An unsecured karaoke machine caused Eastern State Hospital to lose its accreditation last month, according to a report released by the Washington Department of Social and Health Services (DSHS).

The suspension of accreditation for the psychiatric hospital in Medical Lake, Spokane County, came a month after one patient strangled another in November.

The report stemmed from a routine inspection, but it took the homicide into account.

The report, issued by The Joint Commission and released by DSHS through a public-records request, cites the karaoke machine's cords, as well as other cords and patients' belts, as hazardous to patient safety because they could be used for strangulation.

John Wiley, a DSHS spokesman, said the hospital has appealed the Dec. 21 ruling.

Within the next 10 days, The Joint Commission will perform another inspection, and it will render a final decision within the next month.

"We expect to be reaccredited," Wiley said, adding that the potential hazards were addressed within 72 hours of the hospital receiving the report.

The hospital has been able to function at full capacity until the commission's final decision.

Wiley said the karaoke machine was in one of the forensic-science wards, which house the criminally insane. The killing occurred in the same kind of ward but on a different floor, Wiley said.

At about 2:45 a.m. Nov. 20, an Eastern patient told an employee, "I murdered someone," according to court documents. The employee found Duane Charley, 56, dead.

Patient Amber Ilene Roberts, 30, has been charged with first-degree murder.

The state is conducting an investigation.

The Joint Commission's report also noted belts left in rooms where they could be accessed by patients who did not have belt privileges.

The list of violations in the report range from the imminent threat of strangulation to safety hazards like excess lint in a dryer filter.

One violation involved insufficient security outside the building. Wiley said the hospital typically has one security guard patrolling the grounds per shift.

"Our focus in recent years has been in adding clinical staff," Wiley said.

However, with the report pointing out a need for additional security, the hospital has requested additional funding from the state for more guards, he said.

Another infraction detailed a work program that had patients shredding documents containing other patients' personal and medical information, which could be a violation of the Health Insurance Portability and Accountability Act.

"I'm certain by the time (The Joint Commission) gets back to do their inspection, that will have changed," Wiley said.