St. Elizabeths Hospital and a group of patients have settled a lawsuit over the hospital’s mishandling of its October 2019 water crisis and inadequate safety procedures during the early stages of the COVID-19 pandemic.

The settlement requires that the District-run psychiatric hospital update its emergency procedures to prevent situations like these from arising in the future and to better protect its patients — the majority of whom are Black residents.

With the help of local civil rights groups, patients filed a federal class action lawsuit in 2019 after going nearly a month without potable water — officials had discovered Legionella and pseudomonas bacteria in the water supply. The hospital continued to admit new patients, even as the existing patients and staff were forced to use portable showers and cook with bottled water. The Washington Lawyers’ Committee for Civil Rights and Urban Affairs, the American Civil Liberties Union of D.C., and Arnold & Porter law firm filed the suit with the U.S. District Court of D.C. in October of 2019.

The situation worsened in March 2020 when, over a three-month period, more than 187 patients contracted COVID-19 and 14 patients died, according to the settlement announcement. The patients amended their lawsuit in April 2020 to include the COVID-19 crisis. The court determined that patients at St. Elizabeths were 40 times more likely to get COVID than the average resident from March to May 2020, per the Washington Lawyers’ Committee press release. Disability Rights D.C. later reported that in the first year of the pandemic, more than half of the patients contracted COVID-19, while 17 patients and one staffer died.

The court ruled that there was no defense for the hospital’s “perilous practice” during the health emergency and issued an injunction requiring the District to implement stricter testing and isolation practices.

The settlement mandates that the District take additional measures to protect patients at the Southeast D.C. facility. Going forward, the hospital must provide specific documentation to show the water contamination issue has been solved; maintain a supply of personal protective equipment (PPE) for patients and staff; work with other D.C. hospitals to transfer patients if necessary and make sure their care isn’t cut off at those facilities; and keep patients, families, and the D.C. public informed about future emergencies.

St. Elizabeths, D.C.’s only public psychiatric hospital, has faced repeated scrutiny from civil rights organizations which say the hospital has long neglected its responsibilities to provide humane conditions for patients. In September 2020, for example, one group reported that the hospital had increased its practices of restraint and seclusion in recent years, violating its own safety policies, as well as D.C. law. Local advocates hope the settlement will help ensure the D.C. government, at the least, provides a safer environment for St. Elizabeths’ patients during future emergencies.

“The standards for St. Elizabeths should be no different than what we all expect at hospitals treating the general public,” said Kaitlin Banner, deputy legal director at the Washington Lawyers’ Committee, in a statement. “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.”