Staff at the Hawai'i State Hospital are reporting a rash of assaults by patients in the past six months, including a January incident in which a nurse allegedly was beaten by a convict now facing felony charges.

Honolulu police are investigating three assault cases at the Windward hospital.

Former nurse Terry Evans allegedly was attacked by a patient who fractured a bone near her eye on Jan. 23. She said she now suffers from post-traumatic stress disorder and plans to sue the hospital, claiming it created an unsafe working environment.

The patient who assaulted her was arrested and faces a second-degree felony assault charge.

On Friday, a staff psychiatrist resigned after she said four doctors were assaulted in the past several months, one of them twice. The psychiatrist, Dr. Karen Ritchie, said the facility is overcrowded and the workplace is "not safe."

"I'm really concerned that if something doesn't happen, someone is going to get killed," said Ritchie.

The hospital is licensed by the state for 196 beds and yesterday housed 193 patients.

Hospital officials said safety is a top priority.

"Safety is a primary goal for our staff, patients, visitors and the public. A small number of our patients present extreme behavioral challenges which affect safety conditions. We meet those challenges with teamwork and effective communication," said Dr. Mark Fridovich, administrator at the hospital. "We are always very concerned about any assault on a nurse, doctor, staff member and our patients.

"All assaults are investigated thoroughly and if needed, corrective actions are taken. Some are referred for external investigation, by the attorney general's office."

State Sen. Clayton Hee, D-23rd (Kane'ohe, Kahuku) said the hospital is overcrowded, understaffed and may need to be reported to the U.S. Department of Justice, which oversaw the facility from 1993 until June 2006. The federal oversight was imposed after a lawsuit against the state that revealed wide-ranging civil rights abuses at the hospital.

Hee said he has met with 15 workers who voiced concern about safety at the facility.

"If things continue as they have been, we will see a fatality," said Hee. "If the process doesn't improve through legislation, the DOJ may again become involved. The state cannot continue to let this happen."

Through the first six months of 2007, there have been 112 assaults by patients against staff members, according to the state Department of Health. That compares with 187 last year, 133 in 2005 and 170 in 2004.

The hospital considers an assault anything that involves punching, kicking, grabbing, spitting, choking, shoving or biting, hospital officials said.

Not all incidents the hospital records as assaults are reported to police, according to the state, and not all result in injuries.

Of the 112 assaults at the hospital this year, 79 resulted in injury requiring medical attention or resulted in a workers' compensation claim. That compares with 76 such assaults last year, 77 in 2005, 76 in 2004, 69 in 2003 and 63 in 2002.

Reach Peter Boylan at pboylan@honoluluadvertiser.com.