In Arcadia, a state mental patient who had tried repeatedly to kill himself walks through an unlocked door, climbs to the roof and leaps. He is now paralyzed.
In Pembroke Pines, a psychiatric patient loses 30 pounds in 30 days. The schizophrenic is finally sent to the hospital in critically ill condition, but it is too late.
Despite years of efforts aimed at convincing taxpayers, mental health advocates _ and federal judges _ that Florida's state psychiatric hospitals are safe, a series of events in recent weeks at two of the hospitals has left state officials reeling.
After patients at G. Pierce Wood Memorial Hospital in Arcadia and South Florida State Hospital in Pembroke Pines sued in federal court, administrators with the department of Health and Rehabilitative Services agreed to make sweeping improvements. Court-appointed watchdogs monitor the state's progress in keeping its promises and report back to court.
James K. Green, a West Palm Beach lawyer who represents patients at G. Pierce Wood, said Monday the state appears more interested in good publicity than in making real changes at the state-run psychiatric facilities.
"On the one hand, HRS issues press releases saying they've turned things around," Green said. "On the other hand, they stonewall attempts by the monitors to scrutinize those claims."
Green said lawyers for the committed patients have relied on the state to inform them of any incidents involving their clients at the Arcadia hospital. Yet, Green learned from a reporter that another patient had suffered a serious injury due to staff neglect.
On June 4, a patient at G. Pierce Wood Memorial Hospital with a history of suicide attempts was left unattended while smoking on a patio. He walked through an unlocked door, climbed to a roof and plunged. This happened despite the fact that employees had been emphatically warned the patient was at risk, records show.
"It is your responsibility to provide the best care possible and the safest environment possible," administrator Myers R. Kurtz wrote in letters to the two disciplined employees. "Your failure to lock the door has resulted in a serious injury to the resident."
The two employees were suspended without pay, one for 15 days, and another for 20. Kurtz wrote the two were not fired largely because they "made no attempt to cover up" their actions, as had been documented in the past by other employees at the hospital.
Earlier this month, the U.S. Justice Department filed suit against the state, alleging patients at G. Pierce Wood were at "serious risk of harm, including death." In four weeks in the summer of 1994, four G. Pierce Wood patients died and a fifth patient severed his hands on an electric table saw.
Meanwhile, HRS administrators in Fort Lauderdale recently acknowledged they are investigating a series of deaths at the South Florida State Hospital in Pembroke Pines.
Andrea Guy, the local HRS administrator, ordered a review of 11 deaths, after becoming concerned the death rate appeared high. A final report on the incidents is expected within the next couple of weeks, said Lynette Beal, a spokeswoman.
However, three of the deaths were forwarded to abuse investigators for separate reports, Beal said. In at least one case, an abuse investigator has recommended the agency confirm a case of abuse or neglect.
A hospital psychiatrist has been banned from patient care, and other staff members face possible disciplinary action following the patient's death, Beal said. The 36-year-old schizophrenic was suffering from dehydration and a blood test showed he had twice the acceptable level of lithium in his bloodstream.
Administrators already have begun to make changes at South Florida in the wake of findings by protective service workers. "We have all along been making corrections, trying to improve procedures," Beal said.
With respect to G. Pierce Wood, Tony Welch, an HRS spokesman, said the agency has been working hard to balance the rights of psychiatric patients to be free from restrictions against the need to guarantee their safety. "Our job is to strike that balance in the safest setting possible."
Marge Eskenas, a former vice president of the Florida Alliance for the Mentally Ill who lives in Oldsmar, said sometimes it's impossible to protect patients from harm who are intent upon killing themselves.
"When someone is determined to kill himself or herself, you can't win," Eskenas said.