- The Washington Times - Thursday, March 24, 2005

Staffing and management failures at St. Elizabeths Hospital in Southeast have led to the deaths of several patients and overcrowded and unsanitary living conditions for others, according to a group appointed to oversee the city-run facility.

University Legal Services Inc., a federally designated protection agency that advocates for people with disabilities in the District, on Monday filed a federal lawsuit against the District, depicting widespread problems at the psychiatric hospital.

“Patients routinely complain that staff treat them like babies or, worse yet, animals,” the complaint filed in U.S. District Court reads.

An attorney for University Legal Services said yesterday the complaint was filed because D.C. officials have failed to fix the problems and have refused to turn over death and incident reports, daily census data and other information the group needs to monitor the hospital at 2700 Martin Luther King Jr. Avenue SE.

“We have 24-hour, seven-day access to the hospital, so we spend a lot of time there and we’ve been disturbed for quite a while,” attorney Mary Nell Clark said.

Officials at the D.C. Department of Mental Health declined to comment on the lawsuit yesterday and referred questions to the D.C. Office of the Attorney General.

Traci Hughes, a spokeswoman for D.C. Attorney General Robert J. Spagnoletti, said yesterday city attorneys are reviewing the complaint. “It’s still very much in the preliminary stages of litigation,” she said.

The lawsuit seeks a federal injunction requiring “safe and habitable conditions of care” at the hospital.

According to the group, failing conditions at the approximately 460-patient psychiatric hospital have contributed to several deaths there since 2003.

In April 2004, one patient stomped on another patient’s head and face while a nurse was unable to stop the attack, according to the group’s complaint. The victim suffered internal bleeding and fell into a coma, the complaint reads.

That same month, an elderly female patient attacked and killed another female patient in an unsupervised section of the hospital ward, the group said in the complaint.

In February 2003, the group said, St. Elizabeths discontinued physical therapy for one patient despite a doctor’s order to continue the treatment. The patient later died from pulmonary embolism, most likely as a result of blood clots from a lack of physical activity, the complaint indicates.

The group said another patient died under similar circumstances last spring.

Other patients have been kept in restraints or isolation for weeks at a time, the complaint reads. Hospital staff “inappropriately rely on physical restraints” and chemicals to control patients, the group said in its complaint.

St. Elizabeths also has severe infrastructure problems, according to the group.

Rats and mice are common, furniture is infested with bugs and elevators frequently break down during use, the complaint reads.

The hospital has failing heat and cooling systems, and a recent sewer-pipe problem was described in the complaint as “overwhelming both patients and staff with the smell of human waste.”

Staffing levels also are of concern. A lack of nurses and aides has resulted in “unsafe and inadequate conditions of care for patients” and severely overworked employees, the group said.

“Consequently, the staff are exhausted, sometimes even falling asleep while on duty,” the complaint reads.

The issue of staffing levels at St. Elizabeths came up during a recent D.C. Council Committee on Health hearing.

“Without more nurses, the delivery of care to consumers will be hindered and the likelihood of patient death will increase,” said Edward J. Smith, an attorney for the D.C. Nurses Association, who testified at the March 9 hearing.

The group’s complaint comes as the District is working on plans to build a new hospital to replace St. Elizabeths.

Earlier this month, city officials moved ahead on the first of eight contracts to build a new hospital. Forney Enterprises Inc. won a $2.3 million contract for the construction of early road and utilities work.

Martha B. Knisley, director of the D.C. Department of Mental Health, acknowledged during the March 9 hearing that the aging facility has posed difficulties.

She said her department is “working closely with St. Elizabeths to assure the hospital continues to make performance improvements in the face of the challenges presented by the physical plant.”

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