not an income source, but by tying the security expenses more closely to loss
prevention and protection of the organization, it creates a cost justification for hospital and
healthcare security.

Risk-Based Security Links to Hospital Compliance Standards
A risk-based security model also links security to myriad compliance standards that affect healthcare
and this also supports and justifies the costs related to security. For example, hospitals are required
to have a variety of security controls in place related to tagging of newborns, posting of no-weapons
signs, and environment of care issues. Any healthcare organization accepting funds from Medicare
or Medicaid must comply with the new mandate for annual security risk assessments.

OSHA 3148 also requires hospitals and healthcare organizations to do annual workplace violence
assessments, and more than 33 states also require enhanced protection of hospital and healthcare staff.

As security incidents continue to increase and violence in healthcare escalates, making the
switch to a risk-based security program will provide better protection for hospitals and healthcare
organizations, making more effective use of existing security personnel, as well as justifying and
expanding healthcare security budgets.

For more information: contact: Caroline Ramsey-Hamilton at caroline@riskandsecurityllc.com

Two Nurses Stabbed on Easter Sunday in Different SoCal Hospitals

Posted on April 21, 2014 7:17 pm by Caroline Ramsey-Hamilton Comment

Dateline: April 21, 2014

Stabbing at Olive View – UCLA Medical Center

In the early morning hours of Easter Sunday morning, a nurse at Olive View-UCLA
Medical Center in Sylmar, California was critically hurt after being stabbed
multiple times.

Prior to the stabbing, deputies said the suspect had entered the hospital and
allegedly bypassed the weapons screening area. As the deputies searched
for the perpetrator, they heard a woman scream, and located the nurse, who was stabbed in both the upper
and lower torso. The nurse was transported for medical treatment in critical condition.

Torrance Hospital – Later at 9:20 am on Easter Sunday, Thomas Fredette walked
into Torrance Hospital, in the south Bay, and grabbed a nurse from behind and
stabbed her in the ear with a sharp object, according to Los Angeles County
Sheriff’s officials. Fredette faces charges of assault with a deadly weapon,
sheriff’s officials said. He is being held on $130,000 bail.

What We Learned:

Strong Access Controls at Hospital Entrances and Exits are the first line of
defense against injuries to hospital staff. Both events were random and
apparently unprovoked.

Nursing staff in particular, should receive adequate training in situational
awareness, which may be in conflict with their total focus on caring
for patients.

Double Check these critical Potential Controls:
Stronger Access Controls
Panic & Duress Alarms at Entry Points and on Nurses working late shifts
Better Weapons Screening

The LAX Shooting and the Active Shooter Threat

Posted on November 3, 2013 9:26 am by Caroline Ramsey-Hamilton Comment

With the 3^rd Active Shooter incident in less than 45 days, you are probably wondering what is happening here? Why are we having so many active shooters?

There are not any easy answers, but one thing is certain, all the shooters in the Navy Yard Shooting, the Sparks Middle School shooting, and the LAX Shooter all suffered from psychological problems.

In the LAX shooting, the shooter ‘s parent had tried to contact the police because of a suicide text they had received, but it was already too late.

Police red tape being what it is – thorough, the urgency was lost and the incident was already in process before anything had been done.

BUT NOTE: The text was a HELP ME. And it was noticed, but not followed up in time.

All these shooters had major mental issues, that people had noticed, and
that people had remarked on, and that people had worried about.

We don’t know where all the guns in the incidents were purchased, or just picked up at home and taken to the scene.

BUT we know that most of the active shooters had mental issues, which means that the screenings must be approved, and more help available for these individuals, before they can kill or hurt others.

New Active Shooter App Announced on October 20, 2013

Posted on October 19, 2013 12:27 pm by Caroline Ramsey-Hamilton Comment

FOR IMMEDIATE RELEASE

New Active Shooter app released to reduce likelihood of an Active Shooter Incident.

Active Shooter incidents have increased both in the number of incidents, as well as the number of people killed and injured in the last five years. As an aspect of workplace violence, the active shooter has become is a serious recognized occupational hazard, ranking among the top four causes of death in workplaces during the past 15 years. More than 3,000 people died from workplace homicide between 2006 and 2010, according to the Bureau of Labor Statistics (BLS). Additional BLS data indicate that an average of more than 15,000 injuries were annually during this time.

The latest figures show that high-risk organizations like hospitals, schools, malls, universities, military installations and even hair salons have experienced an active shooter incident and are likely to have a dramatically increased risk for experiencing an active shooter incident in the future.

Risk & Security LLC has released a new web-based app, Active Shooter Risk-Pro©, which offers an easy to use risk assessment program that assesses your organizational risk of an active shooter incident, as well as recommending solutions to prevent an incident from occuring in the future.

In additional to using the Department of Homeland Security (DHS) Guidelines on Active Shooter Response, the OSHA standard 3148 (Guidelines for Preventing Workplace Violence for Health Care, the FBI and Secret Service Guidelines on Active Shooter Incidents, and the new OSHA Inspection Directive, Enforcement Procedures for Investigating or Inspecting Incidents of Workplace Violence, from September, 2011, are both included in the new, easy-to-use application.

The program has been tested on some of the largest organizations in the US, and runs on a laptop, PC or tablet, and even on a smartphone!. Active Shooter Risk-Pro© is built to be affordable and simple to use.

The web 2.0 program, includes newly compiled, updated threat databases, new active shooter incident analysis metrics, and automated web-surveys based on the DHS Guidelines..

The new program gives human services and security professionals a quick and easy way to conduct a active shooter, or general workplace violence that will recommend that will pass an audit!

The Risk-Pro© model has been used for easy software applications by the Department of Defense and over hundreds of organizations, hospitals, and local, state and federal government agencies.

About Risk & Security LLC

Risk & Security LLC is a security risk assessment and risk analysis company with over 30 years of combined expertise in security risk assessment. It develops specialized programs and applications which are easy to use, affordable and which help organizations assess their risk, the likelihood of becoing a target, and which recommend cost-effective solutions.

Risk & Security offers full service consulting on critical risk assessments including HIPAA Risk Analysis, Facilities Security Assessments, Hospital Security Assessments, Workplace Violence, Active Shooter Incident Assessment, Environment of Care and more. Risk & Security partners with security companies around the world to provide state-of-the-art security expertise to analyze risk and recommend cost-effective security controls justified by return on investment metrics.

The team of risk and security experts is led Caroline Ramsey-Hamilton, who has created more than 40 software programs, and conducted more than 200 specialized security risk assessments in a variety of environments, including companies in the United States and around the world, including in Abu Dhabi, Hong Kong, Japan, South Africa and Qatar.

Contact Information:

Caroline Ramsey-Hamilton, CHS III

Email: caroline@riskandsecurityllc.com

Phone: 301-346-9055

Twitter: www.twitter.com/riskalert

Planning an Active Shooter Drill, Why Once is Not Enough

Posted on October 17, 2013 8:25 am by Caroline Ramsey-Hamilton Comment

Almost every day I get a note that a hospital or corporate facility is planning to have an Active Shooter Drill. That is always good news because it is a critical part of preparedness that protects not only against an active shooter incident, but also prepares the staff for other emergencies, but it may not be enough.

I’ve found that to be really effective, drills need to be supplemented with short training sessions, and also awareness programs that teach staff to be on their toes, or “situationally aware”. Security awareness training doesn’t have to be a full time job and it doesn’t have to be expensive.

One of the best ways to create an on-going security awareness program is to make a 12-month calendar, with an activity for each month, or better yet, every two weeks. Here’s a list of activities I use:

1. Start with a one page newsletter. You can have the marketing department help, or use WordPress to design your
own newsletter and email it out to all the staff. Whether your staff is 100 people or 6000 people, it’s a great way to promote the security program.

2. Send out very short emails highlighting news items about security incidents at other companies, especially ones in your industry, for example, hospitals. If there’s a terrible incident at another hospital, cut and paste the story and email it to everyone. In fact, if you’re an IAHSS or ASIS member, their publications have great stories about different security situations.

3. Use seasonal reminders. Now that it’s late October and daylight savings time is almost over, send an email reminding staff how to stay alert when they leave the facility after dark and head for their car. How to use the escort service, if that’s available, or how to use your keys as a weapon in a potential incident.

4. Buy posters to put in the cafeteria, or in the elevators that serve as reminders about the concept of staying alert and aware of your surroundings at all time.

I have interviewed more than 8000 staff members in the last 10 years, and they welcome these reminders and feel more secure just because you are keeping awareness up. Remember, it also reminds everyone that there is a Security Department, and that is working every day to keep them safe.

The Department of Homeland Security also provides free brochures and charts you can print out and give to employees, or you can email them for the staff member to print out and put in their purse. There are wallet sized cards, and lots of other great information you can use in your own active shooter awareness program.

Check out the preliminary OIG Report, which was leaked to Time Magazine on their swampland.com site at

What’s Your Active Shooter Risk? How to Assess the Threat!

Posted on October 15, 2013 4:54 pm by Caroline Ramsey-Hamilton Comment

Just the idea of an Active Shooter in your organization, whether you’re a military base, like Fort Hood, and the Washington Navy Yard, or a school like Sandy Hook, a beauty shop, a cracker factory in Philadelphia, a retail mall, a movie theatre, a grocery store parking lot, or a hundred other places, is a terrifying thought.

I lived about 3 miles from one of the shooting sites, a gas station, used by the Beltway Snipers back in October, 2002. They killed ten people, totally at random, and critically injured three others. Both of the snipers were sentenced, and John Muhammad was killed by lethal injection in 2009.

If you lived in the DC area, do you remember how scary it was just to pump gas into your car, people were huddled against the side of their cars in the gas stations, and hidden by their shopping carts at the local Home Depots.

The fear of the Active Shooter comes from the seeming randomness of the action, which means there’s no way to prevent it, unless you give up, stay home, and hide under the bed all day.

But there are things you can do. Instead of thinking of an Active Shooter incident as a totally unique situation, it’s really a form a Workplace Violence, Gas Station Violence, Parking Lot Violence and other related forms of random violence. In fact, the Department of Homeland Security has identified quite a few steps you can take to keep yourself safer if you are in the vicinity of an active shooter (http://www.dhs.gov/active-shooter-preparedness).

Most of the shooters are mentally ill. Normal individuals do not enjoy planning and killing strangers, and it is usually a last ditch effort, with the suicide of the shooter as the grand finale. Their actions can sometimes be identified early, and the police can be alerted, or the Human Resources group at work, or even the local Sheriff can intervene before it gets to the actual shooting.

Signs that someone is having trouble negotiating their life, especially if that someone is a gun fanatic, with their living room full of AK-47 assault weapons and hollow point bullets, is not hard to spot, because these individuals often leave lots of warning signs, like:

Irrational Posts on Facebook or inappropriate tweets.
Threats made against friends and family.
A dropoff in personal hygiene, as the person gets more obsessed.
Problems negotiating their personal life.
Demonstrating signs of isolation and groundless paranoia

Organizations can protect themselves from an potential active shooter through a combination of specific controls that include elements like access control, continuous monitoring of cameras, employee awareness and training programs, clear cut evaluation routes, regular active shooter drills, and hardening of facilities, to name a few.

One of the best preventive measures is to conduct an Active Shooter Risk Assessment, which is similar to other security analyses, except that it is focused on a particular set of threats related to an Active Shooter Incident. As part of my annual Threat Trend Reports, I’ll be releasing a new set of threat data about the Active Shooter, to help organizations calculate their risk of
having such an incident. For example, did you know that the number of active shooter incidents has jumped from 1 in 2002
to 21 incidents in 2010?

Locations have changed, too, and we found that

About 25% of active shooter incidents occur in schools,
About 25% in retail locations, and
About 37% in workplaces.

In future blogs, we’ll be looking at each element of the active shooter incident, and providing more information to keep
your organization safe.

Risk and Security LLC

Risk Assessments, Training and More