Even As Death Toll Of Medical Evacuees Rises, Attorney General Says Official Number Of Hurricane-Related Deaths Will Remain At 5

At last count 49 medical evacuees from the U.S. Virgin Islands who were airlifted out of the territory for medical attention as a direct result of the 2017 storms, had died. The situation has aggrieved many families who for months have decried the way their loved ones have been treated by the local government, stating that the medical evacuees were abandoned after being sent to various states and Puerto Rico for care.

Even the medical evacuees themselves have complained about their circumstance, and someone in Atlanta who is intimately involved in advocacy for U.S. Virgin Islands medical evacuees, who requested anonymity to speak freely, told The Consortium, “It’s as if they’re waiting on them to die. The federal government no longer wants them and the local government doesn’t seem to care.”

During a Committee on Health, Hospitals and Human Services hearing in April at the Earl B. Ottley Legislative Hall, senators, Mapp administration and health officials offered mea culpas to the family members of medical evacuees, with Senator Nereida Rivera-O’Reilly apologizing on behalf of the entire government for the manner in which the process — from the airlifting to placement and communication — unfolded, and Department of Health and hospital officials, while stating that they had worked hard to evacuate residents in the humanest way possible under the worst of circumstances, admitted that more could have been done.

“The only response to what we just heard is, I’m sorry,” said Deputy D.O.H. Commissioner Reuben Molly.

But even as testimonies have been placed on record by family members of medical evacuees who believe that the adverse circumstances their loved ones faced following the storms may have contributed to their deaths, Attorney General Claude Walker, during an interview on Tuesday, told The Consortium that the official death toll of Hurricanes Irma and Maria-related deaths in the U.S. Virgin Islands would remain at 5.

“The issue of a hurricane-related death is one that varies where you have many jurisdictions grappling with what is a hurricane-related death. If someone dies as a direct result of something that transpired during the storm, like getting hit with debris or falling from a building, which is what we had here in the territory, then that’s clearly directly related, that’s a hurricane-related death, no problem,” Mr. Walker said.

“The issue that most jurisdictions are dealing with and what Puerto Rico and the Virgin Islands are dealing with, is that after the hurricanes, as people died, you have to ask yourself would those people have died even if the hurricanes didn’t hit. So after the hurricane, the next day or two days later someone dies as a result of having a heart attack, you have to ask yourself is that death pertaining to the hurricane or would that person have died regardless. This is where you get into issues of having to make that decision and the medical examiner has to determine is it related to the hurricane or not. And you take into consideration the person’s health history. If someone is known to have heart problems and dies after the hurricane, you can’t necessarily say it’s hurricane related if you know the person has serious heart issues.

“Now, the stress and trauma of going through hurricanes could contribute to that, but you still have to leave it to the medical examiner to make that determination as to whether it’s pertaining to the hurricane or not. But you can’t say simply every death that happens after a hurricane is hurricane-related,” said the attorney general.

Mr. Walker said the local medical examiner had not provided any information showing that more local deaths aside from the original five were related to the 2017 storms. And he said he had not received any information from medical examiners outside of the territory where Virgin Islands medical evacuees were receiving care, and have died, relative to what caused their deaths.

On Tuesday, new data from researchers from Harvard T.H. Chan School of Public Health and other institutions, cast doubt on the Puerto  Rico government’s official tally, estimating that roughly 4,645 people died as a result of the storm’s passage — many of them from delayed medical care — and not 64, as the government has said.

During the April hearing in the Committee on Health, Hospitals and Human Services, the testimonies of two families tugged at the heart of lawmakers and other government officials. “My dad was not an animal, he was a human being,” said Luz Correa-Chesterfield, who gave an account of the situation that led to her father’s death.Ms. Correa-Chesterfied, whose father died in Puerto Rico at age 90, had been in the Schneider Regional Medical Center (S.R.M.C.) for a knee replacement surgery, but was airlifted to Puerto Rico before the procedure was performed. Concerned about their dad, family members went to Puerto Rico to check on him, only to find their father in a tent outside the hospital with sores all over his body, and with clothes that needed to be washed.

Ruby Simmonds Esannason, a former senator, said “negligence” amplified the conditions of the medical evacuees, and most likely contributed to their deaths. She too, revealed how a family member had died after being airlifted. The situation cut deep because this family member was her son-in-law, a former police officer who was shot three times in the line of duty in 2012, and had become a dialysis patient.

“He survived being shot three times in the line of duty, but did not survive being evacuated from his home,” Ms. Simmonds lamented. She said her son-in-law, who was a healthy man, had lost 40 pounds following the evacuation and eventually died.

In October, The Consortium reported on the deaths of three medical evacuees and the frustration of those who said they felt abandoned by their government. Following our report, D.O.H. Commissioner Michelle Davis said the department would work to improve its communication with the patients. In November, medical evacuees described themselves to The Consortium as “The Forgotten Virgin Islanders”, again protesting the government’s seeming lack of care for its people.

Yet even with mounting evidence that negligence and delayed care may have contributed to the deaths of some medical evacuees, Mr. Walker said the official count would not be updated, adding that speculation by news publications and others who Mr. Walker said may have agendas, would not move him to amend the official number.

“The medical examiner determines the cause of death, not a politician, not a lawyer, not somebody just sitting on a couch, not a reporter,” Mr. Walker said. “The medical examiner has to say what is the cause of death and that’s a scientific determination. So people can say, well we have all these deaths because you moved somebody from point A to point B [so] they’re hurricane-related deaths. That’s not science, that’s not based on forensic science,” the attorney general contended. Mr. Walker said he had not received — and was not seeking out — information from medical examiners outside the territory where Virgin Islanders were sent, to determine the cause of death in an attempt to find out whether those deaths were in some form related to either Hurricane Irma or Maria.

According to the published results on the hurricane-related deaths in Puerto Rico, researchers surveyed 3,299 residences across Puerto Rico and interviewed their occupants. These occupants reported that 38 people living in their households had died between Sept. 20, when Hurricane Maria struck, and the end of 2017. That toll, converted into a mortality rate, was extrapolated to the larger population and compared with official statistics from the same period in 2016, according to the results.

“Our results indicate that the official death count of 64 is a substantial underestimate of the true burden of mortality after Hurricane Maria,” the researchers wrote. “Our estimate of 4645 excess deaths from September 20 through December 31, 2017, is likely to be conservative since subsequent adjustments for survivor bias and household-size distributions increase this estimate to more than 5,000. These adjustments represent one simple way to account for biases, but we have made our data publicly available for additional analyses.

“Our estimates are roughly consistent with press reports that evaluated deaths in the first month after the hurricane. Our estimates also indicate that mortality rates stayed high throughout the rest of the year. These numbers will serve as an important independent comparison to official statistics from death-registry data, which are currently being reevaluated,13,34 and underscore the inattention of the U.S. government to the frail infrastructure of Puerto Rico.”

Feature Image: Schneider Regional Medical patients land on St. Croix near the Juan F. Luis Hospital following Hurricane Irma, to be evacuated to medical facilities in Puerto Rico and the U.S. mainland. (Credit: Ernice Gilbert, VIC)