St. Elizabeths Hospital in Southeast D.C. (Evy Mages for The Washington Post)
6 min

St. Elizabeths Hospital patients settled a lawsuit with the District-owned psychiatric hospital and the city over allegations that the facility failed to provide needed care during an extended water outage in 2019 and the coronavirus pandemic.

As part of the settlement with the three patients, filed Tuesday in federal court, the District agreed to provide a water remediation plan as well as the process for regular testing. It also agreed to revise its emergency plans to include maintaining agreements with other hospitals to transfer patients in case of an emergency; housing an adequate supply of personal protective equipment (PPE) for patients and staff; and implementing agreed-upon protocols for how to respond, treat and communicate to patients and the community during a crisis.

This settlement, said Kaitlin Banner, the lead attorney for the plaintiffs, “represents a really important victory for the patients at St. Elizabeths hospital.” The terms, she said, will provide safeguards during future emergencies to ensure patients receive proper medical care and conditions are kept sanitary.

“Unfortunately what we saw over the course of the past almost four years is that the patients at St. Elizabeths hospital have been a little bit of an afterthought,” said Banner, the deputy legal director at the Washington Lawyers’ Committee for Civil Rights and Urban Affairs. “For patients who are there now, or in the future, facing any kind of public health emergency, [the settlement ensures] that they will be treated and given the supports and services that they need to weather that crisis in a way that doesn’t harm their physical and mental health.”

The plaintiffs, Enzo Costa, William Dunbar and Vinita Smith, are all indefinitely, involuntarily civilly committed to the District’s care, and they said the hospital’s response to the water crisis and the coronavirus resulted in inadequate care and safety that violated their due process and rights under federal law, according to court records. They were represented by the Washington Lawyers’ Committee for Civil Rights and Urban Affairs, the ACLU of the District of Columbia, and the law firm Arnold & Porter.

A D.C. Department of Behavioral Health representative did not immediately respond to a request for comment on Wednesday. When asked for comment, a D.C. Attorney General’s Office spokesperson pointed to the settlement agreement, which states that the District has not admitted liability or admitted “any factual contentions that have been asserted by Plaintiffs in this Lawsuit.”

St. Elizabeths Hospital in Southeast Washington was founded in 1855 as the nation’s first federally funded mental hospital and serves a majority Black population. Its patients include criminal defendants, including those awaiting competency hearings and those found not guilty by reason of insanity.

The hospital has a troubled history and has been criticized by advocates for issues including its allegedly excessive use of restraints. In 2022, authorities said a patient was killed by a fellow patient. At the time of the assault, an advocacy group said in a December report, St. Elizabeths staffers were looking at their phones and a computer.

He was supposed to be safe in a mental hospital. Police say a fellow patient killed him.

In 2006, the Justice Department found that the hospital conditions violated patients’ constitutional rights, and the District later entered into a consent decree. It ended in 2014 after the department found conditions had improved.

This recent settlement stems from complaints around the hospital’s water crisis in 2019, when the facility was without potable water for nearly a month. Legionella bacteria, which can cause Legionnaires’ disease, and pseudomonas bacteria, which can cause severe infections in people with weakened immune systems, were found during routine testing. At the time, the hospital continued to admit patients.

On the same day that water was restored to the hospital, the American Civil Liberties Union of D.C. filed the class-action suit in the U.S. District Court for the District of Columbia on behalf of patients against the hospital and the city for “horrifying” conditions during the outage.

During this time, officials said, none of the hospital’s approximately 700 staff members and 270 patients became sick.

Still, the complaint said patients were unable to shower, wash their hands or regularly use the toilets in bathrooms that were filling up with fecal matter, urine and menstrual blood.

Psychiatric care that patients depend on, such as group therapy, art therapy and music therapy, was “curtailed or suspended” while patients were “confined to their units,” according to the complaint.

These conditions, according to the complaint, exposed “these vulnerable patients to irreparable harmful physical, emotional, and mental health consequences.”

Barbara Bazron, director of the city’s Department of Behavioral Health, said at the time that it cost more than $1 million to buy portable showers, toilets and hot meals and asserted that “there was no break in the continuity of care.”

“The staff did, I thought, an outstanding job of managing the situation, and patient care continued throughout this process,” Bazron said in 2019.

The patients also alleged in an amended complaint that the District failed to follow Centers for Disease Control and Prevention guidelines for infection control during the onset of the pandemic, leading to deadly consequences. According to the amended complaint, this included failing to: provide space for social distancing; test symptomatic patients at all or in a timely manner; or quarantine those who tested positive for the coronavirus.

More than 187 patients were infected with the coronavirus, and 14 patients died from March to May 2020, according to a news release about the settlement from the Washington Lawyers’ Committee for Civil Rights and Urban Affairs.

Banner said it is especially important to make sure there are plans and processes in place to ensure these patients can receive the care and treatment they depend on the District to provide. The compounding crises of the water contamination and the coronavirus pandemic, she said, left patients especially vulnerable.

“It took a long time for the hospital to figure out how to get people the treatment that they needed, and the treatment that they’re at Elizabeths for,” Banner said. “At the very basic level, we want to make sure that there is a strong system in place so that when a crisis hits, they are not scrambling, that there are there are methods of ensuring that plaintiffs and patients at the hospital get the basic care that they need.”