By Y. Peter Kang

Law360 (May 26, 2020, 10:16 PM EDT ) A District of Columbia psychiatric hospital accused of subjecting patients to "inhumane" conditions that caused the deaths of 14 people from COVID-19 has been ordered to institute staffing measures that exceed guidelines set by the U.S. Centers for Disease Control and Prevention.

U.S. District Judge Randolph D. Moss on Sunday partially granted a preliminary injunction ordering Saint Elizabeths Hospital to restrict staff movements and to broaden monitoring efforts on the advice of a court-appointed expert panel, which investigated the circumstances of an outbreak at the public hospital that resulted in dozens of infections and the deaths of 13 patients and one worker.

The ruling extends a prior temporary restraining order compelling the hospital to buckle down on a range of alleged shortcomings, including inadequate testing, social distancing and isolation of exposed residents.

While the hospital had argued that injunctive relief was not necessary, because it had complied with the temporary restraining order, Judge Moss said that if compliance with the terms of a TRO were enough to beat a preliminary injunction, "few — if any — cases would make it past the TRO stage."

The judge ordered the hospital to keep staff assigned to a single unit throughout the day, including during overtime shifts, even though CDC guidance doesn't mandate one unit to have a dedicated medical staff.

Judge Moss cited the recommendations of an expert panel, including two infectious disease experts and the former CEO of Saint Elizabeths, that investigated the situation at the hospital and concluded staff members were the most likely source of the disease's continued spread.

"After conducting an extensive and thorough assessment of conditions at the hospital, amici explained the reasons why staff are the most likely sources of reintroduction and further spread of COVID-19 at Saint Elizabeths," the judge said. "Thus, even if CDC guidance does not require dedicated staff in all circumstances, amici have persuasively explained why it is essential in the present context."

Hospital staff must also be included in the so-called point prevalence surveys and mass testing designed to track exposure to the virus, the judge ordered. If a staff member tests positive for the coronavirus, they must be excluded from the hospital for 14 days and must have two negative tests over a three-day span before returning to work, according to the order.

However, Judge Moss rejected the patients' bid to appoint an independent monitor to oversee staff infection control measures at the hospital, saying the facility has already taken steps to improve its procedures.

"The court is unpersuaded that imposing the drastic step of appointing an independent monitor is warranted at this time," he said. "Should issues persist, plaintiffs may renew this request."

The preliminary injunction is the latest turn in a rapidly evolving case that began in October as a class action alleging "inhumane" conditions at the public psychiatric facility, and has since evolved into a court-mediated scramble to halt the spread of COVID-19.

Kaitlin Banner, one of the attorneys for the patients, said in a statement on Sunday that the hospital has become a coronavirus hotspot, "because the District failed to implement necessary infection control measures appropriately and in a timely manner."

"This order is essential to slow the spread of the virus and limit further tragedy," Banner said.

Representatives for the hospital and the D.C. attorney general's office did not immediately respond to requests for comment.

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.

The defendants are represented by Micah Ian Bluming and Honey C. Morton of the District of Columbia 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.

--Additional reporting by Jack Queen. Editing by Nicole Bleier.

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