Memphis authorities release video in Tyre Nichols' death

Power outage at DMC Sinai-Grace Hospital may have resulted in patient death, family believes

Karen Bouffard
The Detroit News
Mary Brown and her husband, Sterling,  show a photo of Mary's mother at their home in Detroit.  Minister Anna Belle Smith died on Nov. 22 after being taken to Sinai-Grace Hospital, where the power was out,  and then transferred to Henry Ford Hospital.

The corridors were dimly lit in the emergency department at DMC Sinai-Grace Hospital on Nov. 21 when 87-year-old Anna Belle Smith arrived with chest pain, according to her family.

In the middle of a power outage, the Detroit Medical Center hospital was running on partial power from generators, which are required by state law. 

Within minutes of arriving at 9:35 p.m., Smith was diagnosed with STEMI, a blockage in one of the main arteries that supply blood to the heart. It's a type of myocardial infarction that calls for quick action or the patient could die.

But doctors there couldn't perform a potentially lifesaving procedure due to insufficient power, the emergency physician at Sinai-Grace wrote in medical records provided by Smith's family. According to DTE Energy Co., the power went down at 9 p.m. when an electric cable was accidentally cut near the hospital. 

Smith needed a procedure in the cardiac catheterization lab, but the lab was closed because of the power outage, hospital records state. To make matters worse, just one elevator was functioning and the lab was located on another floor, Smith's family said. 

Hospital staff wanted to transfer Smith to another hospital and said they didn't want to put her on the elevator because they feared it too might lose power, according to her family.  

By the time Smith was transferred to Henry Ford Hospital approximately two hours later, it was too late to save her — leaving her five children, 21 grandchildren, 30 great-grandchildren and five great-great-grandchildren without their matriarch.

"When we arrived (at Sinai-Grace Hospital), they were not prepared for us, and we did not know that," said Mary Lisa Brown, 54, Smith's daughter. "The end result: My mom ended up passing.

"The family is left with questions. We feel like it was a breakdown."

The Detroit Medical Center issued a statement in response, saying: "Our hearts are with the Smith family during this difficult time, and we have reached out to them after their loved one was transferred from our hospital during the DTE power outage. 

"Power outages affect community resources, including the need to transfer patients who seek treatment at the hospital to facilities where appropriate levels of care may be offered during a power outage. The hospital worked with DTE to restore power during the outage, and we are supportive of any efforts DTE makes to power grid infrastructure improvements for the future.”

DTE boosted power inside the hospital by bringing in diesel generators, but it's not clear what time those were brought in. No further details were provided by the energy company. 

"We were saddened to learn of this tragic event. We extend our thoughts and prayers to the family. The safety of our customers is always DTE’s No. 1 concern," DTE spokeswoman Randi Berris said in a statement. 

"During power outages, restoring energy to hospitals is our top priority. In fact, our engineers and field crews worked closely with Sinai-Grace Hospital during the outage in November to provide additional power to supplement the hospital’s onsite backup generation. 

"Once repairs to the energy grid were complete, we timed the switchover from backup generation to the grid based on the hospital’s schedule to ensure patient safety.”

Generator standards

The Michigan Building Code and Michigan Electrical Code require emergency backup power for hospitals, and the city of Detroit is the enforcing agency for the administration and enforcement of these codes. The Michigan Department of Licensing and Regulatory Affairs makes sure facilities comply with the Michigan Public Health Code and other state laws.

State standards for hospital generators were last updated in 2015 and require that hospital power systems be sufficient to maintain cooling, power and lighting for at least one operating room, delivery room, trauma room, angiography room, interventional radiology room and cardiac catheterization lab. 

But those standards only apply to new construction or major renovations completed after Oct. 1, 2015, according to LARA spokesman Pardeep Toor.

According to Toor, the Sinai-Grace facilities were constructed in 1950 and 1970. An addition added in 2014 was required to comply with the 1998 Minimum Design Standards, which instead requires hospitals follow National Fire Protection Association Standards.

According to the Detroit Buildings Safety Engineering and Environmental Department, a new generator at the hospital was tested for proper installation and functionality on Nov. 10, 2016. The results of the inspection testing were satisfactory and found to be in compliance with the applicable codes. 

A tragic Thanksgiving

Smith lived independently in Detroit's River Tower Apartments but decided to spend the night before Thanksgiving at the home of her son, Christoper Smith, who lives on Stoepel on the city's west side. 

"She lived in her apartment, and I would go down there every day. We all checked on her," Brown said. "She loved to do bingo; she loved to color; she loved to paint."

Brown described a woman who was still relatively healthy and active despite her advancing age. Smith came from a family of 16 children, born in Kentucky, and had raised her children alone since their father died when Brown was 5. 

"My mother was a church-going woman. She believed in the Father, the Son and Holy Spirit. She gave a lot to the community," Brown said. "Most of all she told us how to pray and to stick together as a family. 

"She believed in praying for you and with you. My girlfriends would call her and say …can you watch my baby?  And she would. She was a grandmother to other people, not only to us but other people in the neighborhood." 

Brown was helping her mother get ready for a shower the night Smith started to experience chest pain. They quickly called an ambulance, which arrived within minutes. Brown and other family members followed it to the hospital in their cars. 

When Smith's son, Jeffrey Smith, 52, approached the hospital, he could see that the northeast side of the building at Outer Drive and Schaefer Highway was dark. The emergency entrance at Schaefer near Six Mile was dim, he said. 

"The power was dim in the emergency area, and the computers were down, they couldn’t get to her files," Smith recalled. "They had problems with the computers, the elevator, etc."

Family members say they were told Smith could not be transported to the procedure room because just one elevator was working, and staff worried the door might close and not open again. And the cardiac catheterization lab wasn't operational, according to hospital records.

"They (Sinai-Grace medical staff) didn't want to put her in the elevator because they only had a partial working elevator," Brown said. "(The doctor) said we got a power outage.

"Then he said we can’t do the procedure because that room is dark." 

Sinai-Grace emergency physician Dr. Daniel Ridelman Monzon noted the predicament in Smith's patient records. Efforts by The News to contact Ridelman Monzon for further comment were unsuccessful. 

"Because of power outage ... it was determined that the Cath Lab was not functioning the patient needs transfer," Ridelman Monzon wrote in his final report on Smith's care. 

At 10:27 pm, Ridelman Monzon called Henry Ford Hospital to request a transfer.

"He stated the power was out at his hospital and there was no cath lab of lytic therapy available," Henry Ford Hospital emergency physician Dr. Emanuel Rivers noted in Smith's patient record of the call from Ridelman Monzon. "I reluctantly accepted the patient after expressing my concerns about the safety of the transport.

"I told the referring physician the patient could die in route and he must educate the family. He agreed ... on the phone. The patient did not arrive to HFH for over 1 hour after this conversation." 

Brown said the family was not informed of the risk that their mother could die during transport. According to Henry Ford Hospital records, Smith was transported at about 11:37 p.m.

Smith's records note that her blood pressure dropped to an abnormally low level while in transport. Upon arrival at Henry Ford Hospital, her mental awareness was fluctuating, she was unstable and critically ill.  She couldn't be given nitrate because her blood pressure was too low. 

"Decision to intubate patient with etomidate and succinylcholine. Effort to obtain right femoral arterial line unsuccessful due to loss of pulses," a resident physician noted in the record.  

"Compressions started."

At 12:03 a.m., Henry Ford doctors ceased cardiac resuscitation, per Smith's advance wishes. She was pronounced deceased at 12:11 a.m.

"When we’re at the hospital at Henry Ford, they finally take us in a room, and the Henry Ford team started working on my mother," Brown said.  "I don’t think they knew the beginning of our journey that day. 

"She suffered. She suffered. That’s all I can say."

Twitter: @kbouffardDN