- The fire on St. Joseph’s inpatient psychiatric unit, according to a hospital vice president, lasted about ten minutes. According to an eyewitness, Melonie’s room was “completely black—all four walls, the ceiling.” Melonie suffered smoke inhalation. The other patients suffered assorted levels of confusion and terror. There was water damage to three floors of the hospital.
- The Post-Standard reported “There were 21 other patients on the floor at the time of the blaze . . .”
The psychiatric unit has thirty beds and the census of occupancy never slips below 26, and rarely that. The unit is usually fully occupied and has a waiting list. On a Monday after a holiday, it typically would be 27 inpatients with other patients backed up in the Comprehensive Psychiatric Emergency Program (CPEP) and Emergency Rooms around the city waiting for psychiatrists to return from holiday and begin moving patients from emergency to inpatient status.
After the fire, doctors were told to discharge patients. Six patients who were receiving acute inpatient treatment were discharged because hospital conditions had become too unsafe to sustain them.
- “Most of the patients were able to return to their rooms Monday, but staff had to relocate some people . . . They should be able to return to their rooms by Wednesday, [Kathryn] Ruscitto, [a senior vice president at the hospital] said,” according to the newspaper report.
The psychiatric unit was immediately closed to admissions. By Wednesday, the census was down to twelve; in two days, about fifteen patients had been discharged. People who ordinarily would have been admitted for acute treatment of psychiatric symptoms were now without protective care.
People do not get admitted to 3-6 because they are sick; they get admitted because they are sick unto death. A great many are admitted because they are severely depressed and in danger of killing themselves. There are people whose diagnoses include genetically inherited diseases like bipolar disorder (manic depression), schizophrenia, psychosis, drug addiction, and aggression disorders. There are people whose psychiatric diagnoses are complicated by major medical illnesses such as cerebral palsy, multiple sclerosis, heart attack, stroke, and kidney damage. One man had multiple cancers and was admitted to help him fight his suicidal feelings.
Diagnoses notwithstanding, these are people who, by and large, get up in the morning, get some sort of dressed, and stumble down to the day area for a cup of coffee. The dominant distinction between an inpatient and an outpatient is the level of suffering and the proximity to death. Because a staff member did not confiscate a cigarette lighter, and a patient at high risk was not put under observation, dozens of these people are now without an appropriate level of care.
There is nowhere else to go in Syracuse. Upstate and Community General Hospitals run at full capacity and cannot absorb the overflow. Hutchings has two hundred beds but state policy—driven by service to taxpayers—has limited current occupancy to one hundred patients. Four Winds has empty beds but—driven by American capitalism—it does not admit people on Medicaid or with poor insurance.
St. Joseph’s Hospital bills $710 per bed, per day, on the psychiatric unit—nearly $8 million a year. That doesn’t include pharmaceuticals, physicians, adjunct therapies or equipment (i.e., Prozac, Dr. Kou, physical therapy or respiratory machines). For $710, one expects minimal safety standards to be met.
Two days after the fire, with only twelve beds occupied, St. Joseph’s was losing $12,780 a day; ten days after the fire, with only twenty-two beds occupied, the daily loss was cut to $5,680—just for bed charges. St. Joseph’s has lost at least $100,000 in billable income. There is no public estimate of the cost to repair the psychiatric unit, or the other floors damaged by water. There is no indication that the irresponsible staff members have been identified, disciplined, or re-trained. There is no indication of management responsibility or accountability.
Melonie was moved to a room on the front hall where she continued to yell, disrupt the inpatient community, and create what a staff member called “situations.” Other patients continued to be “scared . . . who knows what they’ll do next?” A wall was built in the back hall to seal off the eight-bed section that cannot be used. Patients report that staff members have become more attentive.
Later reports were that it was six months before the eight-bed secure unit in the back could be used again.