Emergency Room Death Sparks Outrage

(CBS/AP)  New York City hospital officials agreed in court Tuesday to implement reforms at a psychiatric ward where surveillance footage showed a woman falling from her chair, writhing on the floor and dying as workers failed to help for more than an hour.

Esmin Green, 49, had been waiting in the emergency room for nearly 24 hours when she toppled from her seat at 5:32 a.m. on June 19, falling face down on the floor.

She was dead by 6:35, when someone on the medical staff, flagged down by a person in the waiting room, finally approached, nudged Green with her foot, and gently prodded her shoulder, as if to wake her. The staffer then left and returned with someone wearing a white lab coat who examined her and summoned help.

Until the staffer's appearance, Green's collapse barely caused a ripple. Other patients waiting a few feet away didn't react. Security guards and a member of the hospital's staff appeared to notice her prone body at least three times, but made no visible attempt to see if she needed help.

One guard didn't even leave his chair, rolling it around a corner to stare at the body, then rolling away a few moments later.

Green, who had been involuntarily committed the previous morning, and had waited overnight for a bed, stopped moving about half an hour after she collapsed.

The New York City Health and Hospitals Corporation, which runs the hospital, said six people have been fired as a result, including security personnel and members of the medical staff.

The incident in New York recalls a similar situation involving another dying patient last year in Los Angeles, also caught on tape by security cameras, in which a woman collapsed in an emergency room lobby. Edith Isabel Rodriguez writhed on the floor for 45 minutes while hospital personnel stood idly by and a janitor mopped the floor around her, The Los Angeles Times reports. Excerpts of that video were made public after Green's death in Brooklyn shocked New York City this week.

Watch the Los Angeles Times video:

An attorney representing Rodriguez's children, Franklin Casco Jr., said the family had been pressing Los Angles County to view the video before it was sent anonymously to the Times this week.

"My clients and I have been working very hard with the county of Los Angeles to at least view this so they can have some form of closure of their mom's death so they can put this behind them, and the county has refused," he told the newspaper. "The county has refused to provide us with anything. It seems like they're attempting to cover up the whole situation."

The psychiatric unit at Kings County Hospital in Brooklyn had already been a subject of complaints by advocates for the mentally ill.

A state agency, the New York State Mental Hygiene Legal Service, and the New York Civil Liberties Union filed a lawsuit a year ago, calling the psychiatric center "a chamber of filth, decay, indifference and danger."

Both sides in the dispute went before a federal judge Tuesday to jointly file papers in which the hospital system agreed to a series of reforms. Under the agreement, patients in the waiting room will now be checked every 15 minutes.

Over the next four months, the hospital will attempt to shorten the median waiting time to around 10 hours. A judge is scheduled to sign off on the agreement Wednesday.

The tape of Green's wait has also been turned over to prosecutors.

Green's medical records raised the possibility that someone might have tried to cover up the circumstances of the death.

One notation said that at 6 a.m., she was "awake, up and about" and had just used the restroom. Another said that at 6:20 a.m., she was sitting quietly in the waiting room, and had a normal blood pressure. During both of those times, Green was either in her death throes or already dead.

Mayor Michael Bloomberg said he was disgusted by the tape, and that the actions of the hospital staff were unacceptable.

"I think what they said is, 'Oh well, people sleep on the floor all the time, and I didn't pay any attention,"' he said. "They shouldn't be sleeping on the floor ... and you should pay attention."

HHC's president, Alan Aviles, said in a statement that he was shocked and distressed by the situation and promised a thorough investigation.

"We are all shocked and distressed by this situation," HHC's president, Alan Aviles, said in a statement. "We express our deep regrets to the patient's family and will ensure a thorough investigation to answer any questions that remain."

Details of the death were disclosed by the hospital on June 20, but the case largely remained unnoticed until the video became public.

According to the lawsuit, patients at the hospital "are subjected to overcrowded and squalid conditions often accompanied by physical abuse and unnecessary and punitive injections of mind-altering drugs."

"From the moment a person steps through the doors," it added, "she is stripped of her freedom and dignity and literally forced to fight for the essentials of life."

The suit was especially critical of the hospital's emergency ward, saying it is so poorly staffed that patients are often marooned there for days while they wait to be evaluated.

Sometimes the unit runs out of chairs, according to the lawsuit, forcing people to wait on foam mats or on the waiting room floor. The suit also claims that bathrooms are filthy and filled with flies, and that patients who complain too loudly are sometimes handcuffed, beaten or injected with psychotropic drugs.

The office of the city's medical examiner said it was still trying to determine why Green died. She had been brought to the hospital suffering from agitation and psychosis, city officials said.

Green was born in Jamaica, and the city has agreed to fly her body home for burial.

[amjsmom3]

The biggest problem that I see on these videos is the people in the waiting room! How could someone set by and watch someone fall out of their chair and not rush over to help or get help for them? What has this world come to? Common courtesy, that is all. It should be a natural reaction to jump up and run to help! What is wrong with these people? How could they sit there for 45 minutes or longer watching someone lying in the floor? It is disgusting!

[niffervu]

When are we going to stop blaming the hospitals, the nurses, the doctors...
We as a society need to be held accountable for how we spend our money...
Maybe if we spent money on healthcare like we do on concert tickets or sporting events then helathcare will have the resources to provide quality care to everyone...
Unfortunately this situation was a result of cutbacks and poor conditions in a PUBLIC hospital...
If the patient was in another country she literally would have been sent home to die....

[ianlou]

Nurse Ratched would fit right in at this place.
Posted by Taildragrrr

....and Dr. Nick "Hi Everybody. Whats this pointy thing for?"

[mydiatribe]

This is the most flagrant example of cruel NDIFFERENCE and INCOMPETENCE, ever brought to the public attention. Every emloyee at this hospital who was on duty in this ward at the time of this incident ought to be terminated immediately with extreme prejudice!

This video tape illustrates what can only be a pervasive view of patient care taken by an entire staff.

Supervisors had to be tolerating this level of incompetence & indifference for a very long time for this to have happened.

Increasingly the mentally ill are being abused because no one is effectively advocating for them.

Personally, I hope this woman''s family sues the hell out of the hospital, as weel as the city and state of New York!

[whiskyrocker]

She was only waiting 24 hours. Not bad.

[erasmus81]

"Unlike brianbwb, erasmus, jwhitman etc and the other liberal bloggers on this site that post ALL DAY LONG barking at the moon..." Posted by cbville70 at 12:23 AM : Jul 03, 2008

Okay jerkface, you like talking out of your a-s-s? You have insulted me by lumping me with these two.:) And I am NOT a Liberal.

[cjbrix]

The people who do nothing to help are despicable. But the fact that it keeps happening points to an underlying problem that has to be dealt with.

Our health care system is broken. The insurance companies and their pure profit motivation are sucking the life out of health care, leaving increasingly overburdened ERs as the catch-all for the results of their greed.

We need an overhaul that removes the insurance companies from the loop. Public health care *works* in countries around the world, and there is no reason for the American public to keep paying more and getting less, just to support the greed of a few.

[differnet]

This and other situations like it are why we do NOT need tort reform. Punative damages are designed to force organizations, businesses and even the government to stop putting people at jeopardy. The court system is the only defense that little people have against big bureaucracies.

[acolton1]

The Hosipital is going to get sued for Millions and Millions of dollars & and they have no defense because its caught on video tape and it an open and shut case and has been shown on National TV. Even a potential jury has seen the news story or the video on TV.

I feel very sorry for the Esmin Green''s family but they are now MILLIONAIRES and I hope they sue the LIVIN POOP out of this hosipital. I am sure this case will be settled OUT of Court for an undisclosed amount of FAT, FAT, JUICY, DELICIOUS CASH.

[flreason]

Why would anyone post the unsourced, unsubstantiated, slanderous comment of one person suggesting that governments in Canada and Europe murder homeless people?!! That''s not funny. It''s vile and it perpetuates the image of Americans as ignorant, xenophobic hatemongers.

If Americans are ignorant in geography, the xenophobic right-wing radio talk shows should take some responsibility. When all listeners hear is how rotten every other country in the world is, why would they have any interest in anyplace else? George Bush epitomizes that deliberate ignorance. He can''t even pronounce half of the names of countries he''s dealing with as President...and he doesn''t care. If Americans are ignorant in general, the blame lies with parents who don''t take responsibility for their children''s learning, and political parties who cut taxes so that schools can''t pay enough to hire and keep good teachers. It''s a sad commentary that American schools were at their apex when women were discriminated against in business, so the best and brightest women became teachers.