Austin Health has been fined $30,000 after pleading guilty to criminal charges arising from a serious incident three years ago when a male nurse was assaulted by a mental health patient wielding a motorcycle battery.
The fine, handed down in July, is believed to be the highest so far levied against a Victorian hospital operator for criminal breaches of workplace health and safety.
It comes as WorkSafe Victoria pursues several other cases against health networks in relation to assaults or harm caused to nurses at work, and it follows the $25,000 fine levied against Alfred Health in December 2018 for breaches arising from an assault on a nurse in 2015.
Austin Health averted a conviction for breaches of sections 21(1) and 21(2)(a) of the Occupational Health and Safety Act 2004, which relate to the failure to provide a safe working environment. These provisions provide for penalties of up to $1.5 million for breaches by corporate entities.
Heidelberg Magistrates’ Court heard that a long-term mental health patient being held in Austin Health’s Secure Extended Care Unit (SECU) developed over time a fixation on a mental health nurse who was attending a patient in the same ward.
The mental health patient had chronic, treatment-resistant schizophrenia and a recorded history of physical violence.
The court heard that, more than a year before the assault, SECU had assessed the patient as having a “high risk of psychotically-driven interpersonal violence” and that he tended to have delusional beliefs, including paranoia, leading to violent behaviour.
The court also heard the health network knew that the patient’s “trigger signs” for violence included fixating on a person, “often a nurse”, who he deludedly believed was trying to kill him.
During 2017, the mental health nurse was attending to another mental health patient in the SECU unit who had been transferred to a room close to the offending patient.
WorkSafe told the court that although the nurse had a “friendly” and reasonable relationship with the offending patient, and knew that he had a chronic, paranoid schizophrenia, he was not made aware of the patient’s history, trigger points or tendency to violence.
In mid-October 2017, the mental health patient’s daughter contacted Austin Health several times over three days, repeatedly warning the hospital that her father’s mental state had deteriorated and he was under the delusion that the mental health nurse was trying to kill him.
The court heard this was noted in the patient’s health notes, but that the nurse was never told that he was the target of the patient’s paranoid delusions and fixation.
On 18 October 2017, a day after barricading himself in his room, the mental health patient approached the nurse in the foyer of the SECU ward and severely assaulted him using a motorcycle battery disclosed in a bag.
WorkSafe told the court that, in the three years since the assault, the nurse has not returned to work as a mental health nurse.
Austin Health made representations that they had various policies in place to prevent aggression and violence and referred also to the 10 Point Plan to End Violence and Aggression as part of the Victorian Public Mental Health Services Enterprise Agreement (2016-2020).
WorkSafe told the court that, contrary to its policies and procedures, Austin Health “failed to alert the nurse to the risk of physical violence that he faced, and to provide him with the option to leave work or be redeployed until the risk no longer presented”.
Austin Health was also ordered to pay WorkCover’s costs of $5,683.
Health services must ‘live and breathe’ the 10 Point Plan
ANMF is calling on all health services to properly and fully implement the 10 Point Plan to End Violence and Aggression to protect all healthcare workers.
ANMF (Vic Branch) Secretary Lisa Fitzpatrick said ‘Just having policies and the plan referenced as part of the public sector agreement is not enough.
‘The plan must be implemented in its entirety and become a part of the everyday systems of work, workplace culture and the organisation’s DNA.
‘Health services must live and breathe the plan and set up all of the systems and behaviours that identify risk and prevent and reduce violence and aggression.’