St. Elizabeths Settles Case with Patients Who Endured Life Threatening Conditions During Water Crisis and COVID-19

Gregg Kelley, Washington Lawyers’ Committee for Civil Rights and Urban Affairs, [email protected], 202-319-1070

Contact Yvonne Slosarski, ACLU-D.C.
[email protected], 202-615-5124

WASHINGTON-Patients at St. Elizabeths Hospital settled their lawsuit against the Hospital and the District of Columbia for the unconstitutional conditions during the water shut-off in October 2019 and the start of the COVID-19 crisis. The settlement requires the District to implement new emergency preparedness procedures that will protect patients from the harms they experienced during these past emergencies.

St. Elizabeths patients, who are majority Black, with limited resources, and all of whom have disabilities and depend on the District for their care, were exposed to inhumane conditions as a result of the District’s mismanagement of these crises. When water to the Hospital was shut off in 2019 because of a bacterial contamination, critical treatment was terminated for many patients, and all patients had, for more 30 days, limited or no access to showers, other basic hygiene, and hot food.

When the COVID pandemic hit in the wake of the water crisis, the District failed to put into place basic infection control measures recommended by the Centers for Disease Control and Prevention. From March to May 2020, more than 187 patients in the hospital contracted COVID resulting in 14 patient deaths. During this period, the Court estimated that the chances of a person in St. Elizabeths contracting COVID was 40 times the risk for a person living in the community.

Until ordered to do so by the Court, the District failed to have an adequate testing and isolation program. In April and May 2020, the court issued a temporary restraining order and then a preliminary injunction requiring the District to conform to CDC guidance by increasing its use of medical isolation for COVID and to test all patients and staff for the virus. As the court concluded, the Hospital could not defend its “perilous practice” regarding isolation and D.C. officials’ “delay in testing all staff and their lack of a plan to continue testing all patients and staff constitutes a substantial departure from professional judgment.” The injunction was in place for nearly a year and resulted in significant improvements in the care and testing for patients and staff, as reflected in the lower numbers of infections and deaths under the injunction than before it.

The current settlement requires the District to take affirmative steps to protect patient safety, to ensure they are receiving the medical and mental health care they need, and to ensure they are not placed in unwarranted restrictive settings as the result of an emergency. Specifically, the District has agreed to provide documentation that the water contamination has been remediated; has agreed to procure and maintain a supply of personal protective equipment for patients and staff; has agreed to maintain agreements with other District hospitals to ensure they can accept St. Elizabeths patients in the event of an emergency and that resources are available for the patient to continue receiving medical and mental health treatment at those facilities; and has agreed that patients, families, and the community will be informed about future emergencies at St. Elizabeths. The District has also made substantive improvements to its Outbreak/Pandemic Management Plan in compliance with the standards set by the D.C. Department of Health and CDC.

“The standards for St. Elizabeths should be no different than what we all expect at hospitals treating the general public. This settlement will go a long way to make sure that this vulnerable population of patients is not yet again neglected during public health crises that impact their safety and care,” states Kaitlin Banner, Deputy Legal Director at the Washington Lawyers’ Committee for Civil Rights and Urban Affairs.

“The government has a basic constitutional duty to provide humane conditions for the people confined in its facilities, and for too long, the District has defaulted on that responsibility at St. Elizabeths Hospital,” said Scott Michelman, Legal Director, ACLU of the District of Columbia. “This settlement will help ensure that the government meets its constitutional obligation to provide a safe environment for the patients of St. Elizabeths.”

“We are proud to have been able to achieve this tremendous result for our clients,” said John A. Freedman, Senior Pro Bono Counsel, Arnold & Porter.  “What happened during the early pandemic was a tragedy but this settlement will help ensure St. Elizabeths is better prepared to protect patient health during any future emergencies.”

The case, Costa v. Bazron, was brought by the Washington Lawyers’ Committee for Civil Rights and Urban Affairs, the ACLU of the District of Columbia, and the law firm of Arnold & Porter.

Amended Complaint
Preliminary Injunction Order
Preliminary Injunction Opinion
Notice of Settlement and Settlement Agreement


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ABOUT THE WASHINGTON LAWYERS’ COMMITTEE: Founded in 1968, The Washington Lawyers’ Committee for Civil Rights and Urban Affairs works to create legal, economic and social equity through litigation, client and public education and public policy advocacy. While we fight discrimination against all people, we recognize the central role that current and historic race discrimination plays in sustaining inequity and recognize the critical importance of identifying, exposing, combatting and dismantling the systems that sustain racial oppression. For more information, please visit or call 202.319.1000. Follow us on Twitter at @WashLaw4CR.

ABOUT THE ACLU OF THE DISTRICT OF COLUMBIA: With more than 14,000 local members, the ACLU of the District of Columbia fights to protect and expand civil liberties and civil rights for people who live, work, and visit D.C., and in matters involving federal employees and agencies. ACLU-DC pursues its mission through legal action, legislative advocacy, and public education.  

ABOUT ARNOLD & PORTER: With more than 1,000 lawyers practicing in 15 offices around the globe, Arnold & Porter serves clients across 40 distinct practice areas. The firm offers 100 years of renowned regulatory expertise, sophisticated litigation and transactional practices, and leading multidisciplinary offerings in the life sciences and financial services industries.

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