NEW YORK (CNN) -- Blood clots from a long period of inactivity killed a woman who died last month on a waiting room floor at a New York hospital, the state's medical examiner said Friday.
Surveillance video shows Esmin Green on the hospital floor for more than an hour before anyone helps her.
The death of Esmin Green attracted media attention worldwide when a security camera captured hospital employees and other patients appearing to ignore her when she slumped out of a chair and began convulsing on the floor.
The Jamaican immigrant had been involuntarily admitted to Kings County Hospital in Brooklyn, New York, on June 18 for what the hospital described as "agitation and psychosis."
The security video, released earlier this month by the New York Civil Liberties Union, showed that the mother of six waited in a chair for nearly 24 hours before she fell on the floor on June 19.
An hour went by before a hospital employee nudged Green, 49, with her foot and summoned help.
The NYCLU alleged that hospital records were falsified to show that Green had been "sitting quietly in the waiting room" a little more than 10 minutes after she had stopped moving and 48 minutes after she slid to the floor.
Green's autopsy reveals that she died from pulmonary thromboemboli -- blood clots that formed in her legs and eventually made their way into her lungs, according to Ellen Borakove, the medical examiner's spokeswoman. The clots came from deep vein thrombosis, which complicated Green's chronic paranoid schizophrenia.
Many people afflicted with deep vein thrombosis are unaware they have the condition, but symptoms including pain or swelling in the leg or shortness of breath.
Drugs that stop the clots from forming can help and can also prevent existing clots from growing larger. Doctors recommend that people with deep vein thrombosis avoid long periods of inactivity and frequently exercise their legs during long trips.
After the security videos were released, the New York City Health and Hospitals Corporation, which oversees the hospital, said it was "shocked and distressed by this situation. It is clear that some of our employees failed to act based on our compassionate standards of care."
Seven workers, including doctors, nurses and security guards, have been fired or suspended since Green's death, the corporation said. It's not clear whether any of the employees have appealed the disciplinary actions against them.
The agency, which acknowledged the discrepancy in the hospital records, said it referred the matter to law enforcement and is cooperating with the investigation.
Green's relatives say they plan to file a $25 million lawsuit against the city and the hospital and have called for criminal charges against hospital workers.
Kings County Hospital is already the subject of a lawsuit filed in May 2007 alleging that conditions at the facility are filthy. Patients are often forced to sleep in plastic chairs or on floors covered in urine, feces and blood while waiting for beds, the groups allege, and often go without basic hygiene such as showers, clean linens and clean clothes. The lawsuit claims that patients who complain face physical abuse and are injected with drugs to keep them docile.
The hospital lacks "the minimal requirements of basic cleanliness, space, privacy, and personal hygiene that are constitutionally guaranteed even to convicted felons," according to the suit.
The video of Green's death sent the organizations back into court July 1, demanding immediate reform. Among the reforms agreed to in court by the hospital are additional staffing; checking of patients every 15 minutes; and limiting to 25 the number of patients in the psychiatric emergency ward, officials said.
In addition, the hospital said it is expanding crisis-prevention training for staff; expanding space to prevent overcrowding; and reducing patients' wait time for release, treatment or placement in an inpatient bed.
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