Death on a Hospital Floor

Shouldn't somebody have to pay?

You'd think after Beatrice Vance of Illinois and Edith Isabel Rodriguez of California both died on the ER waiting room floor while hospital staff just looked on, that maybe hospitals would be on red alert to avoid this type of bad publicity—not to mention the loss of human life.

But now there is the story of Esmin Green, 49, of New York. She, too, died on the hospital waiting room floor while patients and hospital staff looked on. Surveillance video showed a guard rolling his desk chair around to get a better look as Green writhed in pain, and patients watched unflinchingly from just feet away. This horrific tale is a sad commentary on the state of human compassion and the state of our health care system.

While it is not in time to save Esmin Green, maybe increased public attention and litigation arising from the event will help save a future patient's life.

As editor of a torts law blog and a policy fellow who researches the civil legal system, I encounter tales like this everyday. These real life horror stories of ordinary people seriously injured or killed by someone else's conduct should not only evoke outrage at our broken health care system. But, they should also remind us why it is important to have a legal system that helps people hold their injurers accountable and get the compensation they deserve.

It may sound like stating the obvious to say Green's family should have the right to explore their legal options for holding the hospital accountable. After all, this is what the Rodriguez family did after—despite two 911 phone calls from panicked ER patients and clear signs of her impending death—hospital personnel did not examine her until it was much too late to save her life. And this question certainly must have surfaced after a coroner's jury ruled Beatrice Vance's death—from a heart attack while she waited for two hours in the emergency room—a homicide.

But the right to access the courts should not be taken for granted. Some states have prohibitive restrictions on a victim's ability to file a lawsuit against negligent hospitals, thanks in large part to the Bush administration and its friends in the corporate lobby. Some restrictions keep injured victims out of court by arbitrarily reducing the compensation they can receive, thereby making it more difficult and expensive to file a lawsuit. Some groups even want to take these claims out of court altogether.

Why is this problematic? Because of what lawsuits can do.

Litigation initiated by trial lawyers at NYCLU and Mental Hygiene Legal Service has prompted the Brooklyn hospital where Green died to implement reforms regarding patient service. The reforms, like reducing the median wait-time to a still-hefty 10 hours, seem fairly modest. But the changes are an important start that may not have happened without the pressure of litigation.

A lawsuit would also compensate Green's family, although, to a limited extent. In cases in which a victim dies, the family can never truly be made whole through compensation. But some steps should be taken to address the tangible costs associated with their loss, as well as those losses that are less calculable.

Lawsuits also draw public attention to systemic problems that everyone should be involved in addressing—like in this case, the problem of a crisis in access to quality health care, especially for women of color like Vance, Rodriguez and Green. Women of color face staggering disparities in the quality of treatment they receive in hospitals. According to the Kaiser Family Foundation, women of color are more likely to be treated at less well-funded, less well-staffed hospitals with fewer mechanisms for ensuring quality care to patients. This is why it is especially important that they and their families have access to the courts to hold negligent hospitals accountable and demand substantive changes to a broken system.

One question may not be answerable with a lawsuit: Could there be a level of indifference, conscious or unconscious toward women of color and their health? The shocking details of the deaths certainly do not allay such suspicions—a custodian mopping casually around a dying Rodriguez, a security guard watching Green lie in anguish, Vance being returned to the waiting room despite clear signs of a heart attack. Countless other anecdotes tell about women being barely examined, told they were "fine" and sent home only to suffer unnecessarily later. These stories could be outliers or just symptoms of a problem that affects everyone. But one cannot be blamed for wondering whether an unconscious devaluation of women's lives plays a role in the poor care they receive.

Lawsuits may not be able to answer those types of questions, but they do garner the public attention necessary to get communities talking about how to improve access to quality health care. And despite questions lawsuits cannot answer, what happened to Green, Rodriguez and Vance reminds us of the important function of our civil justice system. It compensates families who lose loved ones in an untimely, unnecessary way, and it creates pressure on hospitals to take steps necessary to prevent such injuries from ever happening again.

Kia C. Franklin is a senior fellow in civil justice at the Drum Major Institute. She blogs at www.TortDeform.Com.