Monash Health will face trial in the County Court next year after pleading not guilty to criminal charges relating to an incident at Dandenong Hospital in 2017 that resulted in serious injuries to a nurse.
The charges, which are being prosecuted by the Victorian WorkCover Authority, allege Monash Health breached section 26 of the Occupational Health and Safety Act because it failed to maintain a safe workplace.
On 18 November 2020, an online committal hearing in the Melbourne Magistrates’ Court heard how in September 2017 an acutely-ill mental health patient burst through a set of security doors separating the hospital’s high-dependency and low-dependency mental health units.
The patient then passed through the low-dependency unit and down a corridor to a second set of security doors, where he scuffled with a nurse as he tried to grab her staff security pass. The court has previously heard the nurse was injured at that point.
Magistrate Fiona Hayes was told the patient had been admitted to the high-dependency unit after spending some hours in the emergency department, and that he had exhibited highly aggressive behaviour and had damaged property during a previous admission to Dandenong’s HDU.
A senior nurse in charge of the mental health unit at Dandenong Hospital told the court that the security doors separating the HDU from the low-dependency unit were used as much as 1000 times a day.
Doctors, nurses, cleaning staff, kitchen staff and others used the doors, which could only be opened with a staff security pass. These solid doors also served as fire-retention doors, and they had to be manually opened to evacuate HDU patients if a smoke alarm was triggered.
But the nurse told the court the doors required several modifications after they were installed in 2013. The first involved the installation of viewing panes, or small windows, on each door to ensure staff could see who might be on the other side.
The nurse said patients from the high security units occasionally tried to slip through the doors when they were opened, and some intellectually-impaired patients would sit at the doors and kick them.
She told the court patients discovered that by kicking the lower section of the doors, they could break a magnetic field holding the security doors shut. That led to further modifications to fit a central locking system, followed by key-operated steel bolts at the top and bottom of one of the double doors plus steel panels to protect the locking mechanisms.
The nurse said she had never seen a patient break through the doors before the 2017 incident.
The committal hearing was told that after the patient had been restrained, he was reassigned to one of the HDU’s three seclusion rooms, which are located wholly within the HDU behind another set of security doors.
A WorkSafe inspector told the court that he did not initially issue Monash Health with a formal notice to make improvements in September 2017 as he believed the risk “at that time” had been mitigated because that particular patient had been put into seclusion.
Under questioning by counsel for Monash Health, the WorkSafe inspector said he had suggested the health network, which had its own engineering and maintenance team, should consider installing a steel-framed door.
The court heard discussions continued between WorkSafe investigators, inspectors, Monash Health and others for at least a year. But when the hospital ultimately secured funding for a more permanent and extensive remodelling of the security doors, the logistics involved in relocating the mental health patients led to further delays.
Magistrate Hayes said she was satisfied there was sufficient evidence presented in the committal hearing for a properly instructed jury to convict in relation to the charges.
Monash Health’s chief legal officer Peter Ryan entered a plea of not guilty on behalf of the health network.
The case will now move to the County Court for a directions (or preliminary) hearing in mid-December. The court heard a trial could take up to 10 days.
Section 26 of the OHS Act relates to the responsibilities of persons who manage or control workplaces. Breaches of this provision are considered a serious criminal offence and can attract penalties of more than $1.4 million for corporate entities.