Two club-wielding patients of the Clifton T. Perkins Hospital Center for the criminally insane attacked four employees last night. The unrest was partially prompted by the hospital's recently imposed smoking ban, authorities said.
The patients tore legs off a heavy table in a maximum-security ward and smashed several light fixtures before striking two ward orderlies and two security guards, said Michael Golden, a spokesman for the state health department.
Police said the four employees received only minor injuries and the uprising was brought under control within about a half hour.
However, two of the four employees received additional minor injuries when a van, which was taking them to the Baltimore Industrial Medical Center in Linthicum for treatment, slammed on the brakes to avoid a collision on U.S. 1 near Levering Avenue in Howard County, police said.
"It was a bad night for a lot of people," Mr. Golden said.
"It's a volatile place," he said of Perkins, "and the patients have a history of acting out their aggressions in a violent way. The smoking policy may have been just one of several concerns that these people had."
The two patients, whom state police did not identify, were upset not only over the smoking policy but also over the recent news that a beloved nurse had announced her intention to leave, Mr. Golden said. Also, recent patient transfers in and out of the ward had upset some people, he said.
About 30 people live in the ward where the 6:15 p.m. assault occurred. One of the attackers attempted to use his club to smash his way through a wire security window but was unsuccessful, state police said.
Perkins adopted the no-smoking ban Jan. 8 to comply with national regulations that give all U.S. hospitals until 1994 to prohibit smoking or risk losing their accreditation.
Some critics opposed the concept of depriving mental patients of their cigarettes, saying that smoking is often the sole relief for them. Also, some said, the deprivation might lead some patients' condition to deteriorate due to the added stress of going cold turkey.
Perkins patients, who formerly received cigarettes as rewards for good behavior, are also not allowed to go outside to smoke.
In the weeks following the imposing of the ban, Perkins officials said, violence had decreased and patients had not needed more medication to cope with it.
"We're still very pleased with it and haven't noticed any problems," Mr. Golden said. "Tonight, it was just a variety of factors that seemed to upset these two patients. One of the guys is usually very quiet."
Police said they did not expect to charge the patients since there were no serious injuries involved. But the two will likely be moved to another ward at the Jessup hospital, Mr. Golden said.