Patient dies on Kings County Hospital floor

[soparu]

[youtube]http://youtube.com/watch?v=omoX9vkyOU0[/youtube]

A 49 year old mental patient at Kings County Hospital in Brooklyn, was left on the floor to die. This video was edited, by whom, I do not know. I do know that a more complete version of this tape, shows a male security guard walking over to the patient, and simply walking away. Moments later, a male Dr. does the same thing. News reports indicate that the Dr. was fired, and the nurses and security guards were suspended.

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A shocking video shows a woman dying on the floor in the psych ward at Kings County Hospital, while people around her, including a security guard, did nothing to help.

After an hour, another mental patient finally got the attention of the indifferent hospital workers, according to the tape, obtained by the Daily News.

Worse still, the surveillance tape suggests hospital staff may have falsified medical charts to cover the utter lack of treatment provided Esmin Green before she died.

"Thank God for the videotape because no one would have believed this could have happened," said Donna Lieberman, executive director of the New York Civil Liberties Union.

"There's a clear possibility of criminal wrongdoing with regard to recordkeeping, and that has to be investigated."

The city Department of Investigation is part of a sweeping probe that has brought some changes to the ward known as G Building.

A federal suit filed last year in Brooklyn alleged neglect and abuse of mental patients at the hospital. The suit sparked an investigation by the Brooklyn U.S. attorney's civil rights unit before the June 19 death.

Two different security guards spotted Green, a native of the island of Jamaica, prone on the floor and did nothing, the tape shows. They have been fired, along with four other staffers.

Green, 49, taken to the unit for "agitation," keels over out of her chair at 5:32a.m., according to the time stamp on the video. She had been sitting about 3feet from an observation window. Two other patients were in the room.

Green is lying facedown on the floor, her legs splayed, when a security guard strolls by at 5:53 a.m., looks at her for about 20 seconds and then walks away.

She is writhing on the floor, thrashing her legs, about 6 a.m., when her medical chart contends she was "awake, up and about, went to the bathroom."

Green rolls on her back at 6:04a.m. She stops moving at 6:08 a.m., but two minutes later a security guard pushed his chair into camera view.

He never gets out of the chair, but looks at Green and scoots away. A female patient who was in and out of the room finally brings a clinic staffer to check the woman and a crash cart is summoned.

The medical chart claims she was "sitting quietly in [the] waiting room" at 6:20 a.m., although she was already dead. The cause of death is still under investigation.

"We are shocked and distressed by this situation," the Health and Hospitals Corp. said in a statement.

BY JOHN MARZULLI
DAILY NEWS STAFF WRITER

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[WinterLights]

[youtube]omoX9vkyOU0[/youtube]

A 49 year old mental patient at Kings County Hospital in Brooklyn, was left on the floor to die. This video was edited, by whom, I do not know. I do know that a more complete version of this tape, shows a male security guard walking over to the patient, and simply walking away. Moments later, a male Dr. does the same thing. News reports indicate that the Dr. was fired, and the nurses and security guards were suspended.

That is absolutely ridiculous. I did not see a single person check her pulse. I guess this is what happens when you are part of the "holy Underserved."

 

[Charles English]

sad, bizarre, and horrible. do you all think the mistreatment was simply due to the mental illness? i know there is a continued stigma against those with mental illnesses, and this incident only serves to strengthen the belief of those prevailing attitudes. unless that entire hospital is ****, or maybe the staff had it out for that one particular patient... it just doesn't make sense. i'm glad someone caught their a**es doctoring the reports-- it is all about the CYA, never ends.

 

[Turtle01]

Very sad

 

[LadyWolverine]

News reports indicate that the Dr. was fired, and the nurses and security guards were suspended.

Why weren't they all fired?

 

[Princess87]

Just saw this on Nancy Grace. The patient had been waiting for 24 hours, and was only checked up on an hour after she had died. The security guard's window had been blocked out with paper so they didnt have to be bothered...

My question is doesn't the feed of the security camera get fed to computers located in the hospital being monitored by security guards/nurses/doctors? Even if they can't consistently be checking the waiting room it's hard to believe that there's not procedures to ensure that people who have come to the ER are being monitored.

By the way, the staff at the hospital had doctored records to take blame off of themselves. Seems like a pretty heartless bunch in the least.

 

[Princess87]

Why weren't they all fired?

I heard that they're suspended and in the process of being fired. Don't really understand why you have to fire them in stages though...

 

[dienekes88]

Why weren't they all fired?

From the associated press...

six people have been fired as a result of the incident, including security personnel and members of the medical staff.

 

[dienekes88]

I don't see anything stating that a physician was fired...

I heard that they're suspended and in the process of being fired. Don't really understand why you have to fire them in stages though...

It may have to do with the unions...? The AP says they were all fired, but they may have decided to skip the bit about the suspension.

 

[EpiPEN]

I heard that they're suspended and in the process of being fired. Don't really understand why you have to fire them in stages though...

bureaucracy is something beyond me as well

 

[foster033]

It is sad...but it just goes to show you that doctors/nurses really don't pay attention to the mentally ill/poor people who come to the hospital. They just assume they are trying to take advantage of the system even if there really is something wrong with them.

 

[dienekes88]

It is sad...but it just goes to show you that doctors/nurses really don't pay attention to the mentally ill/poor people who come to the hospital. They just assume they are trying to take advantage of the system even if there really is something wrong with them.

Whoa. I don't think you can take one incident and claim that all doctors are callous to the poor and mentally ill.

I know you and Panda Bear are having an argument in another thread, but there's no reason to become bitter.

 

[niranjan162]

This is absolutely horrible. The staff should def. be fired, but what about the people in the waiting room? They couldn't have gotten somebody or asked if she was alright. Man is truly the worst of the animals.

 

[Princess87]

This is absolutely horrible. The staff should def. be fired, but what about the people in the waiting room? They couldn't have gotten somebody or asked if she was alright. Man is truly the worst of the animals.

I was thinking about that too, but I think that patients trust the hospital staff and feel assured that they will carry out their jobs (which I think is a reasonable assumption in most circumstances).

 

[Princess87]

Also, they are pursuing criminal and civil rights suits against the people involved.

 

[foster033]

Whoa. I don't think you can take one incident and claim that all doctors are callous to the poor and mentally ill.

I know you and Panda Bear are having an argument in another thread, but there's no reason to become bitter.

I'm not bitter, and was in no way calling out PB....

but you can bet this wouldn't have happened if this had been a rich patient, or a patient with insurance...

I wasn't limping that ALL drs would do this, but a fair amount would, which is why stuff like this happens...people get dehumanized and mistreated and it's (admittedly) easier to do that to a poor or mentally ill patient.

 

[PowerButton]

Well, the outcome is pretty horrible, but there's not enough information provided to allocate blame. The staff definitely should have checked up on the patient, and at least put her into a room, medically evaluated her, and perhaps gotten social services involved if needed.

That being said, I don't think it's fair to necessarily say the staff was evil or callous. They were negligent, yes, but there's a lot we don't know. What if that patient was there every single day, and numerous workups had been done, yielding no significant findings? What if the patient just did exactly that, to go and lie down on the floor day after day?

Yes it is a tragedy, but people shouldn't jump to conclusions. The staff should definitely be blamed for being negligent - you always need to work up patients no matter how many times they come in, just in case. "Frequent Flyers", as we call them in the ER here, tend to make people turned off to them and less likely to believe them. The real tragedy, to me, is that most of these kinds of patients don't get proper social services dispositions and followups, and as a result, come time and time again to be ignored.

 

[thethethe]

I wonder who released the video.

 

[cornpops21]

This is absolutely horrible. The staff should def. be fired, but what about the people in the waiting room? They couldn't have gotten somebody or asked if she was alright. Man is truly the worst of the animals.

Can't the people in the waiting room be held criminally responsible for failing to act. Wouldn't this be some sort of "murder by negligence" case? I'm not sure what the correct legal term is.

 

[dienekes88]

I'm not bitter, and was in no way calling out PB....

In that case, I apologize.

but you can bet this wouldn't have happened if this had been a rich patient, or a patient with insurance...

I wasn't limping that ALL drs would do this, but a fair amount would, which is why stuff like this happens...people get dehumanized and mistreated and it's (admittedly) easier to do that to a poor or mentally ill patient.

Is that really the case? I realize that this is the popular belief, but I wonder if it really happens.

My hospital experience is decidedly narrow, but I didn't see it happen.

 

[Princess87]

Can't the people in the waiting room be held criminally responsible for failing to act. Wouldn't this be some sort of "murder by negligence" case? I'm not sure what the correct legal term is.

Might be possible, but keep in mind that these patients are in the psych ward and may have legitimately not known what reaction was appropriate.

 

[PowerButton]

In that case, I apologize.



Is that really the case? I realize that this is the popular belief, but I wonder if it really happens.

My hospital experience is decidedly narrow, but I didn't see it happen.

It's not, at least not in my experience. Patients are patients - when their names pop up on the board, they need to be put in a room and seen by a doctor. Sometimes we let homeless people sleep in the waiting room, if that's all they're here for (which does happen a lot - real chief complaint = bed and meal).

I mean, I agree someone like Britney Spears would never be treated that way, but money/insurance makes its biggest difference in the quality of specialized care you get. The ED treats everyone (or at least, it's supposed to :/ ).

 

[WinterLights]

Can't the people in the waiting room be held criminally responsible for failing to act. Wouldn't this be some sort of "murder by negligence" case? I'm not sure what the correct legal term is.

I think thats going a bit too far. Have you ever heard of the bystander effect? This kind of thing happens all of the time. At a hospital, your staff should be alert to these kinds of situations and should respond appropriately. That is the reason why they should be held accountable. Also, they tried to doctor the files (no pun intended), which is extremely unethical. I don't think you can hold bystanders (other patients) accountable in this situation.

 

[MedicFL]

I can tell that most of you have never been in an inner city psych ward before. They do the strangest things. Hell even patients sitting in the waiting room of the ER often times will fake seizures and lay on the floor. I agree someone should have checked a pulse early one, but as far as not running over there when he laid on the floor, there isn't always the free staff to baby sit these people..

 

[PowerButton]

I can tell that most of you have never been in an inner city psych ward before. They do the strangest things. Hell even patients sitting in the waiting room of the ER often times will fake seizures and lay on the floor. I agree someone should have checked a pulse early one, but as far as not running over there when he laid on the floor, there isn't always the free staff to baby sit these people..

Exactly. Not condoning the actions of the people involved in this case, but you have to take this into account when considering their perspective.

 

[dienekes88]

It's not, at least not in my experience. Patients are patients - when their names pop up on the board, they need to be put in a room and seen by a doctor. Sometimes we let homeless people sleep in the waiting room, if that's all they're here for (which does happen a lot - real chief complaint = bed and meal).

I mean, I agree someone like Britney Spears would never be treated that way, but money/insurance makes its biggest difference in the quality of specialized care you get. The ED treats everyone (or at least, it's supposed to :/ ).

Well, this case was inpatient care. The patient was already in the psych ward.

I think Emergency Departments worry less about insurance, because they are required by law (EMTALA) to stabilize the patient at the very least.

 

[PowerButton]

Well, this case was inpatient care. The patient was already in the psych ward.

I think Emergency Departments worry less about insurance, because they are required by law (EMTALA) to stabilize the patient at the very least.

Ahh, I misread the location of the incident. Well, insurance probably didn't play as much of a role in these guys' actions, compared to the fact that they probably all thought the patient was BSing.

 

[parto123]

I love idealistic college students who see the boogey man behind every shadow. Sorry to spoil your little crusade but this has nothing to do with being poor. This is kings county hospital- 90% of their patients are poor.

 

[WinterLights]

I love idealistic college students who see the boogey man behind every shadow. Sorry to spoil your little crusade but this has nothing to do with being poor. This is kings county hospital- 90% of their patients are poor.

So when are they going to release the video of a wealthy patient dying in the waiting room of "Any hospital USA?" When exactly are we going to see doctors altering a wealthy patients record? Just a few reasonable questions.
I'm actually surprised that this story wasn't swept under the rug.

 

[Princess87]

I love idealistic college students who see the boogey man behind every shadow. Sorry to spoil your little crusade but this has nothing to do with being poor. This is kings county hospital- 90% of their patients are poor.

And >90% of people who saw her did squat.

 

[moose21]

So when are they going to release the video of a wealthy patient dying in the waiting room of "Any hospital USA?" When exactly are we going to see doctors altering a wealthy patients record? Just a few reasonable questions.
I'm actually surprised that this story wasn't swept under the rug.

I know of a specific incident where an upper-middle class man died of an MI in a ER waiting room about one year ago. So while there may not be a video, it can and has happened. There was no altering of records as fas as I know.

 

[parto123]

So when are they going to release the video of a wealthy patient dying in the waiting room of "Any hospital USA?" When exactly are we going to see doctors altering a wealthy patients record? Just a few reasonable questions.
I'm actually surprised that this story wasn't swept under the rug.

If you think the wealthy are immune from medical neglect, you are quite mistaken.

Falsifying the records is another story. This has nothing to do with wealth per se but more with the odds of them getting caught. Wealthy families have more resources and would be more likely to find a cover-up, so doctors would be less likely to do so to the wealthy.

And contrary to your post, a discovery of major medical screwups usually does not get swept under the rug. In fact, they usually make national headlines. Much like this story, or the operation on the incorrect lung several days ago.

 

[Pedsbro]

Wow... Stop blowing smoke or giving the staff the benefit of the doubt. There is no excuse for that to have happened, period.

 

[WinterLights]

If you think the wealthy are immune from medical neglect, you are quite mistaken.

I do not think the wealthy are immune. To make such an assumption would be naive. However; it is very unlikely that this incident would have occurred if the patient was wealthy. I cannot imagine the doctors reacting in such a way if they knew that the patient had the ability to sue the proverbial pants off of them and/or the hospital. It seems to me as though the staff reacted in a casual way because they knew that the patient was indeed just a run-of-the-mill underserved patient. It is very disturbing to see that hospital staff can become so desensitized to this kind of situation.
This is just my opinion on the matter.

Falsifying the records is another story. This has nothing to do with wealth per se but more with the odds of them getting caught. Wealthy families have more resources and would be more likely to find a cover-up, so doctors would be less likely to do so to the wealthy.

So explain how this has nothing to do with wealth? It seems to me that you pointed out why it has to do with the wealth level of the patient.

And contrary to your post, a discovery of major medical screwups usually does not get swept under the rug. In fact, they usually make national headlines. Much like this story, or the operation on the incorrect lung several days ago.

Usually when these kinds of things happen to the disenfranchised, little is said about it in the media. The media tends to publish stories that are relevant to the consumer. I think that you make a relevant point; this does seem to be part of a larger indictment of the medical profession. However, at any other time I do not think that this story would make national news.

 

[foster033]

I know of a specific incident where an upper-middle class man died of an MI in a ER waiting room about one year ago. So while there may not be a video, it can and has happened. There was no altering of records as fas as I know.

So he had a heart attack while waiting in the ER...that doesn't seem entirely unreasonable or particularly the fault of the ER staff.

When he collapsed in pain did they just look at him and let him lie on the floor dying or did they rush and try to save his life?

 

[Maxx4]

An hour passed by and no one came to her help? WTF?!

 

[parto123]

So explain how this has nothing to do with wealth? It seems to me that you pointed out why it has to do with the wealth level of the patient.

I thought my post was pretty self explanatory, but in case it wasn’t, here is an illustration. A poor person at a hospital is constantly being visited and checked up on by his large (in number) family. A doctor wouldn’t risk altering medical records with such patient, simply because he knows he can never get a away with it.

Usually when these kinds of things happen to the disenfranchised, little is said about it in the media. The media tends to publish stories that are relevant to the consumer. I think that you make a relevant point; this does seem to be part of a larger indictment of the medical profession. However, at any other time I do not think that this story would make national news

The story a few days ago with the mistaken lung was also a poor person. These stories pique people’s morbid curiosities, so they are very good for ratings, no matter who the victim is. In fact, a poor victim often makes for a more sensational story because the media and viewer can play the whole class warfare angle- kinda EXACTLY like what is going on in this thread.

 

[WinterLights]

I thought my post was pretty self explanatory, but in case it wasn’t, here is an illustration. A poor person at a hospital is constantly being visited and checked up on by his large (in number) family. A doctor wouldn’t risk altering medical records with such patient, simply because he knows he can never get a away with it.

The above is a tangent from your original statement.

The story a few days ago with the mistaken lung was also a poor person. These stories pique people’s morbid curiosities, so they are very good for ratings, no matter who the victim is. In fact, a poor victim often makes for a more sensational story because the media and viewer can play the whole class warfare angle- kinda EXACTLY like what is going on in this thread.

Perhaps these incidents are more common among the underserved and thus there are more stories to reference? I am not playing the class warfare angle, I am playing the "all patients should be treated equally" angle. If you can say, without a doubt in your mind, that this EXACT same situation could have happened to a wealthy patient, I will discontinue my argument.

 

[parto123]

The above is a tangent from your original statement.

Not at all, its an illustration of that statement.

Perhaps these incidents are more common among the underserved and thus there are more stories to reference? I am not playing the class warfare angle, I am playing the "all patients should be treated equally" angle. If you can say, without a doubt in your mind, that this EXACT same situation could have happened to a wealthy patient, I will discontinue my argument.

I cant say anything without a doubt, but then again I have nothing to prove. Youre the one making the accusation that this happened to the lady because she was poor, so the burdens on you. You may be right in this case, but tahts for you to prove to me.

And im not sure what you would consider playing the class warfare angle if the below doesn’t qualify:

I guess this is what happens when you are part of the "holy Underserved."

 

[WinterLights]

Not at all, its an illustration of that statement.





I cant say anything without a doubt, but then again I have nothing to prove. Youre the one making the accusation that this happened to the lady because she was poor, so the burdens on you. You may be right in this case, but tahts for you to prove to me.

And im not sure what you would consider playing the class warfare angle if the below doesn’t qualify:

I can say with absolute certainty that the staff would not have waited an hour to respond to a collapsed wealthy patient; nor would they have falsified documents to cover such an inadequate response up.

class warfare implies that I am advocating strife between classes, with the goal of achieving dominance for one of those classes. I am merely pointing out that this kind of thing should never happen, and that all people deserve the same basic respect in a medical setting. How hard is it to have a doctor check the patients vital signs? How difficult is it to make sure that the patient is not lying there dying? I have never heard of anything close to this ever happening in non-underserved hospitals. An hour lying there on the floor before anyone responds? Absolutely Ridiculous.

 

[parto123]

I can say with absolute certainty that the staff would not have waited an hour to respond to a collapsed wealthy patient; nor would they have falsified documents to cover such an inadequate response up.

The dichotomy youre setting up in your arguments between poor and wealthy is a bit disingenuous. At first you stated that this happened to her because she was poor. Now youre saying its because she wasn’t wealthy. Those are two completely different arguments. True, this wouldn’t have happened to oprah or bill gates.

class warfare implies that I am advocating strife between classes, with the goal of achieving dominance for one of those classes.

LOL. Yes, if we were sitting in a polsci 101 class you would be correct. However, in media and colloquially, class warfare refers to any tension between classes.

 

[goodlookinrebel]

This story really hit me. I have done a lot of work in the human services field, with the homeless and impoverished, and I know how easy it can be to become hardened and jaded and look at everything through the glass of suspicion. I understand the hospital staff when they look at her and walk away. It is easy to become that way when you work with that population day in and day out. But just because something is easy, doesn't mean that it is ok. It is easy to beat your kids and hit your spouse, it is easy to hate and become bitter, but it is hard to live a good life, to look at each person as an individual and to treat them with civility.

M. Scott Peck MD wrote a book about this, I forgot what it was called, but it was about how we as a culture are losing our basic sense of civility and concern for one another. No Country For Old Men, the book, was also about that. The basic premise being how we know that things are really falling apart at the seams when we no longer bother with the smaller points of civility, opening doors for people, saying good morning, and god bless you, offering a helping hand to those in need, being generally concerned for one another, and, in this case, not letting people die alone on the floors of our waiting rooms.

There seem to be a lot of jaded people on this forum, and I just want to say that it is not ok. I understand it, and I sympathize with you, but it is not ok, and it is not justifiable to remain in that mindset as a medical professional. If you despise the people that you serve, if you don't enjoy what you do, then do something else, either start working to be a better physician, or do something else. In other words: **** or get off the pot.

 

[LizzyM]

The CEO of the Hospital Corporation (which has 38,000 employees and annual revenue of $4.9 billion) where this occurred has written an excellent letter that could serve as a case eample of how to deal with a bad situation

http://newsblogs.chicagotribune.com/triage/2008/07/esmin-greens-de.html#more

 

[Maxwell Edison]

These kind of stories are astounding. In my mind, it's no wonder that public opinion has been slowly turning against medicine. Not, I emphasize, NOT because this actually constitutes a broad or general trend, but because the indifference captured in this little clip is so horribly chilling. This kind of news scares people into thinking that they will be a veritable Kitty Genovese in the clinic, and everyone suffers as a result.

 

[8744]

Why do you say that lady was "underserved?" She was getting free psychiatric care, something that my "overserved" health insurance does not provide.

Seems like she is adequatelyserved, and the fact that she was allowed to lay their for an hour is more a testament to the kind of crappy help the low wages that will become the norm in medicine will buy you.

 

[TheRealMD]

I don't think this is the first time this hospital has been in the news for this kind of stuff either.

 

[Lokhtar]

Why do you say that lady was "underserved?" She was getting free psychiatric care, something that my "overserved" health insurance does not provide.

Seems like she is adequatelyserved, and the fact that she was allowed to lay their for an hour is more a testament to the kind of crappy help the low wages that will become the norm in medicine will buy you.

That's just not true. This would cause a furore even in the socialized medicine states.

 

[8744]

The reality is that in my line of work, we dance around like puppets at the whims of the Holy Underserved.

 

[8744]

That's just not true. This would cause a furore even in the socialized medicine states.

Yeah, like when 15,000 French old people died in nursing homes during a heat wave because the staff were on vacation.

 

[8744]

That's just not true. This would cause a furore even in the socialized medicine states.

Was she, or was she not, being "served" free psychiatric care? In other words, it looks to me like she had great access to psychiatric services but just happened to have a heart attack. I betcha' she got free medical care too.

Underserved my ass.