David McElveen recently had a stroke. The 59-year-old Vallejo resident and John George Psychiatric Hospital nurse has short-term memory problems and has been out of work for more than a year. The stroke may be linked to an attack he suffered last summer.
He was working the morning shift on Sept. 13, 2017 at the Alameda County mental health care facility in San Leandro when a patient punched him the face.
"I heard somebody running and that's the last thing I remembered," McElveen said in an interview on Monday.
He fell to the floor. The patient kept hitting him, slamming his head against the ground.
"The injured was unconscious and had a seizure while bleeding from his face and head area," an investigator with California's Division of Occupational Safety and Health (Cal/OSHA) wrote in the agency's investigation into the attack, obtained through a California Public Records Act Request.
McElveen's facial bones were fractured.
"The left side of my skull was busted open. My right eye was closed for more than 10 days. My jaw was broken in two different places. And, I lost a tooth," he said.
McElveen was hospitalized and underwent surgery. Doctors wired his jaw shut. He also says the morning he was attacked, the hospital was short-staffed.
"We didn't have enough mental health workers. We didn't have enough nurses," he said. "Everyone was just overwhelmed."
Union officials who represent McElveen and other John George workers say the attack is the result of low staffing at the facility's emergency room (known as "emergency services") and poor security protocols at a hospital that has repeatedly come under scrutiny for dangers posed to employees and patients.
Now, dozens of Service Employees International Union Local 1021 members plan to hold an informational picket in Oakland on Tuesday afternoon to draw attention to staffing issues there and two other Alameda County medical facilities.
Two months after McElveen was attacked, another patient fled from the hospital, tried to carjack two vehicles, assaulted a teenage boy and bit an elderly man.
In 2016, the East Bay Express and KTVU reported on severe overcrowding at the hospital where workers described the facility's emergency room as dangerous and inhumane, with patients sleeping and eating on the floor — some moaning and crying for help.
Despite that media scrutiny and probes by government agencies, not much has changed, according to the SEIU Local 1021 field supervisor Ann Schuyler.
"The number of injuries is not abating and the severity of these injuries, caused while at work, is heartbreaking," Schuyler said in an interview.
Investigation Into the Attack
The Alameda County Sheriff's Office has identified 51-year-old Michael Lindsay of Fairfield as the patient who allegedly assaulted McElveen.
Lindsay was on the third day of his stay at John George and "was extremely agitated" during the two-and-a-half hours before the attack, state workplace regulators said.
The patient "expressed that he wanted to leave the facility" and was "verbally abusive to staff," Cal/OSHA's report states.
McElveen and another hospital worker tried to redirect Lindsay's attention and de-escalate his behavior. Hospital staff gave him medication but said it was unclear if he faked digesting the pill.
Minutes later Lindsay went behind McElveen and punched him in the face and continued attacking him, according to the report.
Other staff members subdued the patient, called 911 and administered CPR to McElveen.
When an Alameda County Sheriff's deputy arrived, Lindsay was being held down by staff and was yelling. The deputy placed handcuffs on Lindsay and put his knee on his back while other law enforcement officers arrived.
"McElveen was bleeding from a large wound on his head and was complaining of pain to his jaw," wrote deputy Jeriah Gurley in a report on the incident, noting that the victim had blood on his clothes and there was blood on the floor next to him. Witnesses told the deputy McElveen was gasping for air.
McElveen was taken to Eden Medical Center in Castro Valley where he was treated for the next three days.
Lindsay was taken to San Leandro Hospital and eventually arrested.
Prosecutors later filed felony battery charges against Lindsay.
He has pleaded not guilty and his case is expected to go to trial in November, according to Alameda County District Attorney spokeswoman Teresa Drenick.
The deputy's report also found that there were no surveillance cameras in the area where the attack took place.
Cal/OSHA concluded that Lindsay arrived at the hospital using a different name and that John George did not have policies in place to handle patients who use aliases. Without those procedures, the hospital failed to identify Lindsay as a patient who had a violent history at the facility.
Safety and Staffing Issues at the Hospital
In March, Cal/OSHA cited the Alameda Health System (AHS), which runs the hospital. It issued a $11,250 fine against AHS for a "serious" violation for having an injury and illness prevention program that was ineffective.
AHS officials did not appeal the penalty, and in June they paid the fine.
But hospital leaders emphasize that the facility correctly followed protocol before, during and after the incident.
Luis Fonseca, AHS's chief operating officer, told Cal/OSHA that Linsday did not show signs of violence beforehand.
"We initiated safe practices and processes," Fonseca said. The hospital immediately contacted law enforcement, helped McElveen press charges and provided him with emotional support, he said.
Sandra Williams, director of the hospital system's environmental health and safety department, told a Cal/OSHA inspector "our actions were reasonable and responsible" on the day of the attack.
Lorna Fernandes, an AHS spokeswoman, emphasized that creating and maintaining a safe environment for its workers, patients and visitors is a top priority.
"AHS self-reported this incident to Cal/OSHA and then took immediate action and actively engaged all appropriate protocols to address the situation. Further, AHS cooperated with Cal/OSHA over the course of a thorough investigation," Fernandes said in an statement emailed to KQED.
"Alameda Health System realizes that keeping our employees safe from harm so they can provide quality patient care is of the utmost importance. We continue to proactively address and adjust protocols to ensure we are adhering to best practices for maximum protection for AHS employees, patients, visitors and the community we serve," Fernandes said.
Currently, the nurses' contract with AHS at John George calls for one nurse for for every six patients at the emergency room, according to SEIU.
But the union's Schuyler says with 40 to 60 patients in the ER, the hospital often goes over that ratio.
She says SEIU has pushed for years for more staffing.
"Patients keep arriving," Schuyler said. "There is still an enormous need. It's a constant struggle."
AHS officials have yet to respond to questions about staffing at John George.