Kings County Hospital to be Monitored by Federal Judge

January 11, 2010 at 11:38 am

You offered them as martyrs but that was not your right
God’s instruments of change sometimes walk beneath our sight

Ballydowse — Open the Record

A year and a half after Esmin Green died on Kings County Hospital’s waiting room floor as a direct result of staff negligence, a settlement has been agreed upon which will allow a federal judge to monitor Kings County Hospital. Esmin’s death may have been a turning point but Kings County’s psychiatric ward had already been called a “chamber of filth, decay, indifference and danger” in legal filings which were under way well before Esmin’s involuntary commitment and death. That lawsuit was filed by Mental Hygiene Legal Service, the New York Civil Liberties Union and the law firm Kirkland & Ellis. Unfortunately, it takes more than a lawsuit for most Americans to take notice so we had to actually watch someone die before turning the spotlight onto Kings County.

From the NY Times:

In a 45-minute conference call on Thursday with Judge Kiyo A. Matsumoto of Federal District Court in Brooklyn, lawyers for the city, the federal government and the patients confirmed that they had agreed on a consent decree that would require changes at the hospital and a timeline for enacting them. The conference call was broadcast in the courtroom.

The judge indicated that she was prepared to sign the agreement, even as she expressed some reservations, saying that some parts seemed “vague” and “ill defined.”

Hopefully with this agreement, we can expect some real, immediate and measurable changes. People only seem to act when someone is watching. Still, I’m not exactly encouraged by parts of the agreement being “vague” and “ill defined.” In light of the fact that KCHC staff failed to adhere to existing policy and even falsified reports, I question their willingness and ability to truthfully and effectively report to an outside overseeing body.

Judge Matsumoto could modify the agreement before signing it, lawyers said, and indeed, during the conference call on Thursday, the judge expressed concerns about what she saw as somewhat flabby language.

She noted that the settlement called for the hospital to meet “generally accepted standards” for psychiatric diagnoses, a goal that seemed to underwhelm the judge, who said it was “obvious.”

Judge Matsumoto criticized another section that called for mental health treatment plans to be assessed and revised “when appropriate.”

“O.K.,” the judge said tartly. “How do we decide?”

She pushed the parties to submit progress reports to the court sooner and more frequently than they had envisioned.

Judge Matsumoto would function as the enforcement agent for the decree and would have the power to hold the city in contempt or impose other penalties if the decree’s provisions were violated.

Hopefully Judge Matsumoto can cut through that flab and get to the heart of the matter, making the necessary changes before signing the agreement. When systemic neglect and abuse is allowed to continue and worsen for years, only to be exposed by death on tape, we should be demanding more than vague talk about “accepted standards.” Fortunately,  Judge Matsumoto seems to be of the mind to see it through. I sincerely hope she does. I’m glad to see she’s pushing for more timely and more frequent progress reports but how gradually are we willing to allow things to change and again, how much can we trust the integrity of those reports? These are matters that need to be addressed.

In the end, it shouldn’t take paperwork, compliance and transparency policies and administrative oversight to motivate people in the field of “care” to act as though they care. If you need a court order to tell you to pick someone up when they’ve fallen face first onto cold, dirty tile, then you are not only ill qualified to work in a hospital setting but to call yourself human. We can make all the clerical and administrative changes in the world to enact outward change but we will never be able to legislate decency, respect and dignity.

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