Four Inpatients Dead, Patient with Autism Confined for 200 Days
Administrative Sanctions Such as Business Suspension Recommended to Public Health Center

The National Human Rights Commission of Korea has filed a report with the Serious Crime Investigation Agency against Won Hospital, located in Michuhol District, Incheon, after confirming human rights violations against inpatients. It was revealed that four inpatients died due to incidents such as being found in cardiac arrest in wards without medical staff or choking on food blocking the airway.


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On October 6, the Commission announced that it had reported Hospital Director A to the Serious Crime Investigation Agency on charges of occupational negligence resulting in death and unlawful confinement, and that two nursing assistants, including B, were reported for violations of the Mental Health Welfare Act.


In July, the Commission made an unannounced visit to Won Hospital to investigate complaints about inadequate food provision and restrictions on external transportation rights. They discovered that patients were being restrained in locations other than designated isolation rooms and that some patient rooms had been fitted with locking devices. This prompted the commencement of an ex officio investigation. As of July 22, Won Hospital operated 143 beds with 111 inpatients.


The investigation found that seven inpatients had to be transferred to other hospitals via emergency services in the first half of this year, and of these, four died. The causes of death were: ▲asphyxiation ▲airway obstruction due to foreign matter ▲traumatic subdural hematoma, which is bleeding in the brain caused by head trauma, and ▲suspected gastrointestinal bleeding due to hemorrhage in the digestive tract. The Commission concluded that medical staff were absent from the wards during emergencies, and proper monitoring had not been conducted; it held the hospital director responsible for failing to fulfill their duty of care and protection.


Additionally, among 31 cases of isolation and restraint confirmed over one month since June, five involved nursing assistants and caregivers imposing isolation or restraint without a doctor’s order. In one notable case, a patient with autism spectrum disorder was confined to a locked room from January 3 to July 22—about 200 days—for allegedly stealing another patient’s coffee. The patient was required to use a portable commode in the room and did not interact with other patients or staff, nor participate in any treatment programs. There were no corresponding doctor’s orders or nursing records.


Alongside filing these charges, the Commission also recommended that the relevant public health center impose necessary administrative sanctions such as suspension of business operations.



An official from the Commission stated, “Isolation and restraint in psychiatric medical institutions must only be implemented to the extent necessary for patient treatment and protection,” adding, “There have been previous recommendations for closure of facilities receiving state subsidies, but this is the first time a recommendation has been made for administrative action against a medical institution.”


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