A New York City Department of Investigation (DOI) report released today documents the negligence of Kings County Hospital Center and several medical staff in the June 2008 death of Esmin Green on the hospital’s psychiatric emergency room floor. The report provides further evidence of the need for systemic reform to ensure that patients are treated humanely and professionally and to prevent similar tragedies.

“The DOI report is consistent with the complaint we filed in our lawsuit – that a culture of indifference pervades the psychiatric unit at KCHC,” said Donna Lieberman, executive director of the New York Civil Liberties Union. “Hospital administrators refused to acknowledge this until after Esmin Green’s tragic death. Changing this culture requires top-down, systemic reform.”

The neglectful and abusive conditions at KCHC drew national attention last July after the NYCLU, Mental Hygiene Legal Service, and Kirkland & Ellis released security camera footage of Ms. Green, a 49-year-old Brooklyn woman, dying on the waiting room floor of the hospital’s psychiatric emergency room last June.

The hospital is the subject of a lawsuit filed in May 2007 by the New York Civil Liberties Union, Mental Hygiene Legal Service, and Kirkland & Ellis LLP. The lawsuit describes the hospital’s psychiatric emergency room and inpatient unit as “a chamber of filth, decay, indifference and danger,” and seeks an end to abusive treatment in the hospital’s psychiatric facilities where patients are regularly ignored and those that dare advocate for themselves are punished with forcible injections of psychotropic drugs.

The NYCLU obtained the surveillance footage of Green’s death through the lawsuit.

The lawsuit triggered a U.S. Department of Justice investigation of the hospital’s psychiatric unit. The DOJ report, release in February, found conditions at the hospital “highly dangerous,” and said they require “immediate attention.” It concluded that the hospital regularly fails “to properly assess, diagnose, supervise, monitor and treat its mental health patients.”

The DOI report documents numerous failures on the part of staff in allowing Green to languish on the emergency room floor for hours without helping her. It also documents examples of staff members, including doctors, fabricating records to cover up the incident.

“We fully support efforts to hold individuals accountable for wrongdoing and neglect, but we have a far broader mission,” said Beth Haroules, NYCLU senior staff attorney and lead counsel in the lawsuit. “We are seeking fundamental change to the system at Kings County Hospital that was responsible for Esmin Green’s death. Thousands of New Yorkers rely on KCHC to provide crucial services, and the hospital has an obligation to meet that responsibility.”

While the NYCLU applauds many of the measures taken to improve conditions at the hospital’s psychiatric unit, including appointing new leadership, hiring new staff and upgrading the physical plant, the hospital still has a long way to go.