St. E's Still Lacks Staff, Court Is Told

Advocates' Lawsuit Cites Dangers to Hospital Patients and Employees

St. Elizabeths, the District's public mental hospital, does not have enough psychiatrists, psychologists or nurses to treat and supervise its patients, a civil rights organization charged in court documents filed yesterday as part of a lawsuit against the District.

Despite damning reports last year by federal investigators, the hospital has failed to deal with staffing shortages that are at the root of problems ranging from inadequate psychiatric care to unsanitary living conditions, University Legal Services said.

For more than a year, the organization has been reviewing documents and deposing witnesses as part of its 2005 lawsuit against the District. The examination has bolstered its contention that the court must step in and order changes at the Southeast Washington hospital, it said.

Patients and employees are in danger, according to University Legal Services, which serves as a federally mandated advocate for disabled people in the District.

In January, in a case that the plaintiffs say highlights the perils of understaffing a psychiatric hospital, a patient who had become disruptive and violent died when an employee tried to restrain him, according to authorities. No charges have been filed in the death of Mark Harris, 39, who went into cardiopulmonary arrest after the altercation.

An internal investigation by the D.C. Department of Mental Health found a number of problems in how the incident was handled: A poorly timed shift change left the staff short-handed; a registered nurse was not present in the area where the incident took place; other employees were slow to respond to the initial call for emergency assistance; oxygen tanks were locked away and not immediately accessible, and one of the tanks that was eventually retrieved was not functioning.

Traci L. Hughes, a spokeswoman for the D.C. attorney general's office, said the city would respond in court to yesterday's filing and would not respond in the media to any of the specific assertions or characterizations in the filing.

Two earlier deaths of patients led University Legal Services to begin examining staffing levels at St Elizabeths, which has about 400 patients. In spring 2004, a 55-year-old patient was stomped into a coma by another patient and eventually died. Soon after that attack, a 76-year-old patient was fatally beaten by another patient.

In its inquiry then, University Legal Services documented widespread understaffing and excessive use of overtime, and it extracted promises for increased staffing.

The Justice Department has echoed those concerns. Last year, it cited the two deaths in warning that St. Elizabeths "fails to provide its patients with a reasonably safe living environment."

University Legal Services says too little has changed.

An expert hired by the organization to evaluate the hospital concluded that St. Elizabeths needs at least 16 more psychiatrists, 20 more psychologists and 60 additional nurses to properly care for patients in a safe, therapeutic environment.