Internal records show workers at a state mental hospital in Butner strapped a patient to a bed face-down for more than an hour earlier this week, violating proper procedures and potentially endangering the patient.

The incident occurred early Wednesday morning at Central Regional Hospital after a 24-year-old man resisted having his blood drawn for tests and made verbal threats, according to a staff report.

At least five health care technicians, working under the supervision of a nurse, responded by carrying the patient to a restraint room, placing him face down on a bed with his arms and legs strapped down.

It is not clear from the report why he was placed face-down, rather than on his back as the staff at state mental facilities are trained to do.

But some knowledgeable with operations inside state mental hospitals said Friday the staff may have been attempting to punish the mentally ill man by restraining him in an uncomfortable position.

The practice is known to potentially cause fear and panic in the person being strapped down because their vision would be limited. It can also make it harder for a patient to breath and exacerbate the risk of heart problems.

“It’s a life-threatening position,” said Barbara Gardner, a retired state mental health administrator who helped run Dorothea Dix Hospital in Raleigh. “It’s the most dangerous position you could have a patient in because of the difficulty breathing when the patient is face-down. It’s an absolute no-no. You never restrain anyone face-down.”

According to the hospital’s internal timeline of the event, the patient was left restrained face-down from 6:20 a.m. until 7:25 a.m., though handwritten notes indicate he was calm, cooperative and asking to be let up for much of that time. The staff is supposed to release a patient as soon as he is no longer acting aggressively.

The handwritten notes also indicate the restrained patient asked for a bandage for a bleeding finger, though an electronic record entered into the hospital’s computer system indicates there was no injury.

The revelation comes at a delicate time for Central Regional. The new $138 million hospital partially opened in July after repeated delays due to design flaws and safety concerns. It has not yet been accredited.

A team of state inspectors working on behalf of the federal Centers for Medicare and Medicaid Services has been at the facility all week, reviewing the hospital’s operations. It is not clear administrators at Central Regional informed the regulators of the improper restraint.

There are security cameras in the restraint rooms at the new hospital, meaning the incident should have been recorded.

At stake is the state’s plan to close Dix Hospital and transfer the patients and staff to the new facility in Butner. That plan has been stymied by regulatory hurdles and a court challenge from the advocacy group Disability Rights North Carolina.

A superior court judge issued a temporary restraining order in September that bars the state Department of Health and Human Services from moving Dix’s patients. That order is still in place.

Central Regional partially opened last summer with the closure of John Umstead Hospital, less than a mile away. That older facility, the staff from which was transferred to the new hospital, was cited by federal regulators in December after three workers beat a mentally ill woman who was strapped to a bed.

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