Prior to the event of a prisoner as a patient in a medical facility, a meeting between local law enforcement, corrections officers and hospital security to review points of contact and contact information, entry points, preferred room in the ED, routes to testing areas, elevators to use, preferred intensive care room, medical surgical room and maternal child health room is important. Pre-identify rooms to be used by these patients similarly to how VIP patient’s rooms should be pre-identified. This eliminates any confusion of where a prisoner patient should be when in the facility. Such things can be considered at a meeting between local law enforcement and correctional officers. Review policy on court orders, releasing of information to family members, visitors, mail, weapons, use of radios, handcuffs, restraints, and training to be provided to law enforcement. It is essential that between local law enforcement and hospital security it is clearly defined what kind of training they require for their officers, whether it is in-house training or from an outside security association.

Among all of the things to consider prior to the medical care, there are many things to consider when the prisoner patient is in the facility aside from the obvious.  For instance, before a prisoner receives their meal tray in the healthcare setting, an officer must inspect the tray to ensure that only paper products and a plastic spoon were provided to eat with. In most situations where a hospital room is occupied by a prisoner, the phone is disconnected. If for some reason the phone is not disconnected, the phone number is not to be given to anyone except for law enforcement. The officer assigned to the room is the only one who should answer the phone. These guidelines are from Maryland’s Model Guidelines for the Security of Prisoners from EMS and Hospital Settings. This policy was put into action after several high profile incidences of escapes occurred in Maryland hospitals (Maryland Law Enforcement, Dept. of Corrections, and Maryland Hospital Association.).

Before arriving at a hospital with a prisoner, it is important to make the hospital aware that there will be a prisoner coming to their facility. Informing both the security department of the facility and the emergency department allows for them to prepare for the arrival of the prisoner. When calling ahead, it’s important to find out where is safest to park, find out if there is a private room available or whether there is an isolation room that would be better for security of the prisoner (Lashley, 2009).  In most hospitals, ambulance bays are the safest port of entry into the building (Lashley, 2009). It is in the best interest of everyone to request a security guard be waiting at the entry with a wheelchair and a blanket. The wheelchair’s purpose is security; the prisoner can be secured to the chair and the blankets can conceal the restraints from the public so they don’t become fearful (Lashley, 2009).

Since it can be unclear as to who is responsible for the prisoner when in the healthcare setting, is it the security of the facility’s responsibility or is it the responsibility of the corrections officer? “Hospital security or police staff are responsible for the general safety and security of the hospital, staff, visitors and patients, but prisoners are primarily the responsibility of correctional officers until treatment is completed or transfer to the custody of hospital security staff, following established legal procedures, is made (Kucera, 2011).” Every facility has different procedures for when this situation arises, corrections officers familiarizing themselves with the procedures of nearby hospitals could make a big difference.

When the prisoner is being treated for their condition, a physician or nurse may request the removal of the restraints. If and when this happens, ask first if there is an alternative and then bring awareness to the risk that removal of the restraints would cause (Lashley, 2009). With that being said, there will be situations when they will be required to come off, such as an MRI or x-ray. If a corrections officer is working alone, ask for a security officer to help monitor the prisoner during the procedure, this helps ensure someone has eyes on the prisoner at all times (Lashley, 2009). Use of the bathroom is a situation in which prisoners will request privacy or restraint removal. If applicable based on the risk it poses, ask for nursing staff support to assist with the use of a urinal while the patient is still restrained to the gurney or wheelchair, keeping the patient out of the bathroom if possible. If that is not suitable, it’s suggested that the prisoner be taken into a handicap-suited bathroom and restrained to the safety bar mounted next to the toilet (Lashley, 2009).

Their [corrections professionals] presence and the safety measures they use have been created to minimize the risk and inconvenience to hospital personnel, patients, hospital security staff, and the general public during emergency clinical evaluation, outpatient treatment, or admission to medical facilities. Since the number of prisoners who need medical treatment is escalating, it is critical for health care industry to understand the conditions under which prisoner escapes occur and learn more about what can be done to prevent them (Mikow-Porto, Smith 2011).

Maintaining a safe and secure environment is the ultimate goal of both security officers and correctional officers. Being mindful of all of the risks that can occur and following protocol is essential for minimizing risk.


Security leaders must be aware of the risk that prisoner patients pose. They must be aware of the possibility of these patients carrying weapons, the possibility of law enforcement officers to not retain possession of their service weapons, assaultive behavior, and the possibility of hostage situations. All of this can be minimized by developing appropriate processes in consultation with law enforcement. Throughout the entire event of a prisoner being in a medical facility, from transport to treatment, communication is essential. Communication between the medical facility’s security, clinical workers, and correctional officers will create a much smoother and secure process.  It is important that all correctional officers assigned to guard prisoners while they are patients adhere to all the laws, regulations, and procedures that are in place to ensure the safety of all people in the medical facility.