The San Francisco Department of Public Health will commission a third-party review of security lapses at General Hospital and across the entire department in the wake of last week’s fatal stabbing of 51-year-old social worker Alberto Rangel.
Department of Public Health director Daniel Tsai today committed to “retaining an independent security firm” to conduct a study on the circumstances that led to Rangel’s killing. Rangel was allegedly stabbed to death by Wilfredo Tortolero-Arriechi, a 34-year-old patient whom multiple hospital workers had reported as dangerous.
Tortolero-Arriechi was charged with murder, alongside other charges, by the district attorney’s office on Monday.
The firm will also undertake a larger “systemwide review” of security at the hospital and its outpatient clinics, like Ward 86, the long-time HIV/AIDS clinic where the lethal Dec. 4 attack occurred.
The review comes over a year after nurses called for an investigation into lapsed security at San Francisco General but were largely rebuffed by the state, according to a 2024 complaint addressed to the California department responsible for workplace safety.
That complaint, written by nurse practitioner Heather Bollinger to the California Division of Occupational Safety and Health, cited a lack of adequate protection including “no security present” on campus.
The nurse’s union called for additional safety precautions “to reduce workplace violence” on Feb. 8, 2024. Their proposal to add security guards, cameras, and metal detectors at every hospital entrance was rejected on May 2, 2024, according to union records.
Additional proposals to keep “crash carts,” mobile carts carrying essential emergency supplies, at outpatient clinics such as Ward 86 were also rejected, say union sources. Hospital staff say there were no crash carts present when Rangel was stabbed, delaying life-saving aid. “EMS arrived so late,” said Jessica Hoopengardner, a Ward 86 nurse.
Bollinger’s complaint to the California health and safety department listed the following allegations: “no security present,” “clinical staffing insufficient at psychiatric emergency services,” and “procedural changes to workplace violence protocols were not communicated to staff.”
The complaint also listed an incident in which a nurse was “kicked in the face” and a patient was found with a weapon.
The state issued a response, dated February 2025. It wrote only that the worksite was inspected and “one general citation was issued addressing screening, staffing, and security.”
Nine months after that, Rangel was attacked. He died two days later.
Additional reporting by Abigail Van Neely
A outside consulting firm being hired to look into what is obvious is part of the problem with San Francisco city government. Will they come to the surprising conclusion that a dangerous individual with a knife had access to most of Ward 86? Will they discover that there were complaints about this individual, and workplace safety, from staff that were dismissed by their superiors?
Or will the third party review issue a report in a couple of years time, a report that no one will read, when this has all blown over?
Ask Sheriff Miyamoto.
Responding to the above comment, no, I don’t think they will wait re their report. People are pretty upset about what happened and will push for all possible security remedies.
But the report will take time. That time will be measured in months to years if past is prologue.
Gonna cost SF taxpayers $10+ million, perhaps up to $30M to settle the wrongful death case. That is roughly $40 from every man, women, child in SF.
Heads should roll. Whoever opposed more security (or perhaps felt that security would scare off some patients) needs to be fired,
Definitely going to be a large settlement for the victim’s family. SF and the hospital had knowledge of a problem and took few if any precautions to prevent harm from happening. Sorry for the family that they lost a loved one particularly in this horrific manner.
It is inconceivable that SFGH, Cal OSHA, and the State of California would ignore or deny a request from the hospital’s nurses. What is WRONG with these people that they do not listen to the front-line staff who are there every day?