State health officials moved Friday to bolster security and reassess patients at Clifton T. Perkins Hospital Center, after the second patient slaying in a week at the state mental facility.
State police said the latest victim, Rogelio Mondragon, 40, was found dead in his room Thursday evening. Another patient, Andre Mayo, 46, was charged with first- and second-degree murder. An autopsy determined the death was caused by multiple blunt-force injuries to his face and neck. Police said video surveillance showed Mayo entering the victim's room twice within a half-hour.
The killing of Mondragon follows the death last Friday of David Rico-Noyola, a Perkins patient who police say was killed by his roommate, and is the third killing at the state's maximum-security mental hospital since 2010.
"The events at the Clifford T. Perkins Hospital over the last week are tragic and unacceptable," said Dr. Joshua M. Sharfstein, secretary of the state Department of Health and Mental Hygiene, which oversees the state-owned hospital. "Hospitals are places for healing, not violence. Perkins Hospital has taken many steps to strengthen the safety of its environment, but more needs to be done."
Some state legislative leaders called on officials to explain how they will prevent further violence at the Jessup hospital.
"It seems like something definitely needs to change," said Del. Peter A. Hammen, a Baltimore Democrat who chairs the House Health and Government Operations Committee. "We have an obligation to be sure everyone is safe."
Hammen had previously called on Mental Hygiene Administration officials to brief his committee on their investigation into last week's killing.
Nearly all patients at Perkins have faced serious criminal charges such as murder, rape and assault, and were ordered to the facility by courts for evaluation and treatment.
Mondragon was being held at Perkins after being found not competent to stand trial on charges that he and two others raped an 11-year-old girl in a Silver Spring apartment. State police said Mayo had been committed to Perkins on a second-degree rape charge, though that information could not be confirmed through court records.
There had not been a homicide at the 50-year-old facility until last year, and several deficiencies in the operation were uncovered in an ensuing investigation. But officials had since believed they had shored up the facility through better oversight and additional staff.
Officials from the Office of Health Care Quality, which licenses hospitals in Maryland, have begun evaluating the facility, as have outside consultants from the National Association of State Mental Health Program Directors in Alexandria.
Robert W. Glover, executive director of the association, said the three slayings since 2010 are unusual. "That's an unusually high number of incidents like that occurring in a single facility in that time frame."
Sharfstein acknowledged that Perkins may need to step up security — both of the patients killed within the past week had been in maximum-security units. Officials would not go into detail about what patients in those units were and were not allowed to do, or how those restrictions might change.
Because Perkins is a hospital, Sharfstein said, "There is not the level of security of a prison."
He outlined some immediate patient-safety measures. The hospital added one new monitor per shift beginning Friday, bringing the total to two.
Dr. Gayle Jordan-Randolph, medical director of the Mental Hygiene Administration, said that each patient with the potential for violence will be reassessed. That assessment helps staff determine to what unit the patient is assigned, from minimum to maximum security, and whether the patient has roommates and is allowed to move around freely on the ward.
Still, she acknowledged that "these are the most challenging patients to treat."
Mental health advocates and others have already called for better oversight and increased staffing. There are 248 beds in the facility and 496 staff, up from 493 in 2010 and 478 in 2009.
According to a report by the Department of Health and Mental Hygiene, there were 129 patient-on-patient assaults at Perkins in 2009, up from 100 in 2008. It rose again in 2010 to 150, according to the Maryland Operating Budget.
One lawmaker said funding has been an issue in running Perkins, leaving many patients housed three to a room, even in the maximum security units.
"Budget starts driving policy, instead of the other way around," said Del. James W. Hubbard, a Prince George's County lawmaker who sponsored legislation this year that now requires separate men's and women's bedrooms. The move was a response to last year's killing of Susan Sachs by El Soundani El-Wahhabi, a known sex offender.