Four emergency department (ED) nurses who worked at Detroit’s Sinai-Grace Hospital sued the hospital and its parent company, Tenet Health, last week for wrongful termination.
RNs Jeffrey Eichenlaub, Catherine Gaughan, Salah Hadwan, and Anthony Bonnett were fired in May for “violating various vague policies,” according to the complaint.
Their lawyer, James Rasor of Royal Oak, Michigan, said the firings were retaliatory because the nurses spoke out about patient safety during the COVID-19 pandemic.
He also claimed that two photos — one of body bags stacked on the floor and shelves in a refrigerated holding unit; the other of body bags placed on beds and a chair in a sleep lab — were a pretext for the terminations. The photos were leaked to CNN in April and raised questions about whether Tenet was in compliance with laws about dead body storage.
During a Zoom interview, the nurses told MedPage Today that, while they saw the photos when they first were circulated, they did not send them to CNN. It’s not known who did, Rasor said.
But the nurses did raise concerns about patient safety, insufficient staffing, and personal protective equipment (PPE) to hospital management, the media, and government officials during the pandemic. The lawsuits claim Dallas-based Tenet violated their rights under the Michigan Whistleblowers’ Protection Act.
“When you fire people because they’re exposing your illegal conduct as an employer, that’s called firing a whistleblower,” Rasor told MedPage Today. “It’s unlawful. It’s wrong.”
The nurses also allege that patients who should have had positive outcomes died because Sinai-Grace was short-staffed, and that Tenet failed to institute emergency protocols to help healthcare workers save lives by increasing staff and equipment levels.
“The lack of staff, lack of equipment, lack of PPE, and lack of leadership presence put patient safety at great risk,” Eichenlaub said. “There could have been a lot of deaths prevented by having appropriate patient-nurse ratios and having the appropriate equipment to take care of the patients we were serving.”
Detroit was hit hard by the pandemic, but other local EDs didn’t have problems like this, Rasor maintained. “I have friends and relatives who work in other hospital systems,” he said. “This didn’t happen in any of the area hospitals.”
Sinai-Grace is situated in a low-income neighborhood in northwest Detroit, about 10 miles from Wayne State University medical school and its nearby hospitals. It’s owned by for-profit Tenet Health and is part of the Detroit Medical Center alliance.
The hospital historically has been understaffed, Rasor said. On April 5, a group of night-shift ED nurses, including Hadwan, staged a protest in the hospital’s break room to demand that more nurses be brought in. Seven nurses were scheduled to cover 130 patients that night; each emergency nurse would have had to care for up to 20 patients at once, the nurses said.
“Tonight, it was the breaking point for us because we cannot take care of your loved ones out here with just six or seven nurses and multiple vents, multiple people on drips,” Hadwan told the Detroit Free Press at the time, adding that the patient load had been building for 3 weeks.
The hospital ordered the protesting nurses to leave, forcing day-shift nurses to continue working for 24 hours straight.
Eichenlaub, a day-shift nurse, told MedPage Today he went to Sinai-Grace’s chief nursing officer later that day. “I said, why did we not declare an internal disaster? Why are we not making this a state of emergency? Within the hospital, where’s all the leadership that should be here right now?”
“We shouldn’t be forcing nurses to work 24- or 25-hour shifts taking care of patients, putting not only the patients at risk, but putting all the staff at risk too for errors that are going to occur — because errors will occur, once you get to a certain point,” he said.
After that meeting, Eichenlaub’s wife, a nurse at another local hospital, emailed state and federal government officials on his behalf, detailing the staffing and patient safety issues her husband had raised.
In the next week, COVID cases continued to pour in. The ED still was short-staffed. Beds, equipment, and oxygen were scarce. The hospital was “a war zone; there were patients lying everywhere,” Eichenlaub said.
“All three coolers are filled, the morgue and the viewing room next to the morgue are full and right now, we’re taking bodies to the sleep lab to store them,” he told Detroit News reporters. “We initially had to double-bag each patient, but we started to run out of body bags and began scrambling floor-to-floor to find places to take them.”
A Detroit firefighter told local TV news that Sinai-Grace couldn’t find his 68-year-old mother’s body for nearly a week after she died.
After the COVID surge waned — when the number of ED patients fell from 130 to 30 — hospital management met with employees about the CNN photos. “They told us we ruined our relationship with the community because those pictures were sent to the media,” Gaughan said.
“I want people to know that we — the nurses and doctors and hospital employees — didn’t fail their families,” Hadwan told MedPage Today. “The corporation, Tenet, failed their families.”
Brian Taylor, a spokesperson for Detroit Medical Center, told MedPage Today the company doesn’t comment on litigation, but shared a statement it released when the nurses were terminated:
“Our ethics hotline received complaints that employees had taken inappropriate photos of deceased patients at Sinai Grace Hospital and shared them with other employees,” the statement read. “We conducted a comprehensive investigation and took appropriate action based on employee admissions of violations of our patients’ right to privacy.”
“We have an unwavering commitment and obligation to respect the privacy of our patients and to treat them with dignity and respect,” it continued. “We will not tolerate actions to the contrary.”
Last month, the Michigan Department of Licensing and Regulatory Affairs cleared Sinai-Grace of alleged infection prevention and nurse staffing violations. The department does not have jurisdiction to investigate the way the hospital handled body storage, public radio station WDET reported.
On May 4, Tenet’s report to shareholders showed the company had $2.2 billion in excess cash and $1.9 billion available through lines of credit. Tenet had received about $1.5 billion of Medicare advance payments from the Centers for Medicare and Medicaid Services and approximately $345 million in grant aid through the CARES Act.
Shares in Tenet have doubled since market lows in mid-March, the New York Times reported in June. Tenet remained profitable in the first quarter, despite a $73-million hit due to COVID-19.
While the company faced an influx of COVID-19 patients in Michigan, Massachusetts, California, and Florida, Tenet chief executive Ron Rittenmeyer told analysts and investors last month they were never overwhelmed, according to the Times.
The plea for support at Sinai-Grace didn’t happen just because of COVID-19, the nurses emphasized. “We’ve been crying for help long before the pandemic,” Eichenlaub said.
“And now we had a true state of emergency, we truly needed help, and we still were ignored.”
Last Updated June 15, 2020