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Posted by on Jul 2, 2008 in Ethics, Health care, Neuropsychiatry

As She Lay Dying at G Building

As She Lay Dying at G Building


By now, pretty much everyone has seen the June 19 videotape of Esmin Green, 49, dying on the waiting room floor of Brooklyn’s Kings County psychiatric facility, aka G Building, while othersincluding security guardssaw the prostrate woman and did nothing. Until it was too late.

But reports of inhumane psychiatric care at Kings County Hospital (dubbed “Killer County” by online wags) are nothing new. A search of the NYT archives reveals that repeated and gross deficiencies in treatment existed there at least as far back as the 1960s. On a least 2 occasions, the facility lost its accreditation status, according to the paper. The remarkably dubious history of the public facility, culminating in Green’s death, suggests that blame could go as high up as possible, arguably to city hall.

Last year, the Mental Hygiene Legal Service (MHLS) and the NY Civil Liberties Union, on behalf of patients, filed suit against the NYC Health and Hospital Corporation (HHC) and others, alleging that the Kings County facility is a “chamber of filth, decay, indifference, and danger where individuals…are subjected to overcrowded and squalid conditions often accompanied by physical abuse and punitive injections of mind-altering drugs.” The plaintiffs cite lack of basic sanitation and laundry services, inadequate food, no wheelchair accessibility, vermin infestation, and neglect alternating with verbal or physical abuse from healthcare staff and security personnel.

The HHC, the largest city hospital and healthcare system in the United States, comprises more than a dozen hospitals, including Kings County, in the city’s 5 boroughs. The HHC Chairperson, Charlynn Goins, along with HHC President and CEO, Alan D. Aviles, are named defendants in the lawsuit. Goins and Aviles, both lawyers, were appointed to their positions by Mayor Bloomberg in 2004 and 2005, respectively. Yesterday, Aviles provided a written statement to news sources on the death of Green: “We are shocked and distressed by this situation. It is clear that some of our employees failed to act based on our compassionate standards of care.”

The suit also names the following defendants, at least 2 of whom are longstanding employees of Kings County:

  • Jean G. Leon, RN, Executive Director, Kings County Hospital: Leon, a native of Trinidad, has evidently held her position for at least 13 years (see 2005’s “10 years of inspired leadership“). A PR-type video on YouTube featuring Leon was posted April 2008.
  • Kathie T. Rones, MD, MPH, Medical Director, Kings County Hospital: Rones, a 1980 graduate of the Brown University School of Medicine and a board-certified internist, has held her position since 1996. She received a tribute for her services from the NY House of Representatives on April 3, 2006.
  • David K. Dailey, MD, Chief of Psychiatry, Kings County Hospital: According to the NY State Department of Health, Dailey is a 1981 graduate of the Loyola University Chicago, Stritch School of Medicine and has been licensed in the state since 1998.
  • Joseph A. Charlot, MD, Comprehensive Psychiatric Emergency Program, Kings County Hospital: Charlot received his medical degree in 1968 from the State University of Haiti and has had a NY medical license since 1979.
  • Ellen B. Tabor, MD, Medical Director, Adult Psychiatric Inpatient Services, Kings County Hospital: Tabor is a 1983 graduate of the Rush University School of Medicine in Chicago. She has held a NY medical license since 1990.
  • Jacqueline Purser, Captain, Hospital Police
  • Oswald David (or David Oswald), Assistant Director of Nursing/Product Line Manager, Comprehensive Psychiatric Emergency Program, Kings County Hospital
  • Elsa P. Bush, Associate Executive Director of Nursing, Kings County Hospital

According to today’s NYT, the hospital fired the director of psychiatry, the doctor on duty, and the director of security at Kings County on June 20, the day after Green died.  It is not clear if the “director of psychiatry” refers to Dailey, Charlot, Tabor, or someone else. According to Esmin Green’s medical records, provided by the NYCLU, a “Dr. Estes” was on duty at the time of her death. Two nurses and one security guard were also “suspended pending union-mandated hearings.”

The NY Daily News provides earlier coverage and more background on Esmin Green and Kings County:

June 27 “Shocking death on Kings County Hospital psych ward stirs reform call”

June 22 “Video shows staff ignored patient later found dead”

June 21 “Patient dies waiting for bed at Kings County Hospital”

June 21 “Video shows Brooklyn hospital staff ignore patient later found dead”

May 17 “US Attorney probes claims of patient abuse at Brooklyn psych ward”

In addition to a Federal investigation of civil rights violations at Kings County, the latest reports indicate that criminal charges are being considered in the case of Green’s death.

07/03/08 update: The NY Daily News reports that Pierre R. Arty, MD, the head of psychiatry at Kings County, was 1 of 6 people fired after Esmin Green’s death. The others included Kenneth Jones, the hospital’s director of security, and the 2 security guards (not 1, as previously reported) seen in the waiting-room videotape.

bmartin (1127 Posts)

A native East Tennessean, Barbara Martin is a formerly practicing, board-certified neurologist who received her BS (psychology, summa cum laude) and MD from Duke University before completing her postgraduate training (internship, residency, fellowship) at the Hospital of the University of Pennsylvania in Philadelphia. She has worked in academia, private practice, medical publishing, drug market research, and continuing medical education (CME). For the last 3 years, she has worked in a freelance capacity as a medical writer, analyst, and consultant. Follow Dr. Barbara Martin on and Twitter.