The Caribbean Guyana Institute for Democracy (CGID) has expressed outrage at the death of a Caribbean woman at Brooklyn's largest hospital and trauma center - Kings County Hospital Medical Center (KCHMC), and has joined the call for a thorough investigation and for those culpable to be held to account.   

KCHMC is part of New York City's public hospitals network and is managed by the City's Health and Hospitals Corporation (CCH). 

On June 19, 2008 49-year old Esmin Green, a Jamaican immigrant,  collapsed and died in the waiting room of the Hospital's Comprehensive Psychiatric Emergency Program (CPEP). She had been admitted one day prior but had been waiting for room placement for over twenty-four hours.

CGID President, Rickford Burke, yesterday expressed sincere condolences to Green's family as well as his indignation over the incident. He said the Institute supports the administrative review and criminal investigation and will await the findings before arriving at any further conclusion. "This shocking and apparently criminally negligent episode by specific individuals, notwithstanding, Kings County Hospital Center is an excellent facility, with some of the best resources. There is currently a 500 million dollar rehabilitation project there, in its penultimate phase, which has resulted in a drastic improvement in the quality of care and service to this community," Burke said.

"It is therefore prudent that as we rightly condemn the mistreatment of Ms. Green, by a small number of staff whose conduct defy basic human decency, as well as the breakdown of professional protocols, we not ignore the reality that Kings County Hospital has been invaluable to the people our community, especially the indigent and disadvantaged. It is one of the only institutions in this community whose work has led to a significant reduction in heath care disparities in Brooklyn. I can only imagine that its management is just as outraged as the community; wants a fair and thorough investigation and justice for this victim and her family, and will do everything possible to ensure there are appropriate protocols in place to, not only bar the mistreatment of patients, but that service is par excellence," Burke asserted.

Video surveillance tape show a slumping Green sitting in a waiting room chair for hours, then falling face down on the floor. Her head trapped between the legs of another chair, she remained in this position on the floor for over one hour, incapacitated and unattended. During this time she appeared to have had at least two convulsions. (See video clip here: http://www.youtube.com/watch?v=FOCpOZ4txvs.

Surveillance tape show that at least three other patients as well as hospital staff; including a security guard, witnessed Green fall and failed to render any form of assistance or to alert medical personnel. Another security guard subsequently wheeled into the waiting room, on a desk chair, looked at the patient and then nonchalantly rolled away uncaringly. Sometime later, a medical doctor - a psychiatrist, arrived and saw Green on the floor but callously turned way as well.  

The tape then shows a nurse entering the waiting room and having observed Green on the floor, pushed her slightly with her foot. Green remained unresponsive and although the nurse failed to examine her vital signs, she rushed of and returned with medical equipment and another nurse who then attempted to resuscitate Green. However, this was too late – Ms. Green was already dead. The nurses then falsified the patient's medical chart; reporting that she was checked thirty minutes prior to them attending to her, and was found to be "ambulating" (moving around) and doing well.

Six hospital staffers, including the security guards, the nurse and a doctor have been terminated amidst a criminal investigation.

The American Civil Liberties Union has filed a lawsuit against Kings County Hospital on behalf of the family.

Commenting further on KCHMC, Burke added that it is arguably the best equipped and best staffed trauma center we have and that CEO, Jean Leon, is a consummate professional who demands the highest possible care and standards. "She and her staff have worked, since her appointment over a decade ago, to transform this facility into an entity which has been exceptionally responsive to the health care and needs of our community. So, I am anxious to see the investigative findings of this horrific breakdown in professional care and protocol," the CGID President contended.

He stressed that the community "cannot allow the unacceptable and inhumane treatment of Ms. Green, by some callous individuals who should have never been within the employ of an emergency department, to tarnish the reputation of an otherwise excellent facility with excellent providers. If we do so it will be a deficit to the community," Burke posited.

He said that the vast majority of the staff are caring professionals whose desire is to go to work daily to serve the community with the highest degree of professionalism, and that they do so with public note and respect. "Like many Brooklynites, I have on numerous occasions visited this Hospital. I share the view that there are many areas for improvements. It appears that what happened to Ms. Green is an unacceptable insolated incident that must never happen again. 

He noted that the 500 million redevelopment project, when completed, will have a tremendous impact on health care delivery in Brooklyn. Burke who has been in consultation with elected officials also acknowledged that the facility has already instituted policies to prevent a reoccurrence; including close monitoring of all patients at the hospital's psychiatric department; clinicians' monitoring of each waiting room patient once every fifteen minutes, improved training and the minimization of patients wait time.  

He said he was also advised by an elected official that Dr. Ann Sullivan, a psychiatric administrator and Senior Vice President at HHC's Queens Health Network, will function as the interim Aministrator of the psychiatric department and will work closely with Leon to review and improve psychiatric care.

However, Burke observes that CGID has serious questions about accountability at the very top of HHC. "I intend to ask our City government representatives and our elected officials, including Mayor Michael Bloomberg, to not scapegoat anyone in this investigative process," he said.

The Institute's head said he would like to know from HHC President, Alan Aviles, what reform measures and policy changes he implemented to improve the delivery of psychiatric care within the HHC system, since the ACLU filed a lawsuit against HHC on this issue over a year ago."

CGID is questioning to whom the management of the Kings County Hospital Psychiatric unit reports. "It seems as though they report directly to HHC and not to KCHMC management. If this is the management structure in place, then HHC as well as the administrative and psychiatric supervisors on duty at the unit at the time must also be held to account. I have spoken to some of our elected officials about this," Burke observed.   

He said that he would not be surprised if the investigation led to criminal indictments of some of hospital personnel who may have demonstrated negligent conduct towards Mr. Green which could have been a factor in her death.  

The investigation is ongoing and the medical examiner is yet to release the cause of Ms. Green's death.

HHC has reportedly offered to pay the cost of Green's funeral in New York as well as to defray expenses for her burial in Jamaica.