A patient died earlier this year when no one was around to treat him in the emergency department of Loretto Hospital, where about 200 unionized workers are on strike over staffing conditions.

WBEZ obtained an inspection report about the death from the Centers for Medicare and Medicaid Services, which funds hospitals and investigates patient safety issues. Loretto Hospital officials acknowledged “staffing challenges” in the report. The waiting area and the triage room within the waiting area, where the patient was found in a bathroom, were both covered by one nurse, the report said.

“Loretto Hospitals recognizes this poses a risk from a patient safety standpoint i.e. the waiting area is not monitored when the triage nurse is with a patient in the triage room,” according to the report.

About one-third of the staff at Loretto went on strike this week over better pay and safer staffing conditions. They include ER techs, nursing assistants and maintenance workers, all of whom are represented by SEIU Healthcare. Union leaders say some Loretto employees make less than minimum wage, they’re burned out working long shifts and are getting injured on the job. They say the turnover rate hovers around 60%.

As dozens of people lined the sidewalk in front of Loretto on Wednesday, shaded by trees on the third day of the strike, some employees shared stories of feeling unsafe at work.

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Shiniki Davis-Jackson, a tech in the emergency department, said she was beaten up last week by a patient. The ER is supposed to have at least five technicians, who help with everything from getting patients into gowns to drawing blood, but only three were working, Davis-Jackson said. While she escorted a patient back to his room, “he started swinging on me.” She said the patient punched her in the face and on her side, kicked her leg and punched her head into a linen cart.

“I called out for co-workers, but there was no one there because there was no adequate staffing to come help,” Davis-Jackson said, adding that it took a few minutes for other employees to arrive to help. “It was very scary.”

She said she’s been assaulted before, a few years ago. It’s one of her biggest fears.

“I do not feel safe at work, even if it’s fully staffed,” Davis-Jackson said. “But when it’s short-staffed, it’s even worse because you don’t have the manpower to (handle) some of these strong patients.”

Loretto is a safety net hospital on the West Side that serves mostly low-income Black patients. Davis-Jackson sees patients who are unhoused, drunk or high on drugs, and many have mental health conditions. It’s common to have patients who overdose on opioids. In other words, the patients have a lot of struggles, and they can be tough to treat.

Records show federal inspectors have long had concerns about Loretto not having enough staff and the ripple effect on patients. In recent years there was a suicidal patient left alone who attempted suicide in the bathroom in the ER waiting room. A pregnant patient died after the hospital failed to make sure an immediate ultrasound was done “in a timely manner.” There haven’t been enough nurses to monitor patients recovering from surgery those in the emergency department.

A Loretto spokeswoman has countered that the strike is over money, not patient safety. Non-union workers haven’t received a raise in three years and took a pay cut to prevent layoffs, the spokeswoman said in a statement earlier this week.

The incident with the patient who died started on Feb. 24. According to the inspection report, video surveillance shows the patient walking into the emergency department at 11:18 p.m., and filling out a chief complaint form — writing “cardiac emergencies” — at the front desk of the waiting room. No staff were around. The patient put the form in a box on the triage nurse’s door, then went to the bathroom just a few feet away. He had a history of schizophrenia, high blood pressure, diabetes and heroin use, according to the report.

A few minutes later, the triage nurse came out, found the form, looked around, then went back to the triage room, the inspection report said. The patient came out of the bathroom and then returned to it.

About 15 minutes later, a patient safety officer opened the bathroom door after knocking, just as the triage nurse arrived, and they found the patient face down on the floor, according to the report. The officer “nudged” the patient and saw he didn’t move, the report continued.

The patient was pulled into a sitting position before the triage nurse left, and two officers got a wheelchair. No one up to this point tried to revive the patient, the report said.

Then an emergency department tech showed up with a “transportation cart” and took the patient to a treatment area.

Staff intubated him, administered the opioid overdose drug Narcan and gave him three rounds of epinephrine to help jump start his heart.

The patient was placed on a ventilator, and his mother gave consent to not resuscitate him, according to the report.

He was pronounced dead at 7:30 p.m. the next day. A physician note said, “Assessment: Cardiac arrest, Fentanyl (opioid) overdose.”

Loretto Hospital leaders created a so-called plan of correction for inspectors. They vowed to make sure the triage waiting area would be monitored at all times by a clinical employee, such as a nurse. The ER director would audit a sample of charts every day to make sure all patients who come to the ER are screened. And staff in the emergency department would be educated once again about the importance of immediately providing life support including CPR, among other changes

The Loretto spokeswoman declined a request for an interview about the patient’s death.

Vidal Williams, a lead mental health specialist on the hospital’s behavioral health unit, said he feels unsafe at work, but has gotten used to not having enough colleagues to help treat patients.

“There’s a fear there,” said Williams, who has worked at Loretto for nearly 20 years. “But I try to stay prayerful for the most part, just hoping that things would get better.”

Last Sunday, he said he worked the overnight shift alone. There were supposed to be two more workers. There were 13 patients on the unit, including one who was supposed to have one-on-one supervision because he was at risk of falling and has dementia, Williams said. The unit has two long hallways full of rooms, making it hard to keep an eye on what’s happening on the other side.

A veteran on the unit, he said he often trains new employees who end up not feeling safe and wanting more pay. They leave for other jobs.

Kristen Schorsch covers public health and Cook County for WBEZ.