Hospital vows changes after a death in ER

No aid for patient long kept waiting

Esmin Green lay on the floor in Kings County Hospital's psych ward emergency room for more than an hour before her death. (New York Civil Liberties Union via associated press)

NEW YORK - City hospital officials agreed in court yesterday to implement changes at a psychiatric ward where surveillance footage showed a woman falling from her chair, writhing on the floor, and dying as workers failed to help for more than an hour.

Esmin Green, 49, had been waiting in the emergency room at Kings County Hospital Center in Brooklyn for nearly 24 hours when she toppled from her seat at 5:32 a.m. on June 19, falling face down on the floor.

She was dead by 6:35, when someone on the medical staff, flagged down by a person in the waiting room, finally approached, nudged Green with her foot and gently prodded her shoulder, as if to wake her. The staff member then left and returned with someone wearing a white lab coat who examined her and summoned help.

Until the staff member's appearance, Green's collapse barely caused a ripple. Other patients waiting a few feet away didn't react. Security guards and a member of the hospital's staff appeared to notice her prone body at least three times but made no visible attempt to see if she needed help.

One guard didn't even leave his chair, rolling it around a corner to stare at the body, then rolling away a few moments later.

Green, who had been involuntarily committed the previous morning and had waited overnight for a bed, stopped moving about half an hour after she collapsed.

The New York City Health and Hospitals Corporation, which runs the hospital, said six people have been fired as a result of the case, including security personnel and members of the medical staff.

Green's medical records raised the possibility that someone might have tried to cover up the circumstances of the death. They contained notations indicating that she was up and about during the time in which the video shows her dying on the floor.

"We are all shocked and distressed by this situation," Alan Aviles, HHC's president, said in a statement. "We express our deep regrets to the patient's family and will ensure a thorough investigation."

The case was largely unnoticed until the video became public.