Seven current and former employees at the Independence Mental Health Institute are accusing the state of failing to protect them from violent patients. At least three of them are nurses who say they were brutally attacked by patients after the state-run facility failed to address long-standing safety issues, according to tort claims filed with the Iowa State Appeal Board.
According to those tort claims, the nurses are seeking damages from the Iowa Department of Health and Human Services, naming nearly a dozen former and current state employees who they say knew about the risks and failed to act, alleging “co-employee gross negligence.”
They say the psychiatric hospital lacked working radios, had no security guards or surveillance cameras, and was chronically understaffed — conditions they say left them defenseless in a state-run facility housing high-risk juvenile and adult patients, including those transferred from jails.
Three of the nurses, Angela Timmerman, Olivia Berger and Lora Smith, each detailed violent incidents in which they say they were injured on the job — injuries that changed their lives and, in Smith’s case, ended the life of her unborn child.
A tort claim is a legal notice of intent to sue the state or its employees for alleged negligence. Under Iowa law, a tort claim must be filed with the State Appeal Board before a lawsuit can proceed in court.
According to Smith’s tort claim, she was acting as charge nurse in June 2024 when she was left alone with a 17-year-old patient who wasn’t allowed to attend recreation with the rest of the unit. When the patient began overturning furniture, Smith said she exited the nurse’s station to prevent him from climbing into the ceiling — a known structural hazard previously flagged in emails and leadership meetings. The patient kicked her in the abdomen. Smith, who had conceived after six months of in-vitro fertilization, suffered a miscarriage days later.
“When you left for work you didn’t always know that you were going to come home in the same condition you went to work in,” Smith said in a press release issued Wednesday by her attorneys. “It’s the most unsafe working environment you could walk into; a room full of schizophrenic, violent, paranoid, mentally ill patients and you have no real protection or security. There was no appropriate training at any level.”
According to Timmerman’s tort claim, she was supervising a patient one-on-one on Aug. 18, 2024, when another patient entered the room and began attacking her. She was thrown to the floor, had a large clump of hair pulled from her scalp, and was stomped on repeatedly. Her injuries required spinal fusion surgery and she continues to suffer from post-traumatic stress and limited mobility. She said she filed the claim because she wants to “bring awareness to this whole situation because something needs to change.”
“Somebody is going to die, and I don’t want for that to happen,” Timmerman said.
Berger’s injuries followed what she described in multiple internal emails as months of ignored warnings. According to her tort filing, Berger was physically assaulted by patients at least four times in the summer of 2023. On Aug. 19, she was punched twice in the face, resulting in a traumatic brain injury, concussion, hearing loss and ongoing neurological symptoms including vertigo, vision problems, and panic attacks.
“There was really a disconnect between people working (in the wards) compared to management,” Berger said. “They worked in a completely different building.”
On July 31, weeks before that final assault, Berger emailed hospital nursing leadership. In the email — included in the nurses’ joint supplemental filing — she warned that radios were failing, staff were stretched thin, and code green emergency calls were going unanswered. “Our radios are not very reliable,” she wrote. “They are a life-line”.
According to a 90-page supplement filed with the tort claims, Independence MHI staff documented at least 30 assaults on employees between July 2023 and September 2024. The report includes accounts of staff being punched, bitten, knocked unconscious, and injured while restraining patients or responding to codes with no backup.
Over the course of just one weekend in November 2023, 12 staff were reportedly injured, according to minutes from a facility leadership meeting included in the filings. The notes mention staffing shortages, injuries, and a lack of available support from nursing, but do not document any new safety measures taken in response.
The state has known about safety problems at the facility for years, the nurses allege. A 2019 OSHA inspection found ten serious violations and fined the Department of Human Services more than $72,000. The citations, included in the supplement, describe failed emergency response systems, radios that did not function, inadequate de-escalation training, and a policy forbidding staff from calling 911 without supervisor permission — a rule OSHA said delayed professional help during serious injuries.
The current claims list nearly a dozen current and former state employees as responsible for failing to protect staff, including Independence MHI Superintendent Cade Iversen, the facility’s safety officer, HR director, clinical director and nursing supervisors. The nurses allege those officials had direct knowledge of repeated violent incidents and still failed to fix core safety problems.
“This is a facility that receives inmates deemed mentally unfit to stand trial,” attorney Darin Luneckas said in Wednesday’s press release. “They are brought in under armed guard and then released into an unsecured ward with no protection for staff.”
“The State of Iowa should be setting the gold standard for worker and patient safety,” said attorney Bobby Rehkemper in the same release. “Instead, they brazenly continue to demonstrate a complete and utter disregard for the safety of innocent workers who have committed their lives to helping others.”
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