In America How did eight people die in Florida nursing home?

Shocked Americans were struggling on Thursday to understand how eight elderly people in a Florida retirement home -- directly across the street from a hospital -- could have died in the days following Hurricane Irma's devastating passage.

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Police directing traffic outside a retirement home in Hollywood Hills, Florida after severe heat apparently contributed to the deaths of eight residents play

Police directing traffic outside a retirement home in Hollywood Hills, Florida after severe heat apparently contributed to the deaths of eight residents

(GETTY IMAGES NORTH AMERICA/AFP/File)
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Shocked Americans were struggling on Thursday to understand how eight elderly people in a Florida retirement home -- directly across the street from a hospital -- could have died in the days following Hurricane Irma's devastating passage.

The matter is now in the hands of the law.

Making the drama even more shocking, the deaths could perhaps have been prevented by hooking up an emergency generator to keep air conditioners working in the stifling hot home after it lost electricity in the storm.

The deaths, coming at a time when millions of Floridians remain without power, have fueled new fears. Florida is the US state with the largest proportion of elderly residents, spread among nearly 700 retirement homes.

With temperatures soaring inside the ill-fated home this week, three people in their seventies, two in their eighties and three in their nineties apparently suffered at length before dying, some of them after being transported -- too late -- to the nearby hospital.

Authorities fear others taken there might not survive.

The home -- the Rehabilitation Center at Hollywood Hills, just north of Miami -- seemed prepared for a range of storm-related difficulties: hunger, thirst, isolation and flooding.

It had stocked a week's worth of food, and late last year conducted a hurricane drill.

But it evidently was unprepared for the intense heat and debilitating humidity that had made Floridians miserable before the widespread advent of air conditioning -- the kind of wilting heat that can prove deadly to the elderly.

The temperature Thursday in the region was 90 degrees Fahrenheit (32 degrees centigrade). In uncooled rooms in the retirement home it would have soared far higher.

Irma swept through the area on Sunday, but the first emergency call from the home did not come until Wednesday at 3:00 a.m., after residents had suffered through three miserably hot days.

The crisis was sparked when the storm knocked out a transformer that powered the retirement home's air-conditioning system.

At that point, said nursing home administrator Jorge Carballo, "Staff set up mobile cooling units and fans to cool the facility and continually checked on our residents' well-being to ensure they were hydrated."

'Save your oxygen'

A man waited outside the nursing home in Hollywood Hills, Florida for news of a wife's relative play

A man waited outside the nursing home in Hollywood Hills, Florida for news of a wife's relative

(GETTY IMAGES NORTH AMERICA/AFP/File)

But the temperature continued to rise, reaching unendurable levels. Residents seeking respite flocked into the hallways and gathered around the small -- too-small -- portable air conditioners.

Jean Johnson described her last visit to a friend, 84-year-old Betty Hibbard, who was later to die in the hospital.

"It was hot in there," she told CNN, adding that her friend "couldn't hardly talk."

"So I said, 'Look, honey, we are gonna leave because I don't want you talking, you've got to save your oxygen.'"

Shaking her head, Johnson added, "What a terrible price to pay."

Randy Katz, medical director for the emergency department at Memorial Regional Hospital, across the street from the home, described the chaotic scene he encountered when he arrived there Wednesday: dozens of elderly people severely dehydrated or in respiratory distress, suffering in a sweltering atmosphere. Three had already died.

Some 115 retirees have now been evacuated from the home, one-third of them hospitalized.

Florida Governor Rick Scott denounced the tragedy as "unfathomable." He ordered the closing of the retirement home while an official investigation is conducted.

As investigators work to apportion blame, the management of the Hollywood Hills home and the electric utility that supplies it, Florida Power & Light, have been pointing fingers at each other.

In a statement, the utility noted that part of the retirement home had kept power through the storm, that the facility should have had a working backup generator, and that it could have sent vulnerable residents across the street to the hospital.

The home has had its problems. It was purchased at auction in 2015 after its previous owner was jailed for Medicare fraud, the Miami Herald reported. But the latest state inspection found no deficiencies in its emergency readiness.

Lack of communication

A police officer stands outside the nursing home in Hollywood Hills, Florida where some residents died in extreme heat after Hurricane Irma play

A police officer stands outside the nursing home in Hollywood Hills, Florida where some residents died in extreme heat after Hurricane Irma

(GETTY IMAGES NORTH AMERICA/AFP/File)

Count mayor Barbara Sharief has criticized the facility for being slow to react when its residents' health was in peril. The home's staff also seemed to have fallen short in communicating with residents' families.

"Why they don't call me?" when the air conditioning went out, Carmen Fernandez, a neighbor who took care of 99-year-old Albertina Vega, asked on CBS.

"I'd have brought her here."

Jeffrey Nova learned of his mother's death from a journalist, after having tried in vain since Sunday to reach the home's nursing staff.

"I'm not quite clear on how this happened," he told CNN, adding that even before the hurricane it had been like "pulling teeth" to get answers.

Michael Duffy, an expert in negligence and liability law, said the actions -- or inaction -- of the home's managers and staff had gone beyond simple negligence.

"Their indifference crossed the line and was clearly criminal," he said.

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