Justinian Lane

Another angle on Esmin Green’s death in the E.R. Waiting room

Last month, Kia blogged about the outrageous death of Esmin Green, who died in an E.R. waiting room.  Hat tip to Concurring Opinions for their coverage of this Slate article:

The surveillance video of Green collapsing and lying untended, as hospital staff at Kings County fail to respond to her collapse, is inexcusable by any stretch. And so Nancy Grace, for one, focused on the negligence. But what's largely missing from this story is the likely cause of Green's pulmonary embolism. The answer lies in a far more systematic and widespread danger in hospital care: E.R. waits. Why was Green sitting and waiting while blood pooled in her legs? Despite increasing evidence that crowded E.R.s can be hazardous to your health, hospitals have incentives to keep their E.R. patients waiting. As a result, there has been an explosion in E.R. wait times over the past few years, even for those who are the sickest.


In effect, then, E.R. boarding allows hospitals to insulate themselves from the burgeoning needs of the poor. E.R.s are safety nets: By law, we who work in them see any and all patients, regardless of their ability to pay. But as more E.R. beds are devoted to boarders, the E.R. has less space for new patients, which keeps a lid on the number of un- and underinsured. So unless you are having a heart attack and can jump the line, your emergency—though it may still be serious—may wait for so long that you give up and go home. Bad for you, good for the hospital's bottom line. E.R. boarding also tamps down nursing costs, again not to your benefit. Hospitals generally maintain strict patient-to-nurse ratios for inpatients. But many hospitals don't apply the same rules to the E.R. because they can't control the number of patients who come in that way. Sometimes the nursing ratio in the E.R. can be as high as 8-to-1. That's unacceptable in inpatient units, but just stack 'em in the E.R. hallways and suddenly it's OK.

Source: How hospitals are killing E.R. patients. - By Zachary F. Meisel and Jesse M. Pines - Slate Magazine

Once again, people are dying to protect profits.  What's it going to take to fix the situation?  I've always said that any one of our flawed governmental systems would be fixed virtually overnight if it killed one of the Bush twins, as opposed to another "expendable" poor minority.  Here's some evidence that I'm right:

In England, the National Health System now has a rule that 98 percent of patients have to spend less than four hours in the E.R.. Apparently, the son of a member of parliament spent too long in an E.R., we've heard. Esmin Green wasn't well-connected. But her death should serve as a similar prompt to fix the problem of endless waiting. (Emphasis added.)

Source: How hospitals are killing E.R. patients. - By Zachary F. Meisel and Jesse M. Pines - Slate Magazine

Maybe I'm wrong and we'll fix the healthcare system before it kills the son or daughter of a prominent politician.  I hope so.

Justinian Lane: Author Bio | Other Posts
Posted at 3:18 PM, Jul 24, 2008 in Health Care
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Kings County Hospital does not have profits to protect. It's a county hospital.

The waiting times in the ER are short when it is a real emergency but you will wait when it is not. This is called the acutity factor and is run by the letters. A, B, C, that is to say, airway, breathing and circulation. This is called triage.

Posted by: throckmorton | July 24, 2008 5:27 PM

Of course the tune would change if this were one of the Bush daughters. So, anytime you go to the emergency room, say you think your having a heart attack, even if your standing there bleeding to death...they might just take you seriously.

Posted by: Ajlouny | October 18, 2008 8:41 PM



Contact/Interviews: Lauren Tenney, Psychiatric Survivor
phone: (516) 319-4295

Who: Esmin Green who was murdered-by-neglect at the Kings County Hospital Center Psychiatric Emergency Room, All People.
What: Demonstrations, Speak Outs and Candle Light Vigil to mark 2 years since the murder-by-neglect of Ms. Esmin Elizabeth Green, mourn her loss, and condemn continued human rights violations by organized psychiatry.

Why: WE THE PEOPLE call to shut down Kings County Hospital Center's psychiatric services; for an end of abuse, torture, and neglect in the wake of Ms. Green's death on June 19, 2008, while detained at Kings County Hospital Center's Psychiatric Emergency Room; and to call attention to human rights violations committed since then.

Where: Kings County Hospital Center, Psychiatric Emergency Room, Building R. 410 Winthrop Street Brooklyn, NY 11203

Date: June 18, 2010 5 PM - June 19, 2010, 5 PM

Time: Press Conference 6 PM June 18 (Demonstrations begin at 5 PM June 18, Candle Light Vigil, 8:30 PM - 5 PM June 19)


WE THE PEOPLE began as an alliance of people who were accused of and treated for "mental illness". We have survived with our lives, unlike Ms. Green. However, our liberty, our health, and our futures continue to be under the threat of the therapeutic state - and so is yours.

Sanford Rubenstein, the attorney for the family of Ms. Green will be speaking at the press conference. He urges, "Only by people speaking out and remembering what happened to Esmin Green can we prevent others from suffering her fate".

Also speaking out will be people who survived commitment at Kings County Hospital Center and now work to make sure others do not have to experience what they were subjected to and Assemblyman Felix Ortiz, Chair of the Mental Health Committee (invited).

On June 19 it will be two years since Esmin Green was murdered-by- neglect at the Kings County Hospital Center Psychiatric Emergency Room. In February 2010, it was reported by the media that a male “patient” was raped by an employee of Kings County who was charged for the crime. As recently as April 27, 2010 more citations of abuses were published in the news.

Not only does this abuse and torture happen - but it happens in the multi-million dollar new psychiatric building. This was supposed to end murder, abuse, rape, and torture of people confined within its walls - after the City agreed to court monitoring because of the abuses and torture that people were subjected to while detained in the facility.

•This abuse and torture has been going on for centuries with no end in sight - we must make our voices heard!
•Kings County is not safe.
•Kings County should be closed down.
•Rape and Death are not good outcomes.

Department of Justice; Center for Medicaid/Medicare Services; Substance Abuse Mental Health Services Administration; Health and Hospitals Corporation; New York City Department of Mental Hygiene; New York State Office of Mental Health; Commission on Quality Care; --- where are you?
Why are independent external advocates still not allowed into this facility?
Why is the government paying for this with millions of tax-dollars pumped into this place?
Why is the NYPD Department of Investigations report siting multiple systemic problems being ignored?
When is the Grand Jury going to present a bill?

The experience of involuntarily detainment in a psychiatric emergency room or in a psychiatric institution is tantamount to torture. Human rights and feminist activist Kate Millett during the negotiations on the UN Convention on the subject of forced treatment and confinement of persons with disabilities stated, “"The power of an entire civilization massed against one lone individual. Every phone and lock and guard and drug . . . Everything conspires to make you completely alone and terrified. Malleable. These are the conditions of torture”"..

As in the HIGHLANDER STATEMENT of 2000, we call on all people to "act individually and collectively to ensure that self-determination, respect, ethical behavior, and humane voluntary supports and services become the foundation of a reinvented mental health system. This system must first and foremost do no harm".

We invite you, we implore you, to meet with us and work with us towards a humane environment and to establish alternatives to the atrocities of confinement, drugs, electroshock treatment, restraint, and seclusion. We let our light shine in remembrance of the victims of the mental illness system - for people who have suffered because of fear and ignorance - for people who have been traumatized - for people who have been disabled - for people who are dead - and for people who are not really living

We are lighting candles to celebrate Esmin Green's life and passion as a way to spark necessary change and call for the respect of human rights in mental health. We offer the light of these candles as a sign of love for our families and friends, and our elected officials, and broader communities who often trapped in circumstance and by the psychiatric system cannot understand us as we struggle to communicate.

All people committed to human rights, join us.

We invite all people to join us during this 24-hour period and stand united in support of the demand that everyone receive the full benefit of their human rights and the preservation of their liberty, dignity, and respect. There are vigils happening all over the world for Ms. Green to stand in solidarity with New Yorkers.

If you can attend the vigil or not, call Governor Patterson (518) 474-8390, Mayor Bloomberg, (212) NEW-YORK, and your elected Representatives to express your outrage about Ms. Green's murder and insist that the City of New York stand in full compliance with International law and Human Rights.

If you would like to co-sponsor or endorse this demonstration, vigil, and its follow up forums, please contact us.



Posted by: Lauren Tenney | June 17, 2010 10:31 AM