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16 Sep

Riverside State Hospital is a five-hundred-bed


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Riverside State Hospital is a five-hundred-bed, state-supported psychiatric facility located along the scenic banks of the Tennessee River. Admission to the facility requires a physician’s order or a court referral. The hospital staff consists of physicians, psychologists, psychiatrists, nurses, dietitians, pharmacists, therapists, technicians, and general housekeeping and grounds keeping personnel, all of whom are state employees. The hospital is run primarily as a bureaucracy, with levels of authority and salary based on seniority and rank. All employees hold a government service (GS) rank, the lowest being GS-1 (grounds keeping trainee) and the highest GS-15 (administrator or CEO). In addition, within each rank are seven to ten steps, which are determined by seniority and achievement. Performance reviews are conducted annually, at which time promotions in steps or in GS rank may occur. Employees are given annual salary adjustments for inflation or cost-of-living increases. Full state benefits are provided to all workers. Riverside employees work an eight-hour shift. Employees below rank GS- 12 (head or chief) take a thirty-minute lunch break and two fifteen-minute breaks during their shift. Members of the professional staff (physicians, nurses, pharmacists, and the like) work on a three-shift schedule: 7 a.m. to 3 p.m., 3 p.m. to 11 p.m., and 11 p.m. to 7 a.m. The hospital operates year-round. The Problem A few days ago, a resident patient at Riverside State Hospital was killed when part of the wall next to his bed collapsed. Horace James Wilcox Jr. was fifty-six years old when he died. He had no family and had been a resident at the hospital for three years. He suffered from traumatic amnesia and scored in the borderline range on intelligence tests. He was otherwise in good health. He was also well liked and seemed to be responding to treatment. In statements made to state investigators and the news media, hospital administrators called the accident a “tragedy.” They explained, “There had been no indication that the wall was weak or that Wilcox was in any danger.” You are the government investigator assigned to the Wilcox case. Your job is to determine whether any evidence exists that would make Riverside State Hospital liable for Wilcox’s death. (Eisenberg, 01/2010)

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