Dying for care: Video captures emergency room death

By Ashahed M. Muhammad
Assistant Editor | Last updated: Jul 15, 2008 - 3:03:00 PM

Video: Dying for care (Web Video)

Esmin Green
Photo courtesy, stlouisjohn.blogspot.com

(FinalCall.com) - Horrifying images of the death of 49-year-old Esmin Green, a Brooklyn woman who waited almost 24-hours to be seen at a New York City public hospital and died on the waiting room floor as hospital staff seemingly ignored her, have prompted calls for immediate reform.

Funeral services were held July 6 for the Jamaican national who was to be buried in her home country.

Surveillance video from the Kings County Hospital Center showed Ms. Green falling out of her chair in the waiting room at 5:32 a.m. June 19. Sprawled out face first on the floor, she looks as if she is struggling to get up, then lays lifeless on the floor. Ms. Green had been in the emergency room for almost 24 hours waiting for assistance after being taken to the hospital suffering from agitation and psychosis.

“But for the medical record being altered and but for surveillance tapes, I think this place would have gotten away with her death,” said Beth Haroules, senior staff attorney for the New York Civil Liberties Union, which made the incident public and is engaged in an ongoing legal battle with the hospital over substandard care.

This combination of 6 still photos taken from a video provided by the New York Civil Liberties Union shows the progression of events in the early morning hours of Thursday, June 19, in the psychiatric ward of the Kings County Hospital in Brooklyn, N.Y., Esmin Green, 49, had been waiting in the emergency room for nearly 24 hours when she toppled from her chair at 5:32 a.m. and lay writhing, face down on the floor. She was dead by 6:35 a.m., when someone on the medical staff after being flagged down by a person in the waiting room, finally approached, nudged Ms. Green with her foot, and gently prodded her shoulder, as if to try to wake her. Photo: AP Photo/New York Civil Liberties Union

Atty. Haroules said there is a “dearth of culturally appropriate” psychiatric health services and resources offered specifically in Kings County that may reflect dwindling resources in areas where the poor go for health care and a callous staff attitude.

“They (hospital staff) don’t seem to see the people walking through the doors as human beings,” said Atty. Haroules. “It’s a sign of what goes on a day to day basis.”

The lawsuit against King’s County Hospital was filed in May 2007 described the facility as “a chamber of filth, decay, indifference and danger.”

The family of Ms. Green is contemplating legal action in the case and criminal prosecution—which is up to the attorney general—could be possible. Autopsy results were pending at Final Call press time.

“What’s happening in Kings County Hospital is an affront to human dignity,” said Donna Lieberman, executive director of the New York Civil Liberties Union. “In 2008 in New York City, nobody should be subjected to this kind of treatment. It should not take the death of a patient to get the city to make changes that everyone knows are long overdue.”

According to the NYCLU, after falling out of her chair at 5:32 a.m., Ms. Green “writhed on the floor” and then finally stopped moving at 6:07 a.m. The surveillance video shows a hospital security guard walk over to the doorway, glance at Ms. Green while she lay unconscious on the floor, and then walk away without any intervention. Later, a different security guard—who does not even bother to get up from his chair—rolls over to the doorway, looks for a moment, and then goes about his business, again without any intervention or calls for medical assistance.

Finally, at 6:35 a.m., almost an hour after Ms. Green initially collapsed, a hospital employee “nudges the body with her foot.” Finding Ms. Green unresponsive, but still failing to conduct a medical examination or assessment, the nurse left and summoned another nurse who then examined Ms. Green prompting medical intervention. Ms. Green was already dead.

Authorities are looking into a possible cover-up by hospital staff in documenting the case. According to medical records, a nurse who entered information reported that at 6 a.m., Ms. Green got up and walked to the bathroom and at 6:20 a.m, she was “sitting quietly in the waiting room.” The video surveillance footage contradicted that claim showing that Ms. Green had collapsed 48 minutes earlier.

In a statement, Alan D. Aviles, president of Health and Hospitals Corp., the company responsible for staffing, said, “Anyone who views the tape excerpts will be appalled by the lack of compassion and professionalism exhibited” by those who failed to assist Ms. Green. The company fired or suspended seven employees, including the director of psychiatry, an on-duty physician, a nurse suspected of falsifying the chart and two security guards. New procedures will limit the amount of patients spend in the waiting room and staff will check on patients every 15 minutes, the company said.

The Justice Department is also investigating the death.

Related links:

FCN Editorial - Health care for all! (FCN, 07-05-2007)

The connection between wealth and health (FCN, 06-06-2006)

Family sues New York hospital over death of Jamaican (Jamaica Gleaner, 07-09-2008)

Esmin Green: a 'Beautiful Person' (CNN, 07-03-2008)

The Final Call