The man hurried up the Baltimore sidewalk with a camera in his hand as four black-clad hospital security guards walked toward him, then past him. One of them was pushing an empty wheelchair.
"So wait, y'all just going to leave this lady out here with no clothes on?" said Imamu Baraka, referring to a dazed woman wearing only a thin hospital gown and socks whom they had left alone at a bus stop Tuesday night in mid-30s temperatures. Her face appeared bloody, her eyes empty.
It was the latest incident of "patient dumping," which has sparked outrage around the country — and one that, according to an expert, probably violated a 1986 federal law that mandates hospitals release those in their care into a safe environment.
"This kind of behavior is, I think, both illegal and I'm sure immoral," said Arthur L. Caplan, founding head of the division of medical ethics at the New York University School of Medicine. "You don't just throw someone out into the street who is impaired and may have injuries. You try to get them to the best place possible, and that's not the bench in front of the hospital."
The phenomenon was pervasive two decades ago, when the law was largely unenforced, Caplan said, but it remains a problem from California to Virginia.
On Tuesday, the woman left outside the University of Maryland Medical Center Midtown Campus could barely walk and seemed unable to speak.
Baraka, a licensed counselor, had just left his office across the street to run an errand, he said in a phone interview Friday, when he spotted her being wheeled out. A gust of wind revealed that she had nothing on beneath her gown.
Shocked, Baraka rushed back to work to get his cellphone, then returned and began filming as he followed the guards back to an entrance.
"That is not okay," he shouted.
"Due to the circumstances of what it was," one of them said.
"Then you all need to call the police," Baraka replied.
At the doorway, Baraka asked for a supervisor, demanding to know why hospital staffers were leaving her outside.
"She was . . . medically discharged," one of the guards said, before the camera captured them walking into the hospital, their backs turned.
What Baraka filmed next — the woman, staggering and screaming into a night so cold that the sidewalk remained speckled with salt and bits of unmelted snow — has been viewed more than 2.3 million times on Facebook, triggering a cascade of online fury and an apology from the hospital.
Baraka, who called 911 and remained with the woman until an ambulance took her back to the hospital, talked to her mother late Wednesday night, he said. She told him that her daughter, 22, had been missing for two weeks — and that the episode was triggered by mental illness, not substance abuse.
The mother didn't know where her daughter was until she came across Baraka's video on Facebook and, several minutes in, recognized the face on the screen, he said.
She was stunned.
After the paramedics took the woman back inside, Baraka waited in the cold for about two hours to ensure that the hospital staff didn't kick her out a second time, he said. He later learned that she'd been sent in a cab to a homeless shelter, where her family eventually picked her up.
The mother told him she's now safe and recovering, said Baraka, who's received thousands of Facebook messages from furious viewers around the country.
"I'm speechless. I hope she gets help," one woman wrote on his page.
"This is horrific treatment of another human being," added another.
He posted the video, he said, because people needed to understand what he'd witnessed.
"If I told had someone this, they would not have believed me," he said. "My mind was blown."
At a news conference Thursday afternoon, the hospital's chief pledged to investigate what he described as "a failure of basic compassion and empathy." He said it represented a wrenching departure for a widely respected medical institution — one that has embarked on a major expansion in Prince George's County and Southern Maryland.
"We firmly believe what occurred Tuesday night does not reflect who we are," said Mohan Suntha, the hospital's president and chief executive. "We are trying to understand the points of failure that led to what we witnessed on that video."
Suntha would not provide details on the personnel involved, saying the review of the woman's experience from arrival to discharge had just begun. Nor would he speak to her condition or treatment because of patient confidentiality, but he asserted that her care before being led into the cold was adequate and complete.
Suntha, who cited the hospital's 136-year history of providing indigent care in Baltimore, said the woman's insurance status or ability to pay played no role in the decision to discharge her.
"I share the community's shock and anger at what occurred," he said, although shock and anger haven't ended patient dumping in the past.
Last year, court records show, a man sued Inova Fairfax Hospital in Virginia for $100 million after alleging that he had been prematurely discharged on a cold winter night — and was subsequently hit by a car.
The suit, filed in Fairfax County Circuit Court, alleged that Donald Paul Ryberg came to Inova just after noon on Jan. 29, 2015, a day when temperatures barely edged above freezing.
Ryberg, then a 46-year-old diabetic, had a history of alcohol abuse that had led him to the emergency room before.
The complaint alleges that Ryberg was so weak that he couldn't stand or walk. When hospital staff discharged him around 7 p.m. — without a diagnosis and over his daughter's objections — Ryberg was alone and confused, the complaint said, but had been given bus tokens and directions home. He then stumbled into the street, where a car smashed into him.
Citing privacy laws, an Inova spokesman declined to comment on this specific case but said that patient "safety and quality of care is our top priority."
His daughter, Tabatha Ryberg, said she spent the final years of her high school career caring for her father, who suffered a skull fracture and remained in a coma for weeks after the accident. He continues to have mobility and memory problems, she said, and he lost his job as a laborer at an engineering firm.
"My dad has just lost everything," she said. "I want to bring some attention to this because this is ridiculous. . . . They didn't contact us. If they had, we would have had a ride for him. This has ruined so many people's lives."
In Washington, Howard University officials fired two campus police officers and their supervisor last year after after someone filmed campus police officers dumping a female patient from the school's hospital out of a wheelchair and onto the ground near a bus stop.
Last month, in California, a 78-year-old man, disoriented and suffering from arthritis, was discharged from a Sacramento hospital and sent in a taxi to a homeless shelter that had no room for him, the Sacramento Bee reported. A year ago, according to the Las Vegas Review-Journal, former patients at a state-run hospital in Nevada filed a federal lawsuit after they and others were allegedly placed on Greyhound buses and sent out of state.
In Baltimore, the video's release was just the latest in a string of painful moments for the city, still struggling to move past the 2015 death of Freddie Gray and the riots that followed. The city endured 343 homicides last year, making it the bloodiest, per capita, in its history.
Last week, amid a stretch of frigid weather, images spread of Baltimore students bundled in coats in unheated schools. One teacher described students shivering and able to see their own breath.
"Things are so broken here, so broken," said Bronwyn Mayden, a Baltimore native and executive director of Promise Heights, an initiative established by the University of Maryland School of Social Work. "It's like dominoes — one just knocks down the other. Can it get any worse, y'all?"
The city's troubles have reached a point where there's no outrage, she said. Instead, there's simply acceptance.
"I think," Mayden concluded, "people are numb in Baltimore."
Steve Hendrix and Jennifer Jenkins contributed to this report.