This DefenseMedia article on Ray Nagin’s indictment brings several things to light but fails to address some of the key issues that were covered in our book: “Deadly Neglect: Apathy & Denial vs. Act of Godâ€, which provides an in-depth look at the run up and impact of Katrina and the fatal consequences. Although corruption, bribery and mismanagement – all crimes of which Nagin has been accused – are serious breaches of the Public trust, they usually do not result in the death of hundreds of citizens.

There was a million dollar exercise, PAM, that foretold the consequences of Hurricane Katrina a year earlier which was almost an exact match for what happened in real life down to the levees failing, the number of homeless as a result, lack of electricity, water and other Public Services including Safety and Security. The lack of Security for healthcare facilities included snipers preventing Emergency Room admissions and gangs roaming through dark hospitals and trying to break into unsecured pharmacies.

For many years prior to Katrina, the decision was made to evacuate patients from Nursing Homes and Hospitals to keep them safe during hurricanes. The failure to do so under Nagin’s failed leadership contributed to the deaths of 334 patients, over a third of the overall death toll in the NOLA area during Katrina. As we reflect on this, the question begs itself: was the decision not to evacuate made out of ignorance or as a political favor to people putting patients at risk for financial motives?

We took exception to another point that deals specifically with healthcare: Mayor Bloomberg decided against evacuating the NY hospitals and due to the same issue of flooded generators, was forced to rely on National Guard troops to go in and support the evacuation when electricity was lost. Fortunately there were no deaths (that we know of) that resulted from this decision, but clearly it was a repeat of a Nagin’s bad decision and a failure to learn one of the basic lessons from Katrina. If the water had risen a few more feet, the results could have been catastrophic. With all the Public money that has gone into preventing disasters in NY, it only takes a couple of facilities that are unready and one decision not to evacuate to put the most vulnerable patients at risk.