Connecting Singles^® Forums100% Free Online Dating

Esmin Green's death: the hospital chief responds
Many readers are outraged by the tragic case of Esmin Green, who died in June on the floor of a Brooklyn hospital after collapsing on the ground and being ignored by staff for nearly an hour.

For those of you following the story, here's a copy of the memo that went out yesterday from the president of New York City's Health and Hospitals Corporation. That organization runs Kings County Hospital, where the incident occurred.

Subject: Death in Kings County Hospital Center Psychiatric Emergecy
Room

1 July 2008

A Message from
HHC President Alan D. Aviles

To All HHC Staff:

On June 19th, a 49-year old patient died in the waiting area of the Kings County Hospital Center Comprehensive Psychiatric Emergency Program (CPEP). She was found face down on the floor and unresponsive at about 6:30 a.m. Efforts to resuscitate her were unsuccessful.

A surveillance tape of the waiting area revealed that she had tumbled out of her chair onto the floor a full hour earlier. She lay there, her head under a waiting room chair. During that one-hour period, two
of the hospital's security officers and an attending psychiatrist saw her on the floor. None of these individuals went to her aid or examined her condition. A nurse entered the waiting area after the
patient had been on the floor for nearly an hour, approached the patient and nudged the patient's leg with her foot, as if she thought the patient might be asleep. When the patient did not respond, that
nurse failed to examine the patient and left the area to summon another nurse. The second nurse examined the patient and ultimately called a team to attempt resuscitation.

To make matters worse, the second nurse falsely documented in the medical chart that she had checked on the patient within the previous 30 minutes and that the patient was ambulating and apparently fine.
The surveillance tape demonstrates otherwise.

After reviewing the surveillance tape, we notified the State Health Department, the Office of Mental Health, law enforcement authorities and other regulatory agencies about the incident and supplied them
with a copy of the tape, as well as the patient's medical records.

(Cont'd).....

We took immediate disciplinary action, including termination, against the staff who failed to go to the patient's aid, the nurse who falsified the chart, and certain senior managers. We issued a public
statement at the time, describing the incident and the disciplinary actions taken.

As required by law, we also turned the surveillance tape over to the plaintiffs who filed a lawsuit against Kings County Hospital Center last year alleging substandard care in its psychiatric emergency department and its psychiatric inpatient units. Yesterday, the plaintiffs released the surveillance tape to WNBC-TV, which broadcast it repeatedly during its local evening news and national morning program. News stories also appeared in major daily newspapers today.

Portions of the surveillance tape also were posted by WNBC to its Web site - www.wnbc.com. Anyone who views the tape excerpts will be appalled by the lack of compassion and professionalism exhibited by
the five staff members directly involved.

I bring this to the attention of all staff not just because it is an incident that will receive intense public scrutiny, but because it is a shameful event - contrary to everything that we stand for -- that we
must acknowledge and confront together. How is it possible that five members of the HHC family could fail a patient in our care so completely and so callously?

I do not have the answer, but I do know that we are going to muster every resource at our disposal to ensure that something like this never ever happens again. We have agreed to place ourselves
voluntarily under a court order that requires close monitoring of all patients in the Kings County CPEP, with a clinician dedicated to checking on each waiting patient once every fifteen minutes. We also
have agreed to use our best efforts to minimize the time that patients wait in the CPEP for release, admission or placement. I have appointed Dr. Ann Sullivan, the Senior Vice President for our Queens Health Network and a well-respected psychiatric administrator, as an interim administrator to work closely with Jean Leon to take any and all steps necessary and feasible to ensure timely and responsive emergency and inpatient psychiatric care at Kings County.

I know that HHC shoulders the heavy and difficult responsibility of providing nearly 40% of the emergency and inpatient services in our City, predominately to the most seriously mentally ill patients. I
know that what occurred on June 19th does not reflect the quality of care rendered at Kings County generally or across the other facilities that comprise HHC. I know that the vast majority of staff care deeply for our patients. I know that many staff perform superbly and at times heroically every day throughout our system and that many lives aresaved as a result of their hard work and dedication. And I know that one aberrant tragedy does not negate the world of good performed by HHC staff all year long.

However, none of that can alter the brutal and shocking reality of what happened on June 19th, the sorrow and shame that it evokes, and the necessity to ensure that it never happens again.





I can't imagine the coldness and sheer amount of callousness that it would have to take for this to happen...I wonder if it had anything to do with the fact that this was a psychiatric patient....almost like they don't deserve the same care as other people?????????

Sometimes psychiatric patients do something like that - because they are psychiatric patients.

I once had to extract a blood sample from a guy who thought he was a tree. If I hadn't been told I would have assumed he was asleep. He even got up and said, "swoosh" like leaves in an imaginary wind.
Psychiatric patients are to be expected to do things like that. It’s very common for them to lay themselves on floors, tables etc., because lying down can feel more safe because you are less exposed.
Normally people who lie on the floor either sleep, are drunk, sick or dead – so assuming a person is in normal mental health you would always respond to behavior like that.
But psychiatric patients are not like all other people so the reasons for them to behave the way they do, are almost limitless and add a number of extra possibilities.


This does not excuse how something like this could happen. They should have stopped and at least asked the patient what he or she was doing on the floor and when not getting any response they should have reacted.

But it does explain something. It explains how it does not necessarily mean that the staff is cold hearted or right out idiots, but perhaps too stressed out, too over-worked and overloaded - so they see the person on the floor, thinks "Christ, what's she up to now? I really don't have the time, I have a violent patient in room 4 who needs counselling!" and decides that "that has got to be someone else's problem".

The problem is when every staff member thinks that.

Unfortunately, nurses and doctors and social workers are people too. They are not perfect creatures or robots, so they can make mistakes like everybody else. The consequences of these mistakes are of course more dire than when a staff member of Wal-Mart fucks up, which is also why it’s so damn important to listen to these people when they complaint about too small economic funds, too few beds, too few doctors and nurses, and too much work on their hands.

I for one could never work at a psychiatric ward in the US. As a doctor you WILL fail there, because there is nothing you really can do about anything. The situation is so desperate I believe that WHO should be involved.
The American psychiatric system is a shame to all American citizens.

I agree nurses and doctors are people too...but this was in a waiting room of hospital and I find it inexcusable that a person....any person could lay there for an hour and have 5 people not even check on them and then die....Just because psychiatric patients are expected to act a certain way....doesn't mean that they don't deserve the same level of care as anyone else....perhaps it's those expectations that led to the death of this poor person...being seen as a simple psychiatric patient...rather than just a patient and a person!!!!!!!!!!

quote=Hugz_n_Kissez]I agree nurses and doctors are people too...but this was in a waiting room of hospital and I find it inexcusable that a person....any person could lay there for an hour and have 5 people not even check on them and then die....Just because psychiatric patients are expected to act a certain way....doesn't mean that they don't deserve the same level of care as anyone else....perhaps it's those expectations that led to the death of this poor person...being seen as a simple psychiatric patient...rather than just a patient and a person!!!!!!!!!![/quote]

It was a waiting room in the psychiatric ward.

We don't know whether or not the staff knew the patient. Some patients live by themselves and do great, but still come in every so often to get check-up's et cetera. Some just come in because they feel safe and have nowhere else to go. Some even have sleepovers in the waiting room because the psychiatric ward is one of the few places they can really relax.


I agree that something like that should NOT have happened. It's a disgrace and a lesson to us all.

But I don't think it's proper to ONLY blame the staff or call them cold.

We don't know these very important facts:

- Did the lady have a medical record?
- Was the staff familiar with this?
- Was she a 'regular' within the hospital?

- How many patients came into the psych. hospitals that night?
- How much staff was on duty? Did they have enough personnel?
- How demanding in care were the patients that came in?

- The doctors and social workers who passed by without reacting - where they called to a specific scene? If they were reacting to an emergency call it might explain why they didn't feel like they had the time to react
- The nurse who had to get another nurse to check the woman: How experienced was she? Inexperienced staff will usually call for back up in case they don't feel sure about what to do - and they are usually asked to do this, because there is not enough resources for them to call in emergencies when there is none so better double check with more experienced staff members.

Etc. etc.



But again: It should not have happened. It's very tragic.

It was a waiting room in the psychiatric ward.

We don't know whether or not the staff knew the patient. Some patients live by themselves and do great, but still come in every so often to get check-up's et cetera. Some just come in because they feel safe and have nowhere else to go. Some even have sleepovers in the waiting room because the psychiatric ward is one of the few places they can really relax.I agree that something like that should NOT have happened. It's a disgrace and a lesson to us all.

But I don't think it's proper to ONLY blame the staff or call them cold.

We don't know these very important facts:

- Did the lady have a medical record?
- Was the staff familiar with this?
- Was she a 'regular' within the hospital?

- How many patients came into the psych. hospitals that night?
- How much staff was on duty? Did they have enough personnel?
- How demanding in care were the patients that came in?

- The doctors and social workers who passed by without reacting - where they called to a specific scene? If they were reacting to an emergency call it might explain why they didn't feel like they had the time to react
- The nurse who had to get another nurse to check the woman: How experienced was she? Inexperienced staff will usually call for back up in case they don't feel sure about what to do - and they are usually asked to do this, because there is not enough resources for them to call in emergencies when there is none so better double check with more experienced staff members.

Etc. etc.
But again: It should not have happened. It's very tragic.[/quote]


The reason I call them cold is because on the video surveillance tape....these people either saw...walked by or kicked the patient to see if she would stir....she fell off her chair...did not lay down of her own accord..yet not one person checked her....It would have taken all of 2 seconds and this went on for an hour...the fact people saw her....and yet didn't even bother to ask what was wrong...yes to me is cold and callous...it would be for anyone...but nurses and doctors are there to care for people and have an oath to uphold...without preconceived notions!!!!!!!!!

No they weren't called....the evidence is all on tape...and nobody should have to be called to take a minute and say..."are you alright"!!!!!!!!!!!

just saw it on the late evening news...

how sad that's was when there must been a good few people around her...

even a police officer sitting only a few feet away from here and all he could do was sit there and watch .....

he did even just check too c if she was ok....

very very sad indeed

Yeah it really goes to the question of humanity itself....Have we all become cold and callous when we can't take 2 minutes out to ask if someone is ok and needs help??????????


I saw another case where a man was hit by a car and people just left him to lay there in the street thinking he was a homeless person...because he was in a part of town where there are a lot of homeless people...and not one person went to help him...he layed there until the police got there....so yeah...where is our humaneness today?????????


Turns out he was a store owner...known and loved by all in the city....to me it should have made no difference!!!!!!!!

just goes too show how small mined we have become.....

when u can take a few seconds out too help some one....

where's the humanity gone...

[quote=Hugz_n_Kissez] I can't imagine the coldness and sheer amount of callousness that it would have to take for this to happen...I wonder if it had anything to do with the fact that this was a psychiatric patient....almost like they don't deserve the same care as other people?????????[/quote]

Considering it was in NY, I can imagine it. I have heard of instances where people either don't give damn or just don't want to get involved.

[quote=PeachesandRay]


Yes and that's the sad part about what that says about us as a society today....


When fellow human beings mean nothing to us anymore...there's something very wrong!!!!!!!!!

the ironic part of it was the hole thing was caught on a security camera



so no one could even lie that there was nothing they could do......

and the police office was the worst cause he has too be the leader in that hole situation and take charge and at least tell the hospital staff.....

maybe he did and the staff did nothing who knows

but still people have been suspended from there jobs and some have been sacked... cause i think they tried too cover it up in some way but where found out

Yes if there were no camera...I'm sure the cover-up would have been imminent with every excuse in the book....there was one nurse who tried to say she checked on her 30 minutes before and she was fine...yet the tape showed differently...and yes the police officer is in a role of trust and to serve and protect...no matter what the situation...he is just as guilty as the rest if he in fact did nothing!!!!!!!!

I mean are we that selfish that ourt precious time means more than a human life these days??????

I AGREE WITH YOU, THIS STUFF HAS TO STOP AND DOCTORS AND NURSES AND HOSPITAL STAFF HAVE BE HELD ACCOUNTABLE

that would seem to be the case unfortunately people just don't care...

sad fact of life these days

you are sooooooo right but i try to have faith that there are some decent people left in this world

me too darlynda

I remember hearing about this when it was first in the news ...... totally shocking, but not surprising considering some of my own experiences in hospitals. Staff walk around like zombies (or at least it seems like that) - so is it a matter of being overworked, understaffed or just to the point of not giving a damn anymore?

regardless of whether or not she was a psychiatric patient or not, they should have at the very least checked on her....this is so very sad and inexcusable