By Jack Queen

Law360 (May 19, 2020, 4:32 PM EDT) -- A government psychiatric hospital in Washington, D.C., battling a coronavirus outbreak has pushed back on patient demands for additional court-ordered containment measures, saying further intervention would overburden staff and bog down the facility's response.

Saint Elizabeths Hospital on Monday said the plaintiffs in the proposed class action twisted the facts in their motion for a preliminary injunction but still failed to show that the facility's pandemic response deviated from public health guidelines. The court shouldn't meddle further in the suit over allegedly "inhumane" conditions, Saint Elizabeths said.

"Their requests, which include burdensome monitoring and reporting requirements, would divert the time and resources of hospital staff responding to this pandemic, and would intrude on the judgments of healthcare professionals entrusted with patient care," it said.

The patients' lawsuit began last October as a class action stemming from a Legionnaires' disease scare and resulting water shutoff at the public psychiatric facility. It has since evolved into a court-mediated scramble to halt the spread of COVID-19, which has killed 14 patients at the hospital since the first case April 1.

Containment measures ordered by U.S. District Judge Randolph Moss in a temporary restraining order earlier this month, expanded and extended May 11, have significantly burdened Saint Elizabeths, according to the hospital's filing.

The hospital said its containment policies reflect the sound professional judgment of its leadership that should not be questioned or micromanaged by the court. Judge Moss should not grant the patients their requested preliminary injunction, Saint Elizabeths said.

"To order the time- and work-intensive relief plaintiffs now seek would strain the hospital's staff and threaten to jeopardize the provision of adequate care to patients," the hospital said.

Saint Elizabeths said it had complied with all the court's conditions and managed the crisis in line with guidelines from the U.S. Centers for Disease Control and Prevention. A court-appointed expert panel that examined the facility's response contained ample praise, the hospital said.

Despite the "remarkable" efforts of staff, the unprecedented scale of the pandemic and unique circumstances at Saint Elizabeths — which houses roughly 200 involuntarily committed psychiatric patients — have made containment difficult, the hospital said.

Mask enforcement is difficult among mentally ill patients, the hospital said. Limiting staff mixing between units is sometimes impossible due to medical emergencies, and efforts to reduce the patient population have been hampered by both legal constraints on court-committed residents and the practical difficulty of finding housing for them amid a global pandemic.

Saint Elizabeths noted that much of the relevant COVID-19 guidance from the CDC says hospitals "should" do or "consider" doing things like limiting staffing mixing through units. The guidelines include leeway for a reason, the hospital said.

"As the CDC recently made clear in new guidance issued for psychiatric and behavioral health facilities, its recommendations are designed to be flexible, giving a facility like Saint Elizabeths the room to account for its unique patient population," it said.

Other obstacles to containment are universal, the hospital said, including limited testing capacity and availability of personal protective equipment. Saint Elizabeths has nonetheless done everything it can to on the hygiene, testing and monitoring fronts, it said.

Counsel for the parties did not immediately respond to requests for comment Tuesday.

The patients are represented by Arthur B. Spitzer, Scott Michelman and Michael Perloff of the American Civil Liberties Union Foundation of the District of Columbia; Kaitlin Banner, Margaret Hart, Hannah Lieberman, Jonathan Smith and Maria Morris of the Washington Lawyers' Committee for Civil Rights and Urban Affairs; and John A. Freedman, Tirzah S. Lollar and Emily Reeder-Ricchetti of Arnold & Porter.

Saint Elizabeths is represented by Fernando Amarillas, Micah Bluming, Honey Morton, Gavin N. Palmer and Robert A. Deberardinis Jr. of the D.C. attorney general's office.

The case is Costa et al. v. Bazron et al., case number 1:19-cv-03185, in the U.S. District Court for the District of Columbia.

--Editing by Peter Rozovsky.

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