According to Nelson, the confrontation began after a patient became disruptive inside the hospital's emergency department. "The patient had been verbally abusing staff, spitting on the floor, and behaving aggressively," Nelson said. After hospital staff instructed the man to leave, Nelson escorted him outside the emergency department. According to Nelson, the patient suddenly turned violent in an apparent attempt to force his way back inside. Nelson maintained control of the patient until hospital security officers arrived and took over.