Deaths in hallways, unrefrigerated bodies: Fired nurses sue, cite COVID-19 conditions at Sinai-Grace

Sarah Rahal
The Detroit News

Detroit — Catherine Gaughan said she will never forget the moment she held an elderly woman's hand, comforting her as she gasped for her last breath in the hallways of the Sinai-Grace Hospital emergency room.

She later left the woman's body bag in an unrefrigerated room in the upstairs of the hospital when the morgue and other rooms were full of other bodies, Gaughan said Thursday, a memory that pains her.

"I just had to keep telling her 'It's OK, you can let go,' " said a tearful Gaughan, a former clinical coordinator at Sinai-Grace Hospital.

After the woman died, Gaughan called the woman's daughter.

"She thanked me for everything I had done for her mom and asked if there was anything she could do for my staff; that was probably the hardest thing for me," she said.

Gaughan is one of four former Detroit Medical Center Sinai-Grace emergency room workers who filed a lawsuit Wednesday contending the Detroit hospital wrongfully fired them and alleging that the hospital's understaffing contributed to patient deaths from COVID-19.

The 38-page lawsuit was filed in Wayne County Circuit Court on behalf of the workers who are suing Tenet Healthcare, the for-profit Texas-based parent company of the DMC. The eight-hospital DMC runs Sinai-Grace.

Anthony Bonnett, Jeff Eichenlaub, Gaughan and Salah Hadwan are each seeking $25 million in damages after they were terminated by the northwest side hospital May 6. They argue they were fired for speaking out about unsafe conditions, which would violate the Michigan Whistleblowers' Protection Act, and are suing for traumatic experiences.

The DMC would not comment Thursday, but a spokesman said the employees were terminated for taking inappropriate photos of deceased patients at the hospital and sharing them with other employees.

"We conducted a comprehensive investigation and took appropriate action based on employee admissions of violations of our patients' right to privacy," DMC said in a statement.

An April 16 inspection by state officials for the federal Centers for Medicare and Medicaid Services found Sinai-Grace was in compliance with nurse staffing rules and infection control guidelines. The Michigan Department of Licensing and Regulatory Affairs said it never investigated claims about bodies being storied in vacant rooms because the Bureau of Community and Health Systems only has jurisdiction over the physical structure of morgues. 

An employee for C.W. Morris Funeral Homes in Highland Park rolls out a body from Sinai-Grace on Thursday. The worker said it was a COVID-19 patient, but the funeral home denied it.

Inside a 'war zone'

In the lawsuit, the four nurses allege DMC's corporate officers, at the request of Tenet, made decisions that would hurt patient care. The nurses were required to withhold CPR from any patient suspected of having the virus, regardless of whether the patient had a confirmed positive test, according to the lawsuit.

One man in his 30s died after the staff was too busy to notice a tube on his ventilator came loose, according to the suit. There was no reason he should have died, Gaughan said.

"Multiple patients passed away in front of them because they were not allowed to perform basic life-saving measures, even though none of these people had been confirmed with COVID-19," their attorney Jim Rasor said. "And all of the families that lost loved ones at Sinai-Grace were never told that the understaffing and regulations caused these deaths."

The Detroit News spoke to Eichenlaub and Hadwan along with five other nurses and doctors in April who described the conditions at Sinai-Grace early on during the pandemic as a "war zone."

The medical team painted a grim picture of the emergency department as they scrambled to care for coronavirus patients. The nurses said about five patients died each 12-hour shift with 100 patients admitted to the ER each day.

Patients were dying in the hallways, some in stretchers, others in chairs, as nurses searched for body bags and places to put the dead, according to the accounts of doctors and nurses. Meanwhile, nurses juggled other patients who gasped for breath.

► Our report: Inside Sinai-Grace ‘war zone’: ‘We started to run out of body bags’

"It was battlefield medicine," said Hadwan, who has worked at the hospital for three years. "It’s the situation that you encounter that you move from one patient to the next and if that person is not that sick, they don’t get that much attention. And if they die in the process, that’s a loss in the battlefield."

Gaughan, from Hazel Park, recalled doing her job as a trauma nurse while holding the phone to answer all the calls coming in.

“The amount of codes that we had coming in for people that couldn’t breathe that needed ventilators...

“I remember one morning I had five full charts that literally only had one thing on them, the in time and that was it."

The growing number of dead at Sinai-Grace caught the attention of the federal government. DMC officials had a conference call with the Centers for Disease Control and Prevention in the week prior to The News' April 9 story because of concerns that Sinai-Grace had the highest COVID-19 mortality rates among hospitals in the nation, Dr. Vinay Pallekonda, a DMC chief medical officer, told staff.

Pallekonda attributed the high mortality rates at Sinai-Grace to about 14 nursing homes in the neighborhood and a number of patients with hypertension, heart disease, obesity and diabetes, who are at higher risk for severe coronavirus infections. But he declined to talk to The News about it.

"Heroes Work Here" is posted outside Sinai-Grace Hospital in Detroit on April 23, 2020. Sinai-Grace Hospital is in 48235, one of the zip codes with the highest number of COVID-19 cases.

The crush of patients seemed to cause special duress at Sinai-Grace, a teaching hospital that opened in 1953 and traditionally handles indigent patients. The hospital is the only one in northwest Detroit and happens to have the highest amount of EMS traffic, DMC spokesman Brian Taylor said at the time.

"Among the patient population served by Sinai-Grace, there are extremely high rates of underlying medical conditions such as hypertension and diabetes, which puts people at higher risk for COVID-19," he said in early April. "In addition, there are a large number of nursing homes in the area surrounding the hospital. The spread of respiratory illness and COVID-19 among that population places even more pressure on hospital resources as those patients are sicker and in many cases require ICU level of care."

Since 2010, Tenet invested millions of dollars in new facilities and technology, including the "new 59,000-square-foot emergency room" at Sinai-Grace Hospital, according to the hospital's website.

The nurses and workers said the emergency room was far from advanced. 

Workers stage sit-ins

A group of night-shift emergency room nurses and attendants were told to leave Sinai-Grace on a late night in April after they staged a sit-in to demand more support to treat a surge of COVID-19 patients.

Hadwan had led the sit-in inside the Sinai-Grace break room to voice concerns to management before their shift started. He said there were more than 10 patients to each nurse on any given day and, at their breaking point, it was 25 patients to one nurse.

"We needed more help because we’ve been working under extreme conditions," said Hadwan of Hamtramck. "We told them we need additional staff and went to check on patients. 

"Four hours later, at 11:30 p.m., (management) asked us: What is your final decision? We said we're sticking up for what we believe in. At that point, we were told, 'You can leave.' " 

Sal Hadwan, right, an emergency room attending, says he was dismissed from DMC's Sinai-Grace on Sunday night.

Seven night-shift workers left the hospital, reflecting on the commitment they made for the safety of their patients, family and themselves, he said, hugging each other. Day-shift nurses supported the sit-in and stayed for 24 hours to cover the nurses who left.

It wasn't the first nurse protest. Eichenlaub said workers held an April 2 sit-in and told administrators, "There are only 10 day-shift nurses, and we need more people."

"We’ve been told by the administration that we are replaceable," he said.

DMC said in a statement at the time that they were disappointed in the workers involved in the sit-in but acknowledged it was a challenging time for caregivers.

Hadwan was later firedalong with the others. He documented the aftermath on Facebook Live, saying management believed he leaked photos to CNN of body bags being stacked in empty rooms of the hospital when there was no space left in the morgue. Hadwan denied that he was the source of the photos.

Rasor said the worker who took the photos admitted responsibility and resigned before the others were terminated.

November would have been Gaughan’s 10-year anniversary at DMC. She said the hospital has always been understaffed and tried to work with the Michigan Nursing Association to establish a union at the hospital, but it didn’t happen.

"I voiced many concerns to upper management and they never listened," Gaughan said.

Sal Hadwan shows his termination paperwork from Sinai-Grace Hospital on a Facebook live video.

"We have an unwavering commitment and obligation to respect the privacy of our patients and to treat them with dignity and respect. We will not tolerate actions to the contrary," DMC said in a statement.

"We will continue to uphold our Standards of Conduct applicable to all employees and are grateful for the hundreds of team members at Sinai Grace Hospital whose courageous work and dedication to patients has been inspiring."

Rasor, a Royal Oak attorney is also representing another Sinai-Grace nurse, Kenisa Barkai, in her wrongful termination suit.

Barkai said the DMC fired her on March 27 after she posted a social media video of her gearing up from head-to-toe to see a coronavirus patient inside Sinai-Grace hospital. She was a floating nurse with DMC for 11 years and was the first nurse to speak out about the hospital being overwhelmed with patients.

During the week of March 16, Barkai was taking care of COVID-19 patients and non-COVID-19 patients without protective gear. She voiced to management that she feared cross-contamination between patients. She previously told The News there was a lack of staffing and supplies before the pandemic crisis hit Detroit and threatened to report the hospital to accreditors. 

The aftermath

Rasor argued that because of DMC and Tenet’s decision to refuse to institute emergency protocols and address worker concerns, the nurses suffered severe emotional trauma.

By May, the hospital hired agency nurses for extra aid, but by then the department had fewer than 30 patients. Because the agency nurses were already hired, Gaughan said the regular DMC nurses were sent home or told to allocate to other departments. 

The situation at Sinai-Grace became so dire that the hospital allegedly misplaced the body of a 68-year-old woman who died on April 8 after battling coronavirus for three weeks. The hospital was not able to locate her body, which was stored in vacant rooms until April 14, according to the lawsuit.

"Indeed dozens of patients perished due to the inability of the overloaded medical staff to get to them, monitor them and provide treatment, including those that were only discovered to be deceased after they had died and rigor mortis had set in indicating that they had died some hours earlier and that their deaths had not been noticed," the lawsuit states.

srahal@detroitnews.com

Twitter: @SarahRahal_