The document summarizes workplace violence incidents at VA medical centers and provides prevention strategies. It describes several violent incidents that occurred at VA facilities between 2000-2005, including shootings and physical assaults that resulted in deaths and injuries. The document also lists statistics on workplace violence, noting that 70% go unreported and occupations at highest risk include police, mental health workers, and healthcare workers. It recommends prevention strategies like restricted access and providing safety escorts.

1. VIOLENCE IN THE WORKPLACE VA Police - Reno, NV Slideshow compiled by Officer Eric Alli Department of Veterans Affairs Indianapolis, Indiana

2. WORKPLACE VIOLENCE PROGRAM Examples of Workplace Violence Review of incidents at VA Medical Centers Terrorism (Domestic and International) Personal Safety Resources for further information

3. What is Workplace Violence? Physical Assaults Sexual Assaults Threats Harassing Phone Calls Intimidation Violation of Protective Orders Disorderly Conduct Stalking

4. Workplace Violence Facts 70% of all workplace violence incidents do not get reported Occupations most prone to violence are Police Officers, Mental Health Workers, Health Care Workers and Social Workers There are 1.7 victims of workplace violence each year in the United States Each week an average of 20 people are murdered and 18,000 are assaulted at work

5. Workplace Violence Facts Government employees have a higher rate of violence than private sector employees Women are over 8 times more likely to be victims of Workplace Violence than men Homicide is the second leading cause of workplace deaths Homicide is the #1 cause of workplace death for women

6. Prevention Strategies that Work Metal Detectors installed in a Detroit Hospital prevented the entry of 33 handguns, 1,324 knives, and 97 mace-type sprays in 6 months A system of restricting movement of visitors in a NYC hospital using identification badges and passes limiting visitors reduced violent crime by 65% in 18 months

7. Review of Incidents VIOLENT INCIDENTS AT VA MEDICAL CENTERS

8. Salisbury, North Carolina August 3, 2000 6:00 PM Local Sheriffs Department transports an 83 year old wheelchair bound patient on oxygen to the local emergency room for involuntary commitment order.

9. Salisbury, North Carolina August 3, 2000 6:00 PM As Emergency Room employees are examining the patient, the patient pulls out a hidden .22 caliber handgun and shoots 45 year old Dr. Charles Flynn in the chest at a distance of approximately 3 ½ feet. The patient then shoots at fleeing employees without hitting his target. Other employees drag Flynn from the room.

10. Salisbury, North Carolina August 3, 2000 6:00 PM VA Police Officers Stephen Chandler and Timothy Nason exchange fire with the suspect. The suspect is shot in the head and dies in the Emergency Room. No other employees were injured.

11. Salisbury, North Carolina August 3, 2000 6:00 PM Flynn is immediately airlifted from the scene from a helicopter that was on the property to transport an unrelated patient. Flynn survives the shooting.

12. Buffalo, New York August 17, 2001 11:15 AM Parking attendant stops 39 year old army veteran to prevent him from driving down the wrong way on a one-way street. Veteran shoots the attendant in the neck with a .22 rifle.

13. Buffalo, New York August 17, 2001 11:15 AM Veteran Proceeds into the Medical Center. VA Volunteer wrestles with the suspect and is shot in the hand. Volunteer is then stabbed twice with a large knife. Suspect then fires several rounds in the atrium, pharmacy and E.R. A File Clerk is then stabbed in the chest.

14. Buffalo, New York August 17, 2001 11:15 AM The suspect fled the scene and was arrested by the F.B.I. at his residence. All the victims survived. VA Police Officers received their firearms the next day.

15. Temple, Texas October 7, 2001 11:00 AM 73 year old patient enters a domiciliary with a 9mm handgun and shoots three people. 2 patients dead, one injured

16. San Juan, Puerto Rico April 24, 2002 7:15 PM VA Police Officer Jose Rodriguez-Reyes is working an outdoor gate to the facility. He is jumped by two men from behind, who attempt to take away his weapon.

17. San Juan, Puerto Rico April 24, 2002 7:15 PM Witnesses heard four shots. Officer Rodriguez-Reyes is found dead, shot in the head. He is the first armed Officer to die in the line of duty.

18. Murfreesboro, Tennessee October 7, 2003 7:30 AM EMS employee on administrative leave enters the VA with a shotgun, .38 caliber handgun and a .30-06 rifle. He shoots at a Human Resources employee hiding under a desk. Suspect then shot at a vacant office.

19. Murfreesboro, Tennessee October 7, 2003 7:30 AM After exiting the facility the suspect exchanged gunfire with VA Police Officers. The suspect then laid his weapon down and surrendered to VA Police. There were no injuries.

20. Amarillo, Texas November 13, 2003 8:30 AM 42 year old psych patient opens fire on the outside the Emergency Room with a .22 rifle begging for the police to shoot him.

21. Amarillo, Texas November 13, 2003 8:30 AM VA Police Officers respond and disarm the suspect without any injuries to the suspect or others. The suspect was committed into the psych unit for medical treatment.

22. Dayton, Ohio March 31, 2004 07:10 AM 37 year old male patient enters the Emergency Room complaining of a headache. Nurse gives the patient directions to a clinic.

23. Dayton, Ohio March 31, 2004 07:10 AM Patient pulls out a gun and holds the nurse hostage. VA Police respond and order the suspect to drop the gun. Patient refuses and is shot by Police.

24. Dayton, Ohio March 31, 2004 07:10 AM Patient survives the shooting. Nurse receives minor injuries during the incident.

25. Jackson, Mississippi May 12, 2004 11:55 AM VA Police shoot at car thieves who attempt to run them over. Suspect survives and is charged with Attempted Murder of a Police Officer

26. Fayetteville, N Carolina December 12, 2005 8:15 PM VA Employee Arthur James Charland, (Pharmacy Technician) enters the VA Medical Center with a 12 gauge shotgun. He shot fellow employee Linda Levington at a close distance, killing her instantly.

27. Fayetteville, N Carolina December 12, 2005 8:15 PM Charland then turns himself into VA Police Officers and admitted what he did. He walks back to show Officers the victims body.

28. Other VA Incidents October 28, 2002 Student Nurse at a VA returns to the University of Arizona, shoots and kills three of his professors for giving him bad grades

29. Other VA Incidents 1995 – VA Nurse Kristen Gilbert is convicted of killing four patients, and attempting to kill 3 others. 1997 – 48 year old patient shoots and kills Dr. Ralph Carter at the Jackson, MS VAMC before turning the gun on himself 2000 – Dr. Michael Swango is convicted of murdering three of his patients at the VA in Long Island, New York

30. Other VA Incidents 2001 – Veteran enters VA regional office in Atlanta, GA and holds a shotgun under his chin for several hours before surrendering 2001 – Armed suspects hold VA Pharmacy employees hostage while committing a robbery in Boston, MA 2005 – VA Researcher convicted in the negligent homicide of a patient in Albany, New York

31. VA Police Officers Killed in the Line of Duty Police Officer Marvin C. Bland VA Police – Massachusetts End of Watch: Friday, September 6, 1985 Cause of Death: Automobile accident Police Officer Mark S. Decker United States Department of Veterans Affairs Police, US (Ohio) End of Watch: Friday, January 31, 1986 Cause of Death: Gunfire Police Officer Leonard B. Wilcox United States Department of Veterans Affairs Police, US (Ohio) End of Watch: Friday, January 31, 1986 Cause of Death: Gunfire

32. VA Police Officers Killed in the Line of Duty Police Officer Ronald Hearn US Department of Veterans Affairs Police, US (New York) End of Watch: Monday, January 25, 1988 Cause of Death: Gunfire Patrol Officer Garry Ross End of Watch: Monday, December 24, 1990 Cause of Death: Heart attack Police Officer Horst Harold Woods End of Watch: Tuesday, January 9, 1996 Cause of Death: Gunfire Police Officer Jose Oscar Rodriguez-Reyes End of Watch: Wednesday, April 24, 2002 Cause of Death: Gunfire

33. Preventing Workplace Violence Notify the V.A. Police if you are the petitioner or respondent in a restraining order Report any usual behaviors by your co-workers to your supervisor or the V.A. Police Don’t ignore minor incidents of violence. Minor incidents lead to major incidents. Use code words if necessary to indicate potential violence to your co-worker WORK AS A TEAM!

34. Personal Safety – At Work Keep Your Personal Property Locked Do not keep your purse in your desk drawer Don’t leave valuables in plain view to ‘invite’ a thief Lock your office, even if you are gone for a short period of time Keep personal property secured, even if you are in your work area

35. Personal Safety – At Work Call the VA Police if you are working in the building outside your normal work area. If an emergency occurs, we will know where to locate you Veterans Affairs Police Officers will provide you an escort to your vehicle, anytime you feel your safety is at risk!

36. Personal Safety – On the Street Stay in well lit areas Avoid walking in known trouble spots Carry only what you need Avoid carrying your purse If you believe you are being followed, do not walk home. Try to stay in a public area When approaching your vehicle have your keys ready Carry a whistle

37. Personal Safety – At Home Always keep your doors and windows locked Repairmen should never be let in unexpectedly. Always verify identity Keep exterior of house clear from shrubs and brush blocking windows Never give out any information over the telephone Participate in a Neighborhood Crime Watch Program

38. Personal Safety – Your Car Always be alert!!! Keep your car in good working condition Keep your windows up and doors locked Keep your cell phone ready and charged Try to travel in well populated areas If you feel you are being followed, drive to the nearest police station Don’t leave valuables in plain view

39. Prohibited Items / Activities Firearms / Ammunition Knives (blades over 3” in length) Mace / OC (Pepper Spray) Brass Knuckles / Other Weapons Alcohol Unauthorized Photography

40. Contacting VA Police - Reno EMERGENCIES Ext. 7777 Ext. 1234 Non-Emergency Calls External Line (775) 328-1234 The VA Police Office is located in the hallway near the Outpatient Pharmacy (next to SPD) Room GD136

41. TERRORISM “It is the duty for every Muslim to kill Americans, civilian and military, who can do it in any country” – Osama Bin Laden

42. Terrorism F.B.I Records from 1980 until 1999: 272 terrorist incidents on U.S. Soil 55 suspected terrorist incidents 130 terrorist preventions 2001 there were 348 attacks, 4,655 dead

43. Terrorism Tactics Biological Attacks (Smallpox, Anthrax) Chemical Attacks (VX Nerve Agent) Radiological Attacks (dirty bombs) IED (Improvised Explosive Device) Kidnappings / Murder (Conventional) Hijackings Cyber-terrorism Threats of any of the above

44. Terrorism in the U.S. September 6, 1901 First terrorist act of the 1900’s was the assassination of President William McKinley in 1901 by Leon Czolgosz, an anarchist.

45. Terrorism in the U.S. August 24, 1970 In a protest of the Vietnam War, a car bomb explodes outside Sterling Hall at University of Wisconsin. One dead, one injured

46. Terrorism in the U.S. December 29, 1975 Bomb detonated at TWA Terminal in LaGuardia Airport. 11 Dead. Case remains unsolved. International terrorist are suspected.

47. Terrorism in the U.S. June 3, 1980 Bomb explodes at the Statue of Liberty causing $18,000 damage. No injuries Case remains unsolved.

48. Terrorism in the U.S. February 26, 1993 World Trade Center hit with a car bomb. Six people killed, over 1,000 injured. Al-Qaeda terrorists take claim to the attack.

49. Terrorism in the U.S. February 23, 1997 Palestinian gunman opens fire at the observation deck of the Empire State Building killing 1, wounding 6

50. Terrorism in the U.S. September 11, 2001 Attacks in New York, Pennsylvania and Washington D.C., over 3000 dead

51. TERRORIST / BOMB INCIDENTS AT VA MEDICAL CENTERS

52. Bay Ridge, NY September 23, 2001 Two terrorist suspects arrested at the VA Medical Center in Bay Ridge, NY by VA Police and FBI agents

53. Bay Ridge, NY September 23, 2001 Suspects were found in possession of fake passports, VAMC floor plans and other material inside the parking garage

54. Washington D.C. VAMC October 25, 2001 Anthrax found at the VA Medical Center in Washington D.C. Five employees placed on precautionary antibiotics.

55. Albuquerque , New Mexico April 1, 2004 09:40 AM Manuel Medina, arrested for planning to blow up the VA Hospital after his failed attempt at blowing up the Federal Building downtown with over 1 lb. of explosives in his vehicle

56. Salt Lake City, Utah May 20, 2004 3:50 PM Veteran upset with his treatment makes an small bomb out of fireworks and shrapnel. Approx. 100 patients evacuated. Device is disarmed by local Bomb Squad. Patient was arrested by VA Police and the F.B.I.

57. Seattle, Washington August 22, 2005 Federal Agents arrest Veteran Charles Whitaker for planning to blow up the VA Regional Office in Seattle, Washington.

58. Seattle, Washington August 22, 2005 Agents found guns and manuals for bomb making and booby traps after raiding his apartment. Criminal trial is pending.

59. INTERNATIONAL TERRORISM

60. Al-Qaeda Al-Qaeda “The Base”, lead by Osama Bin Laden has the goal of killing US Military and Citizens anywhere in the world

61. Al-Qaeda Attacks against the U.S. November 13, 1995 bombing of US Military complex in Riyadh (7 Dead) June 25, 1996 car bomb explodes outside of Khobar Towers Military Complex in Saudi Arabia (19 dead) August 7, 1998 car bombs in Kenya and Tanzania (224 dead) Bombing of U.S.S. Cole (17 dead) September 11 th attacks around US (2985 dead) Khobar Towers

62. Hezbollah Hezbollah, has the goal liberating Lebanon from Israel. Opposes administration of Arafat in Palestine. www.hizbollah.org

63. Hezbollah Attacks against U.S. April 18, 1983 bombing, US Embassy in Beirut (63 dead) October 23, 1983 bombing US Marine barracks in Beirut, (299 dead) April 12, 1984 bombing of restaurant near USAF base in Torrejon, Spain (18 dead) September 20, 1984 bomb attack, US Embassy in Beirut (23 dead) November 20, 1984 bombing of US Embassy again in Beirut (24 dead)

64. Hezbollah Attacks against U.S. July 14, 1985 hijacking of TWA flight 847 killing US Navy diver Robert Stetham February 17, 1988 kidnapping and execution of Lt. Col. William Higgens Also involved in kidnapping of Terry Anderson Kidnapping and the execution of Col. William Buckley Involved in the bombing attack of military complex at Khobar Towers

65. Hamas Hamas (Islamic Resistance Movement) based out of Palestine and opposes any peace movement between the US, Israel and the Middle East.

66. www.hamasonline.com

67. Unsuccessful Terrorist Attacks Millennium plot to bomb L.A. International Plot to bomb NYC Subways Plan to blow up 13 U.S. airliners Assassination of President George Bush Richard Reid “Shoe Bomber” plot to blow up an airliner over the Atlantic Ocean Nuradin Abdi plotted to blow up an Ohio shopping mall in Ohio for Al-Qaeda

68. DOMESTIC TERRORISM

69. Domestic Terrorism Oklahoma City Bombing was the largest act of domestic terrorism in U.S. History

70. Domestic Terrorism 168 people were killed along with 19 children. 842 injuries were reported, 50% were from flying glass

71. Domestic Terrorism Timothy McVeigh once sought treatment at a VA facility but was denied because he didn’t want to use his real name

72. Domestic Terrorism Eric Robert Rudolph, Olympic Park bomber, bombed a nightclub, abortion clinic Killed 2 injured 150

73. Domestic Terrorism Theodore Kaczynski “Unabomber” , killed 3, wounded 29 over a period of 18 years

74. Earth Liberation Front Unknown number of members, no centralized office location $100+ Million Dollars damage since 2000 Claimed responsibility of arson in Bloomington in 2000 and 2002 Suspected in damage to Wal-Mart in Martinsville, Indiana under construction

75. Earth Liberation Front

76. Earth Liberation Front

77. Earth Liberation Front

78. Earth Liberation Front

79. Animal Liberation Front Unknown number of members, no centralized office location Against all animal testing including for medical purposes Claimed responsibility of 2002 arson of Bloomington Poultry Farm Truck At the end of the 90’s, they were responsible for $3 million damage to Medical Research Facilities, $500,000 at a VA Facility in AZ

80. Animal Liberation Front

81. Animal Liberation Front

82. Animal Liberation Front

83. PROTECTING YOURSELF Identify potential targets in your area Know your escape route and practice it often Know your best chances on surviving an armed encounter Surviving a Hostage Situation Bomb Threats / Finding a Bomb Surviving in a collapsed building

84. KNOW YOUR ESCAPE ROUTE AND PRACTICE IT OFTEN Familiarize yourself with all stairways in your area, use them on a regular basis Use more than one way to leave your work area (combination of hallways and stairs) If possible set up your office for quick escape route Know your emergency numbers

85. KNOW YOUR BEST CHANCES ON SURVIVING AN ARMED ENCOUNTER Moving targets are more difficult to hit than stationary. Run in a zig-zag pattern

86. KNOW YOUR BEST CHANCES ON SURVIVING AN ARMED ENCOUNTER Use of cover and concealment in a shooting

87. KNOW YOUR BEST CHANCES ON SURVIVING AN ARMED ENCOUNTER Mental Survival after the incident (seeking professional assistance)

88. HOSTAGE SITUATIONS First few moments are most critical. Remain calm and do not speak unless absolutely necessary Do not attempt to escape unless death is imminent and there is a good chance your escape plan will work Try to stay low to the ground and avoid sudden movements Memorize physical traits of your captors Do not complain. Avoid being belligerent

89. Finding a Bomb Bombs can be manufactured in any way, shape or form. They can also be detonated by any means, such as by remote, motion, light wires, timers etc.

90. DON’T TOUCH A BOMB!

91. Finding a Suspected Bomb (VA Policy 07B-07) Do not touch anything, leave everything how you find it (lights, doors, etc) Call VA Police Emergency at 7777 Assign an employee to prevent anyone from touching or moving the object Question area occupants for ownership

92. SURVIVAL IN A COLLPSED BUILDING If you’re not trapped get out as soon as possible and remain calm. Stay low to avoid breathing smoke or fumes IF YOU ARE TRAPPED: Stay in your area so you don’t kick up dust. Cover your nose and mouth with a wet cloth Tap on a pipe or wall so rescuers can hear you. Do not scream or yell as you may inhale toxic dust

93. SURVIVAL IN A COLLPSED BUILDING ARTI recommends not hiding under a desk as most recent studies conclude most victims are crushed underneath their desks

94. SURVIVAL IN A COLLPSED BUILDING ARTI also suggests not staying in your vehicle. They recommend immediately outside of your vehicle in a ‘void’ area

95. Domestic Terrorist and Anti-Government Websites www.antipsychiatry.org - Opposition of psychiatric care www.syc.org - Anti Social Workers website http://indianamilitia.homestead.com - Indiana Militia www.infoshop.org - Anarchist and Activist News www.officer.com/hate.html - Police Officer Directory www.overthrow.com - “ Pushing the limits of free speech” www.stanley2002.org – “Constitutionalist” candidate site www.patriotnetwork.info - Anti-Government Website

96. International Terrorist Sites www.hamasonline.com - Official Hamas Site www.hizbollah.org - Official Hezbollah Site www.assam.com - Jihad site for Afghanistan, Chechnya and Palestine www.jihaduspun.net - features a 30 minute recruiting video from Bin Laden www.jehad.net - Postings of statements and readings from Bin Laden www.aloswa.com - featured quotations from bin Laden and religious legal rulings justifying the attacks of 9/11 and other assaults on the United States and Israel

97. Internet Sources for VA Employees www.va.gov/oig/53/semiann/ - Semi annual reports from the VA Office of Inspector General includes crime at VA’s www.fbi.gov - Online Publications of terrorist reports and other resources www.terrorism.com - Independent institute dedicated to the research and prevention of terrorist acts www.dhs.gov - U.S. Department of Homeland Security www.state.gov - U.S. State Department www.cdc.gov/niosh - Center for Disease Control, National Institute for Occupational Safety and Health

98. Publications from VA Police (available by e-mail in .pdf format) [email_address] Global Patterns of Terrorism, released April 2004 (US State Department) Responding to a Biological or Chemical Attack (Bureau of Diplomatic Security) OSHA Preventing Workplace Violence for Health Care & Social Service Workers OSHA Workplace Violence Fact Sheet VA OIG Semi-Annual Report to Congress Violence – Occupational Hazards in Hospitals (Center for Disease Control)

99. Questions ?