- The Washington Times - Tuesday, April 10, 2007

One patient was killed, another appeared starved to death and hundreds of assaults occurred amid worsening conditions at St. Elizabeths Hospital during the past year, according to a recently filed court document.

The 47-page document filed by the federally chartered watchdog group University Legal Services (ULS) cites dozens of depositions and thousands of pages of internal memos. Group officials also told a judge yesterday the city’s mental institution remains “unsafe, unsanitary and understaffed.”

The group filed the document in federal court in the District and wants an immediate court order mandating the city take steps to fix the troubled hospital.

There were 69 cases of staff assaults and 187 cases involving patient assaults reported in the first five months of the fiscal year, group attorneys wrote in the court documents.

“As a result of the hospital’s history of violence and under-staffing, most staff are afraid of the patients …,” they wrote.

D.C. officials declined to comment on the filing.

“The city is not going to address any of the characterizations made by ULS until it files its response in court,” Traci Hughes, a spokeswoman for the D.C. Office of the Attorney General, said yesterday.

Among the most serious finding by the group is that on Jan. 9 an unidentified hospital staff member “improperly restrained” one patient who later died of asphyxiation, with the D.C. medical examiner ruling the death a homicide, according to the group.

D.C. officials said after the incident the city’s mental health department was investigating. It’s not clear whether charges have been brought in the case.

In another case, the group says a patient “appears to have been starved to death.”

In addition, from September 2005 to October 2006, there were at least six fires at the hospital, documents state. In one fire, four patients “simply walked away from the hospital,” according to the filings.

One patient was returned by police but there was no record of what happened to the other three, according to documents obtained by the group.

Mary Nell Clark, attorney for the group, said members want the District to immediately hire more staff and to have a court-appointed expert monitor the hospital and report on progress to a judge.

She said the group is encouraged by the appointments of the city’s new mental health chief, Stephen T. Barron, in July, and of Patrick Canavan, as chief executive of St. Elizabeths, earlier this year.

“But it’s going to take a lot more than two people,” Miss Clark said. “It’s going to take the City Council, the mayor and the community.”

The group also wants monthly reports with a list of patients placed in restraints, unusual incidents and investigative reports, and names and contact information for patients who have died in the past year.

D.C. mental health officials in previous interviews and court filings have said conditions are improving.

In a D.C. Council hearing during the summer, Mr. Barron said the mental health department “will take whatever steps are necessary to address areas of concern.”

“No person or process that is relevant to patient safety and quality of care will be excluded from our review, including overall staffing,” he said.

The group concluded the problems were linked to staffing shortages, overcrowding and a lack of training. But the group also cited “staff ineffectiveness” and mistakes.

According to the filing, an ongoing Justice Department investigation has found “numerous instances of questionable staff competence and a lack of knowledge about the fundamentals of patient care.”

Founded in 1855, St. Elizabeths was the federal government’s first hospital for the mentally ill.

The hospital’s patient enrollment dropped from 7,000 in the 1940s to about 420 today, including would-be presidential assassin John W. Hinckley Jr. The District is building a new hospital expected to be complete by July 2009.

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