Woman's ER Death Blamed On Blood Clots

Woman Died Unnoticed On NYC Hospital Floor; Scene Was Recorded By Security Cameras

(AP)  A woman who died unnoticed on a hospital floor in a scene recorded by security cameras was killed by blood clots caused by a long period of physical inactivity, according to the city's medical examiner.

Esmin Green, 49, had been sitting in a waiting room at the city-owned Kings County Hospital Center for nearly 24 hours when she collapsed from her chair and slowly died on June 19.

She lay on the floor at the Brooklyn hospital for an hour before a nurse finally checked her pulse.

After an autopsy and weeks of tests, the medical examiner's office concluded Friday that Green was killed by pulmonary thromboemboli, blood clots that form in the legs and travel through the bloodstream to the lungs.

The medical examiner said the clots were due to "deep venous thrombosis of lower extremities due to physical inactivity," complicating an underlying psychological illness: chronic paranoid schizophrenia.

An attorney for Green's family, Sanford Rubenstein, said the finding suggested that the hours she sat in the hospital played a role in her death.

"The length of time that she spent in the emergency room ... very well may have contributed to her death," he said. "Physical inactivity was obviously a significant contributing factor."

The city Health and Hospitals Corp., which owns the hospital, had no immediate comment Friday.

HHC officials have previously expressed outrage at the way Green was treated. Six employees lost their jobs over the incident, even before it became public.

Green died while awaiting care in the hospital's psychiatric emergency room. EMS workers had brought her to the center on the morning of June 18. The hospital said she was suffering from agitation and psychosis and was involuntarily admitted after refusing medical review.

The emergency room is chronically overcrowded, and Green waited overnight for further care.

A recording of her death prompted national outrage when it became public last week.

After she collapsed, neither fellow patients nor the hospital's staff moved to help her, even as she thrashed her legs on the floor and tried to get up.

Two security guards and a member of the hospital's medical staff can be seen on the video, stopping to look at Green briefly before walking away. She stopped moving about 30 minutes after falling and was dead when a nurse finally examined her another 30 minutes after that.

HHC immediately reported the death to the state and voluntarily turned over the security records to lawyers already suing the city over alleged patient neglect at the hospital.

Rubenstein said that had Green been carefully attended to when she arrived at the emergency room, doctors might have noticed swelling in her legs and taken action.

People known to be at risk from deep vein thrombosis are often given anticoagulation drugs or compression stockings, which can keep clots from forming, and advised not to sit for hours at a time.

The condition, however, is not always easy to detect. The National Heart Lung and Blood Institute said about half of the people with deep vein thrombosis have no symptoms at all.

Airlines often advise passengers on very long flights to stroll the aisle, periodically, to prevent blood clots.

[cantshutup]

sounds like this lady needed the hepirin not those babies...i still don''t understand how someone can collapse onto the floor and NO ONE offer to help her...if she would have collapsed at St.John''s in Springfield Missouri any staff or person of the general public would have jumped to aid her the second she fell out of the chair...aren''t the people who were in the waiting room also responsible for not helping her? really, i can''t believe this could happen in an American hospital.

[guest173]

the ER waiting rooms I''ve been in are all uncomfortable, and look like the one pictured here. that isn''t how sick people should be treated anyway, making them wait forever. and I hope the employees that got fired aren''t getting jobs immediately in this same field, they don''t seem to care about people probably just money.

[magoo2u1]

"aren''''t the people who were in the waiting room also responsible for not helping her?"

I am sure you aren''t thinking this question through. No one could expect psychiatric patients to provide emergency medical care to a fellow patient. From the sound of it they have been there untreated for as long as 24 hours and are "off" any meds they were taking which would further incapacitate them.
Our rush to find someone to punish should not attempt to hold mental patients liable to perform medical treatment.

[bb19631]

Clearly, another scenerio of people not wanting to get involved. The hospital is neglient in all aspects. I can''t believe this poor woman died, in such a manner. She could have been saved,if someone just gave a *** about her.

[slim1h2o]

A woman who died unnoticed on a hospital floor in a scene recorded by security cameras was killed by blood clots caused by a long period of physical inactivity, according to the city''s medical examiner.

Another case of blaming the victim, and not the people responsible for her death,,The hospital. Or Doctors.

[Meg003]

What a sad story. Another consequence of unregulated illegal alien residents in the U.S. is that hospital care is getting worse. This poor woman paid a terrible price for coming to the U.S., whether legally or not.

Public hospitals cannot afford to hire adequate staffing. The better nurses and doctors eventually leave the public hospitals in many cases, because the workloads are ridiculous. Then those needing indigent care are sometimes left in the care of the least capable, caring, most overworked health care workers.

My own local public hospital is running in the red because it must provide care for an influx of illegal aliens, including mothers who plan to have babies here so they can eventually become U.S. citizens.

Most of our local doctors will no longer deliver babies because they won''t get paid for indigent care. Those with insurance are now forced to drive to other towns.

[lightningfro]

Oh sheesh people...an "illegal" or not this woman should not have died the way she did (plus, how do you know she was an illegal alien).
What do you expect them to do...wait until they die in "their homeland"? And since it''s obvious you don''t know, NYC is a sanctuary city..if you don''t know what that is look it up.

[eds1980]

Ms. Green was admitted involuntarily for agitation, but if you look at the video, until her collapse she seems to be waiting fairly quietly. This suggests she was almost certainly given an antipsychotic when she arrived at the emergency room. Antipsychotics can be useful and necessary for severe mental illness, and if she really was schizophrenic (not a settled question-- it''s a tricky and stigmatizing diagnosis, and one that''s more likely to be given to black people in emotional distress, such as Ms. Green, more quickly) they may have been the best course. But they''ve got a lot of dangerous side effects, such as... deep vein thrombosis (http://news.bbc.co.uk/2/hi/health/957182.stm). It looks to me like the "treatment" she was given, against her will, killed her.

As for the apathy of the other patients in the emergency room, it''s a psychiatric waiting room; they were likely either disturbed themselves or likewise doped up beyond normal reactivity.

[Meg003]

Oh sheesh people...an "illegal" or not this woman should not have died the way she did (plus, how do you know she was an illegal alien).
What do you expect them to do...wait until they die in "their homeland"? And since it''''s obvious you don''''t know, NYC is a sanctuary city..if you don''''t know what that is look it up.

Posted by lightningfro

Where in my post do you see me stating that this woman was an illegal alien? Nowhere.

My post was on the topic of the poor hospital care found in overworked, underfunded public hospitals. If you do not believe that public hospitals are burdened by nonpaying illegal aliens, you are very lucky. Either there are not large numbers of illegal indigents where you live, or you have not needed a public hospital recently.

I agree with you on one point though, illegal or not, insane or not, criminal or not, no one should die as she did. That was terrible.

[deacon20081]

As one involved with hospital ministry I am totally disgusted with the way this woman was left on the floor. That should be considered manslaughter.

[keena3]

People,People,People have you all forgotten that this 49 yr old died in New York where people do not speak to one another when they pass and you expect them to help a psyco woman that has fallen on the floor in a poor hospital that treats the majority of poor blacks and foreigners that have very little to no money or communication skills. Come on some are like crabs in a bucket as long as they are out of the bucket they dont care about those others that are around or beneath them. How can you ask the question shouldnt the other patients be held responsible, dont think so. Once the hospital staff treated her for any of her problems she became their problem until they give her discharge papers not the others waiting to be treated. What in the heck took them so long to wait on her in the first place that lady was there for 24 hrs before she died. I sure as heck hope I never get ill in NY