Appalling

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OldPsychDoc

OldPsychDoc

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Woman dies in psych ED.

So does this ultimately help or hurt the cause of psychiatry?
I'm thinking there should be some serious head-rollage in this hospital's staff.


(On the other hand--I think we may now know how to direct the gentleman looking for an "arm-pit of hell residency")
 
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Some heads have rolled.

Obviously, more government funding is needed if the government is going to operate these facilities. This may do for psychiatric care what the muckracking at Willowbrook (on Staten Island) by Geraldo Rivera (Jerry Rivers) did for the care of the developmentally disabled. Then again, maybe not.
 
That's horrible but...

Why is psychiatry blamed for this just cause it's in the Psych ED. Why didnt a nurse call a doctor? I'm glad this got exposed that way forces can come down on bad service.

And yes new york can be considered the armpit of hell. Maybe even the crotch of hell.
 
Not to pile on, but there is clearly an underlying reason when a psych ER pays the highest moonlighting rates in the city and still has difficulty filling positions.
 
Kings Co. Hospital. Not that surprising really. It's a very tough place to be (as a patient or doc) and the staff unfortunately probably assumes she's taking a methadone nap. I think I saw another guy on the bench opposite her, barely visible against the wall, also lying down (on the bench).

Now JCAHO will impose even more unmeetable standards upon NYC hospitals based in part on this.
 
The state does not get any sympathy from me. Their residencies are filled with IMGs/FMGs and yet they dont utilize their work force and force them to get a full license after 3 years as opposed to one or two years. A moonlighting resident is better than no coverage.
 
That video made me shudder---> sad and appalling. Definitely a result of a lackluster facility and not the fault of psychiatry.
 
Anasazi23 said:
How does this factor in?
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If it was two years only then third year residents may get the license in NY and moonlight, helping to fill some of the opening gaps in the psych ED.
 
I was reading some stuff in the premed area about how they want to volunteer in hospitals, but not certified in anything to be of use. How hard would it be to train a premed to walk around a hospital with a chart and write down the times he has passed by a department to see if a pt is down, fell out of bed, collapsed in hallway, etc. They could also write in their chart what they found and which nurse/doc they told. A free pair of eyes basically. :idea:
 
Faebinder said:
If it was two years only then third year residents may get the license in NY and moonlight, helping to fill some of the opening gaps in the psych ED.
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Oh I see. I'm not sure if a PGY-II could handle that place in moonlighting call though. It's relatively unlikely that a doc would be that front-line anyway. This looks like a triage-area/nursing staff problem. And security maybe.

It's all over the news now. A lawyer analyst on tv wants to sue the hospital for a "billion dollars" to teach a lesson. People have no idea what's going on with hospitals or the system at this point...hospitals don't have two nickels to rub together. Hence the problem.
 
BabyPsychDoc said:
I think I am missing something badly. Why did they fire people who were only marginally related to the case, and suspended those that actually seemed to have been far more responsible for what happened?
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You missed the words "supended pending union-mandated hearings".

Unionized employees have some protections in their contracts. I don't doubt that those who falisied hospital records will be fired after the hearings.
 
LizzyM said:
You missed the words "supended pending union-mandated hearings".

Unionized employees have some protections in their contracts. I don't doubt that those who falisied hospital records will be fired after the hearings.
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I see now. thanks for this.
 
Hmm,

Without reading this poor lady's medical records, don't you think the doctor that medically cleared this poor lady could also be at fault?

I've had quite a few patients in my day as a resident get cleared by an ER doc who clearly shouldn't have been cleared, and I'm not talking Monday morning quarterbacking...

E.g. 1) a patient who jumped off a building & had no x-rays, came into the psyche unit with 2 broken legs. The ER doc wrote down everything was fine & put a normal physical exam (came in from another hospital so we couldn't double check before the patient came over) 2) patients with histories of grand mal seizures on sub-therapeutic levels of seizure meds & the ER doc did not load up the patient on these meds, it takes several hours between the patient going from the ER to the psyche floor---> and then the patient has a seizure on the psyche floor (no surprise).

The field of psychiatry on this one is not in question. More so the hospital & the management of that specific psyche ER.

Sometimes, IMHO, The Last Psychiatrist writes something brilliant. Why? Because its true and no one is willing to discuss it because of the flack that may be brought upon them.

Step 1: limit the scope of psychiatry. Limit what we are actually going to call depression, let alone medicate. Limit who we will actually call a patient, and for how long. Not all suffering should be treated.
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I'm not justifying their poverty nor blaming them for it, I am stating as fact that the only option for a person with no resources who doesn't want to sleep in a homeless shelter is psychiatry.
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Psychiatry as some people are not willing to admit has become the hospital dumping ground for difficult patients that do not truly suffer from an Axis I disorder, and they try to use us as their defacto social worker. Just because a guy is homeless, (and because surgery doesn't want to deal with their disposition) doesn't mean that they have to be seen by psychiatry. If this isn't happening in your hospital, then good for you, but its happening at several. Those that are in hospitals where this is happening know what I'm talking about. The other hospital depts aren't the only ones. DYFS, nursing homes etc--their patients get out of line to any degree and some places want to turf that patient to psychiatry. Then when the crisis psychiatrist judges that they don't have an Axis I DO (because the patient started crying because they fell & scraped their knee, not because the patient was psychotic), the place that referred them to psyche doesn't want to take them back. I've seen that happen several times.

What I find very appalling is the falsification of records...and on top of that, did those hospital staff know about the video? If so that makes them very stupid.

Somewhat tangential.....
There was a suicide at a NJ state hospital a few months ago--which garnered a lot of headlines. The newspapers reported information which turned out to not be correct, but they never printed any corrections. It then lead to the state creating a bunch of changes in the hospital, none of which would've prevented the suicide, but made life a heck of a lot more difficult at that hospital.
 
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From APA Headlines:
Family of neglected New York City psychiatric patient intends to file $25 million lawsuit.
In continuing coverage from previous editions of Headlines, the AP (7/9) reports that on Tuesday, the family of Esmin Green, the "woman who died unnoticed on the floor of" Brooklyn's Kings County Hospital psychiatric unit on June 19, "notified the hospital, the city, and the city's Health and Hospitals Corporation (HHC) that they intend to file a $25 million lawsuit." The family's attorney, Sanford Rubenstein, "accused the hospital staff of attempting to cover up neglect. In patient records marked 6 a.m. and 6:20 a.m., when surveillance footage shows Green on the floor, hospital staff wrote instead that she was 'awake, up and about,' or sitting quietly." In response, HHC president Alan Aviles stated, "We failed Esmin Green, and believe her family deserves fair and just compensation." Meanwhile, New York City's "Department of Investigation is examining the case," and the "Brooklyn district attorney's office...will decide whether to prosecute." Six members of hospital staff were fired following Green's death.
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Jackpot! This should make everything better.
 
$25 million...

Average income of psychiatrist is 175k per year.

Translation.. if in theory the in charge psychiatrist was to work and use all his income for to pay the family and lawyer.... it would require him/her 142 years to pay it off... assuming no income is used to live and no money value change.

What a small jackpot. The case in Florida had less proof and they got $219 million. They should have asked for $1 billion... maybe $20 billion... yeah ~50% of New York City's annual budget.
 
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Was the woman's family very involved in her life? I thought I read that she lived with roommates, and possible alone at some point. If she was in the psych ER for 24 hours being ignored, why didn't her family check on her? I mean, if it was my mom in the ER like that, even if I couldn't go myself I'd be sure to find out how she was doing. Obviously, I don't know what's going on with this family, but I hope this isn't a case where they are appearing out of nowhere all of a sudden.

This story is so horribly sad. Watching that security guard see her and roll away on his chair made me sick. It seemed like it was out of some twisted psychology experiment or something. How on earth could they just look and roll away? They shouldn't just be fired--they should be going to jail.

Also, why didn't someone else in the waiting room say something? I know those are probably patients and they have their own problems, but to sit there while someone collapses and DIES right across the room? Huh?
 
nancysinatra said:
Was the woman's family very involved in her life? I thought I read that she lived with roommates, and possible alone at some point. If she was in the psych ER for 24 hours being ignored, why didn't her family check on her? I mean, if it was my mom in the ER like that, even if I couldn't go myself I'd be sure to find out how she was doing. Obviously, I don't know what's going on with this family, but I hope this isn't a case where they are appearing out of nowhere all of a sudden.

This story is so horribly sad. Watching that security guard see her and roll away on his chair made me sick. It seemed like it was out of some twisted psychology experiment or something. How on earth could they just look and roll away? They shouldn't just be fired--they should be going to jail.

Also, why didn't someone else in the waiting room say something? I know those are probably patients and they have their own problems, but to sit there while someone collapses and DIES right across the room? Huh?
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I was thinking of a lot of the same things. A security guard, a relative of a patient, or another patient could have saved a life just by getting involved, just by speaking up.

It always seems so odd to me that when a person (who is not an income provider for a family) loses a life due to negligence or sometimes just circumstances that can't be avoided, a random monetary value is sought to somehow compensate for the death.😕 25 million or even 25 billion isn't going to resurrect this woman. Wouldn't this 25 million be better spent providing more caring and competent personnel to care for future patients?
 
futuredo32 said:
25 million or even 25 billion isn't going to resurrect this woman. Wouldn't this 25 million be better spent providing more caring and competent personnel to care for future patients?
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How un-American of you to think such a thing!
Think of all the poor lawyers' children who will go to bed hungry if lawsuits like these are not allowed to go through! 🙄

(If OPD were King, a generous, but proportionate and realistic, settlement would be paid to the family, and $25 million pledged to build and staff a new crisis triage facility...)
 
OldPsychDoc said:
How un-American of you to think such a thing!
Think of all the poor lawyers' children who will go to bed hungry if lawsuits like these are not allowed to go through! 🙄
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:smack: How could I be so unpatriotic , especially after just celebrating the 4th of July.:laugh:

It'd be nice if the family used most of their settlement to do what OPD would do if he were king. Somehow, I don't see it happening that way though.......🙁
 
It'll be a cold day when my mother sits for 24 hrs in a Brooklyn waiting room.

Now here's the question that nobody's allowed to ask:

Was her life worth 25 million?

Before you freak-out, consider how insurance (life) rates are calculated. There are different values for different lives.
 
Anasazi23 said:
It'll be a cold day when my mother sits for 24 hrs in a Brooklyn waiting room.

Now here's the question that nobody's allowed to ask:

Was her life worth 25 million?

Before you freak-out, consider how insurance (life) rates are calculated. There are different values for different lives.
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Financially - probably not. I mean, she would not be sitting in ER waiting room of a rough NY hospital for 24 hrs if her life was worth 25 mln dollars AS CALCULATED BY LIFE INSURANCE COMPANIES.

But, my understanding is that this compensation is not just about "providing comparable level of income to the dependants as would have been provided by the deceased". There are also pain & suffering damages (that any attorney could estimate to be whatever they feel they could squeeze out of the defendant). There are also punitive damages.

Of course, IMHO, even taking all the above into consideration 25mln is an unrealistic figure, but the family probably had to beat attorneys away with a stick, before accepting the highest bid from the most pushy one.
 
Was the woman's family very involved in her life?
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Well with some malpractice suits, when someone dies, out of the woodwork comes people who want to exploit the situation.

Not that this is definitely the case here. Maybe her family really was close with her. Just that it does happen.
 
nancysinatra said:
Was the woman's family very involved in her life? I thought I read that she lived with roommates, and possible alone at some point.
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It always seems so odd to me that when a person (who is not an income provider for a family) loses a life due to negligence or sometimes just circumstances that can't be avoided, a random monetary value is sought to somehow compensate for the death
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I think most of her family is in Jamaica. She immigrated to the US in the 1990s - leaving 6 children behind in Jamaica. She apparently sent money back to Jamaica regularly i.e. she was an income provider for a family - and according to her friend she was depressed in part because she lost her job and could no longer send money to them.

On Sunday, Ms. Green's longtime friends painted a portrait of a deeply religious, if sometimes troubled, woman, who left Jamaica for New York in the late 1990s to earn money for her six children back home. She worked as a caregiver for the elderly, and at a day care center for children, friends said, though she had recently lost her job.
"Her children were her life," said Marlene Sterling, who lives in an apartment above the church, and who rented a room there to Ms. Green for three years. "She came here for the same reason that we all come here: for a better life."

Ms. Green was from a small country village, Lluidas Vale, in Jamaica, according to an obituary printed by the church, and had 13 brothers and sisters. When Ms. Green moved to New York, one of her sisters cared for her children in Jamaica, Ms. Sterling said. Ms. Green pined for her children constantly, Ms. Sterling said, calling them, wiring them money and sending them large barrels filled with groceries and gifts for the holidays. She threw herself into church activities, working with its children's workshops, her friend said, and organizing trips.

"The church was her family," Ms. Sterling said.
http://www.nytimes.com/2008/07/07/n...?_r=1&scp=1&sq=esmin+green&st=nyt&oref=sloginhttp://forums.studentdoctor.net/newreply.php?do=newreply&p=6877702
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Shalom77 said:
I think most of her family is in Jamaica. She immigrated to the US in the 1990s - leaving 6 children behind in Jamaica. She apparently sent money back to Jamaica regularly i.e. she was an income provider for a family - and according to her friend she was depressed in part because she lost her job and could no longer send money to them.
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Terrible. 🙁

Which reminds me, sometimes I feel like I am the only advocate for the patient. Experienced mental health nurses can be vicious and turn jaded after years of exposure to borderlines and seeking patients (not that I blame them mind you).
 
Anasazi23 said:
It'll be a cold day when my mother sits for 24 hrs in a Brooklyn waiting room.

Now here's the question that nobody's allowed to ask:

Was her life worth 25 million?

Before you freak-out, consider how insurance (life) rates are calculated. There are different values for different lives.
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Personally, I have never thought that a life insurance policy or a malpractice settlement could ever or would ever set a meaningful price on the worth of one's life. Life is priceless (a very cliche and simplistic statement, but .... ) I had no idea that life insurance policies had different values for different people, I thought that one just paid a set amount of premiums for a certain amount of life insurance.

Shalom77 said:
I think most of her family is in Jamaica. She immigrated to the US in the 1990s - leaving 6 children behind in Jamaica. She apparently sent money back to Jamaica regularly i.e. she was an income provider for a family - and according to her friend she was depressed in part because she lost her job and could no longer send money to them.
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Being that this woman had family for whom she was providing, a more reasonable settlement would be to generously estimate the amount of money that she would have made for the rest of her life, adjust for inflation,calculate the cost of providing counseling for her children to deal with losing their mother, etc. and award that amount to her kids. Providing for her kids will help her kids, but giving her kids about 4 million each isn't really going to change the fact that they lost their Mom.

In cases where children do receive large malpractice settlements for the death of a parent, I wonder if there isn't likely some added guilt or something for living a newly lavish lifestyle because their parent died.
 
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Being that this woman had family for whom she was providing, a more reasonable settlement would be to generously estimate the amount of money that she would have made for the rest of her life, adjust for inflation,calculate the cost of providing counseling for her children to deal with losing their mother, etc. and award that amount to her kids. Providing for her kids will help her kids, but giving her kids about 4 million each isn't really going to change the fact that they lost their Mom.
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Just because someone sues for 25 million doesn't mean that's what they will receive. Haven't you heard of starting high?

Too bad OPD isn't king - I'd be happy with what he proposes. 😀
 
Apparently, she died of a PE, thought to be a result of prolonged immobility while awaiting admission.
 
strangeglove said:
Apparently, she died of a PE, thought to be a result of prolonged immobility while awaiting admission.
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I'll lay you money (or a bottle of scotch anyway) that JCAHO will add "Are the patients in your waiting room getting lovanox prophylaxis?" to their list of magic questions for the next inspection, and that hospitals will begin employing yet another RN to wander around reviewing charts and monitoring compliance on this single issue. 🙄
 
I'd lay my money on them requiring patients be mobilized every hour, which would also serve the purpose of making sure they're not dead🙄
 
OldPsychDoc said:
I'll lay you money (or a bottle of scotch anyway) that JCAHO will add "Are the patients in your waiting room getting lovanox prophylaxis?" to their list of magic questions for the next inspection, and that hospitals will begin employing yet another RN to wander around reviewing charts and monitoring compliance on this single issue. 🙄
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That's just insane. Which is exactly why JCAHO will consider it.

I didn't see her chained to a chair.
 
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