Irvo Otieno's Death: Records show face-down restraints are banned, hospital employees were trained

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Posted at 6:10 PM, Apr 07, 2023

DINWIDDIE COUNTY, Va. -- Central State Hospital, where Irvo Otieno died, has a policy that bans face-down restraints due to safety risks. However, video appeared to show the three hospital workers charged with second-degree murder in Otieno's death pinning him to the ground in a face-down position.

Darian Blackwell, Wavie Jones, and Sadarius Williams were employed as special management technicians. The responsibilities of that job, according to online descriptions, include controlling access to units where court-ordered patients from the criminal justice system are assigned, transporting and escorting patients, assisting with the admissions process, participating in restraint activities, and explaining policies.

They also have a duty to "intervene verbally and physically to maintain a safe and secure environment."

Central State Hospital
Central State Hospital

Records obtained by CBS 6 through the Freedom of Information Act showed Blackwell completed 74 hours of training between June 2021 and February 2023 to include protective medical restraints, self-awareness in aggression management, and environment of care.

Williams completed 68 hours of training between February 2022 and October 2022 to include the same subjects plus admissions orientation and restraint application.

Jones completed 67 hours of training between January 2022 and February 2023.

All employees completed at least a dozen hours of TOVA (Therapeutic Options of Virginia) training, which according to the provider's resource network, is "a comprehensive and sensible approach to reducing violence and the use of restraint and seclusion in behavioral health care, residential care, health and habilitation, and education settings."

According to hospital policy, TOVA is the Department of Behavioral Health and Developmental Services approved behavioral interaction and crisis management techniques, including non-physical interventions, approved physical holding techniques and restraint training.

IN-DEPTH COVERAGE: Why Dinwiddie's prosecutor decided to quickly press charges in Irvo Otieno death

Irvo Otieno
Irvo Otieno

Central State Hospital policy states that the use of any restraints "poses inherent risks to the physical safety and psychological well-being of the individual and staff and can be a significantly traumatic event for many individuals." It adds restraints should only be used in an emergency or to protect the immediate physical safety of the patient, staff, or others.

Face-down restraints, or prone restraints, are "expressly prohibited." The policy acknowledges that "there is a clear link between sudden death and clients restrained or held in a face-down position."

If a patient is found to be in a face-down position, policy states "the involved staff is to immediately turn the involved client to his/her back."

Despite this, video showed Otieno was restrained face-down by deputies and hospital employees for 11 minutes before he died. The medical examiner's office ruled Otieno's manner of death a homicide and cause of death asphyxia with restraints.

RELATED: What Virginia behavioral health commissioner's emails reveal about Irvo Otieno death

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"Once seclusion or restraint has been chosen, qualified and appropriately trained staff will attentively monitor and regularly reassess the condition of the patient to ensure that the least restrictive approach is utilized; the patient’s rights, dignity, and well-being are being addressed; and that seclusion or restraint will be discontinued at the earliest possible time, regardless of the scheduled expiration of the order," the policy reads.

In bold letters, the policy states that staff should treat the patient with the "care and respect one would wish for themselves or their family members."

Pharmacological restraints, the use of medication administered involuntarily for the emergency control of an individual's behavior, is "not a standard treatment" and not a practice that the hospital uses, according to policy.

Video appeared to show a hospital employee administer two injections into Otieno's lifeless body.

CBS 6 requested the Henrico County Sheriff's Office's policy on use of restraints. Leslie Winneberger, who is legally representing Sheriff Alisa Gregory, rejected our request, claiming that releasing the records could jeopardize someone's safety. 

Depend on CBS 6 News and for in-depth coverage of this important local story. Anyone with more information can email to send a tip.



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