As reported in the Star Ledger of New Jersey. An easy bet seems to be that this is just the tip of the iceberg
Seven state employees, including two psychiatrists, were suspended yesterday for "neglect of duty" and other mistakes that allowed a patient at a state hospital to be killed by her roommate, a Human Services spokeswoman said.
Acting Human Services Commissioner James Smith also dismissed two temporary nurses who were working at Ancora Psychiatric Hospital in Camden County on July 14, the day 54-year-old Margaret Cetrangolo was strangled in her bedroom.
State Police arrested patient Salwa Srour, 36, who was the victim's roommate for less than a day. She has been held at the Ann Klein Forensic Center in Trenton since her arrest.
The disciplinary charges expose a breakdown in communications and a failure to follow hospital policy days before the homicide and an attempt to cover up mistakes after the fact.
"It was human error every step of the way," Human Services spokeswoman Ellen Lovejoy said. "It's unacceptable."
The problems began 11 days before the killing, when one of the hospital's chiefs of psychiatry "prescribed more than the maximum recommended amount" of medication for Cetrangolo. The psychiatrist, who was suspended for 11 days, also failed to keep the patient's files current for two months, Lovely said.
On the day she died, the hospital moved Cetrangolo to a different unit and paired her up with Srour.
One nurse failed to ensure Cetrangolo's medications came with her when she moved, so the patient went from being over-medicated to taking no medication in a single day, Lovejoy said. Another nurse looking after Srour failed to tell her supervisor the patient "had been acting out" and needed medication to control her behavior.
Both nurses were suspended for 30 days.
Two nursing supervisors also made critical errors by failing to note in Cetrangolo's file she was prone to aggressive behavior and needed to be monitored carefully. Both have been suspended for 30 days, Lovejoy said.
At 7:15 p.m. on July 14, Srour slapped one employee across the face and another on the arm. When one of the temporary nurses called the hospital's other psychiatry chief for advice, "the psychiatrist hung up before the nurse could fully complete his report to her and get an assessment and recommendation for treatment," Lovejoy said. The state ordered the psychiatrist suspended for 90 days, she added.
The state also meted out a 45-day suspension to a Human Services assistant who gave conflicting statements and falsified records about when she knew the victim needed closer supervision.
According to a police report, after the attack that evening Srour told a hospital worker, "I killed Margaret.... I strangled her and then put a pillow over her face and sat on her." The staff found Cetrangolo's body in her bedroom, which had a large window to allow staff to monitor patients inside, police said.
The state withheld the identities of the disciplined state employees, citing confidentiality requirements.
Ancora is a 730-bed adult inpatient facility in Winslow Township and one of five psychiatric hospitals operated by the state.
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