SAN FRANCISCO — The memorial for social worker Alberto Rangel continues to grow at the entrance of San Francisco General Hospital.
At a candlelight vigil on a cold Dec. 11 evening, dozens of mourners laid flowers on the steps, lit candles, and wept. Hospital workers finishing their shifts, some still in scrubs, joined friends and coworkers embracing each other.
Rangel worked at the hospital’s Ward 86 HIV clinic, where, on Dec. 4, he was stabbed in the neck by a patient, and died two days later. He was 51.
According to the San Francisco Police Department, 34-year-old Wilfredo Tortolero Arriechi of San Francisco was arrested for the stabbing. Tortolero Arriechi was booked into San Francisco County Jail for murder, assault with a deadly weapon, mayhem, and being armed during the commission of a felony. He is being held without bail.
Rangel reportedly raised concerns about Tortolero Arriechi, a patient on Ward 86, weeks before he allegedly killed him.
Security Protocols
The San Francisco Department of Public Health has announced that it is conducting an internal investigation and review of the incident at General Hospital, along with a review of security protocols and infrastructure across Department clinics. An independent security firm will be retained to conduct their own assessment, as well. That will include “evaluation of staffing, physical layouts, visitor management protocols, and patient processes for high-risk individuals.”
SFDPH has also announced “rapid improvements” like metal/weapon detectors, increasing security presence, and enhancing intervention procedures
“Alberto was an absolute light in the workplace. He’s somebody who was so unique and amazing and wonderful. Supported not just clients but staff as well,” said Juliette Suarez, a clinical social worker at UCSF/General Hospital and a colleague of Rangel’s.
“An absolutely remarkable person that I’ve thought about at different times in many different contexts: whether it be clinically in my work, things that he taught me, or just funny life things and perspectives to keep optimistic. This is deeply heartbreaking and difficult to process,” she said.
Safety Concerns Ignored
Along with grief, there was a sense of frustration amongst the mourners. Rangel’s fellow UCSF workers, largely University Professional and Technical Employees (UPTE-CWA 9119) union members, said the tragedy was preventable. They alleged that safety concerns raised prior to the stabbing went ignored by their employer.
“As we mourn, we also have to ask ourselves how this event occurred. None of us should have to be here right now. All of us, including our colleague, should be home with our loved ones, not doing the work of our employer by raising urgent safety concerns that should have been addressed a long time ago,” added Suarez, addressing the attendees.
“We all deserve a full and thorough investigation into the conditions that led to the violence in our workplace, and any meaningful root cause analysis must look beyond the moment of harm and examine the broader precipitating factors as well. Social workers are on the front lines protecting the most vulnerable members of San Francisco.”
Lack of Resources for Mentally Ill
“In our community, people are navigating long wait times for public housing, dwindling food support, and underresourced vocational programs – these ongoing resource shortages deepen the mental health crisis and create conditions that increase risk in escalation in clinical settings,” Suarez said.
The UPTE workers are demanding safe and adequate staffing for all units; clear trauma-informed return to work policies after violent or traumatic incidents; meaningful structural improvements to our facilities; and time-off policies that allow workers the time and support needed to recover from the impacts of trauma.
“These are not optional upgrades, these are basic conditions for us to provide high quality ethical care,” said Lauren Silver, a clinical social worker at UCSF’s trauma recovery center. “We know patient care and staff safety are one in the same.”
Inadequate Staffing
City leaders are showing support for the union’s demands. District 10 Supervisor Shamaan Walton, who represents the neighborhood, spoke at the vigil: “It should not take a tragedy like this for us to come together to work on solutions so that this does not happen again. My office, our colleagues, have called for a complete investigation.”
He added that he has sent a letter of inquiry to the Sheriff’s Department and the San Francisco Department of Public Health, echoing the union’s demands for immediate solutions to address safety at the hospital.
“At the very least, we should have adequate staffing levels,” said Walton.
UPTE has sent their demands to both UCSF and hospital DPH leadership, who have agreed to meet with them. The next step, says Suarez, is to ensure violence prevention by continuing to discuss what each UCSF workplace, not just General Hospital, specifically needs.
“Our community of social workers is so amazing, we are people that are passionate about taking care of one another, so that extends throughout our work place,” said Suarez. “We don’t want this just to turn into a series of meetings where then nothing happens – we will do anything that we need to do in order for this to happen as quickly as possible for everyone to feel supported.”
Ultimately, a lasting safety solution is strengthening care for both patients and staff, said Suarez.
“UCSF has a huge presence within mental health services in San Francisco, especially acute emergency services. They need to live up to that responsibility that they’ve taken on, and support their frontline staff in doing so, as well for lower levels of care in their outpatient clinics. We are going to hold them to that because if we don’t do it I don’t think anybody else will,” she said.
