On June 18, 49-year-old Esmin Green was admitted to the Kings County Hospital Center psychiatric ward. After waiting to be seen for 24 hours, she fell to the floor, began to convulse and then passed out. Two security guards and one doctor walked into the waiting room, looked at her and then walked away. After one hour, a nurse finally came over, kicked Ms. Green, and then proceeded to get a stretcher. Shortly afterwards, Ms. Green was pronounced dead. The entire incident was documented on a security camera, and is now on YouTube, thanks to the Associated Press.
Hospital officials said they fired three of the workers and suspended another three, the New York Times reported on July 7. However, it is clear that Ms. Greene’s death is far from an isolated incident at Kings County Hospital. The New York Civil Liberties Union, in conjunction with Mental Hygiene Legal Service and the law firm of Kirkland & Ellis LLP, filed suit against the New York City Health and Hospitals Corporation (the agency that runs Kings County Hospital) in May 2007. The plaintiffs claimed that patients at the hospital’s psychiatric facilities were subject to conditions of squalor and filth, as well as abuse by hospital employees. A summary of the case can be found on the NYCLU website.
The evidence displayed in the lawsuit shows that Ms. Green’s death is not solely the fault of the hospital employees who watched her die. The conditions in the hospital, particularly the psychiatric ward, and the treatment of the patients are the responsibility of the city agency that runs the hospital. It was not until over one year into the litigation, and after Ms. Green’s death, that the city finally agreed to adopt a series of basic stop-gap measures, including:
* That every patient be checked every 15 minutes.
- That there be no more than 25 patients at any time in the psychiatric emergency ward.
- That detailed records on the ward be turned over every week to the advocates involved in the lawsuit.
- And that the advocates be active participants in the search for a new deputy executive director and emergency room director for Kings County Hospital’s Behavioral Health department.
It is shocking that it took a lawsuit and the very public death of a woman to get New York City to agree to such basic levels of care for mental health patients. Donna Lieberman, executive director of the NYCLU, said:
What’s happening in Kings County Hospital is an affront to human dignity…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.
What is even more distressing about Ms. Green’s death and the allegations of gross negligence of patients at Kings County Hospital is that many residents in Central Brooklyn do not have access to other hospitals. This is mainly due to the fact that the predominantly black, low-income areas of Central Brooklyn, particularly the neighborhoods Bedford-Stuyvesant, Brownsville, Canarsie, Crown Heights, East New York, and Flatbush have seen numerous hospital closures in the last few years.
The Opportunity Agenda has documented these hospital closures on its website Health Care That Works. Since 1985, Central Brooklyn has seen five local hospitals close their doors. Because of these closures, people in these minority communities have been forced to rely on Kings County Hospital even more. Local residents also begged the city to keep local clinics open – their requests can be seen in a video on The Opportunity Agenda’s YouTube channel. At the same time all of these facilities were closing, allegations of mistreatment at Kings County were surfacing.
The fact that people of color have inferior access to health care in New York contributes greatly to the health disparities in the city. The Opportunity Agenda report Dangerous and Unlawful: Why Our Health Care System Is Failing New Yorkers and How to Fix It documents how areas with high concentrations of African Americans, Hispanics and Asian Americans are more likely to have shortages of primary care physicians than predominantly white communities are. The distribution of hospitals and other health care services has a significant discriminatory effect on these communities of color – their health care access is simply inadequate.
Ms. Green’s death should do more than signify the need for improvement of existing hospitals like Kings County. It should also remind us that many people in New York, and across the country, lack basic primary care and access to emergency services. Changing this reality needs to be a part of health care reform discussions. If it isn’t, we will continue to see needless deaths like Ms. Green’s occur.
