Q.

My center operates an adolescent residential treatment center.  There is a weight room in the building for the residents to work out.  Unfortunately, one of the residents punched another in the face either with his fist or with a weight.  This resulted in broken bones which required surgical intervention.  The chief executive officer made the decision to pay for the required surgery because the child had no health insurance or other means to pay.  I am concerned that there may be some liability on the part of the center for negligent supervision of the children involved.  There were a substantial number of young men in the weight room at the time and there was no direct staff supervision.  These young men are court ordered to the facility based on drug abuse involvement.  Some of the children may have histories of violent behavior.  We do not have a policy requiring that a staff member actually be in the room to supervise the weight lifting.
 

A.

A history of past violent behavior is one of the risk factors for future violent behavior.  Therefore, it is prudent to have sufficient number of staff available to pay attention to the dynamics between the residents so that the staff can intervene as appropriate.  It would be best if this staff member has only a limited number of residents to supervise and is trained in de-escalation techniques such as taught by the crisis prevention institute program.  I also recommend that your center have crisis prevention and de-escalation training in place which provides adequate practice for staff at least once every six months. 

You advised me that you had already reported the incident to the insurance company.  I recommended that if your center does pay for the surgery that you obtain a release from the resident’s guardian releasing the center from any claim including claims which could arise out of the violent interaction between the two residents.

Disclaimer:  This letter is intended to be general and educational.  No statements made should be considered as legal advice and no action should be taken in reliance on the statements contained in this letter.  The law in the area discussed varies from state to state.  Competent local counsel should be consulted prior to taking any action.  The opinions expressed are solely those of the undersigned and are not necessarily those of the Mental Health Risk Retention Group, Inc.