Just 22, she lived in a railroad flat in Bushwick, a part of Brooklyn that at the time was cheap but not yet hip, with a roommate who worked at the Museum of Modern Art. Ms. Seelig worked as a waitress in bistros on the Lower East Side while writing a novel and studying classics at Hunter College.
One night she stayed up all night translating a Latin text into English for a college paper. At 4 a.m. she e-mailed her professor saying she would deliver it in person. During the all-nighter, Ms. Seelig took Ephedra, a stimulant dietdrug that had been banned by the Food and Drug Administration three years earlier, and had a few beers. When she felt sick, she called Poison Control for help, and spoke very clearly, a recording of the call shows. She arrived by ambulance at Wyckoff Heights Medical Center, long regarded as one of the most troubled hospitals in the city, at 11:05 a.m. on May 30, 2007, conscious and alert but complaining of vomiting and dizziness.
She was given a sedative that put her into a deep sleep, and her wrists were tied to the bed. None of her friends or relatives knew that she was there, and medical records show no measurements of her vital signs for hours that afternoon, suggesting that she was left unattended by the medical staff.
By that evening she was brain damaged and on life support, with little hope of recovering. She died six days later.
Ms. Seelig's case brings to mind the death of Libby Zion, an 18-year-old Bennington College freshman who died in 1984, eight hours after being admitted to New York Hospital, where she had been sedated and tied down. Ms. Zion's death led to changes in the training of young doctors across the country, in a campaign led by her father, Sidney Zion, a well-connected New York writer.
But Ms. Seelig's grieving parents, Warren Seelig and Sherrie Gibson, carried on their crusade in private — and without the satisfaction of knowing that her death had changed the way medicine was practiced.
How could a 22-year-old woman die so abruptly? How could a youthful misstep have had such disastrous consequences? Those are questions the Seeligs still struggle to answer after five years. Because their daughter was alone at the hospital, they are left with only a sketchy record of her treatment and no way to know what she felt during her final hours. Her mother and her estate sued Wyckoff Hospital and staff members who had treated Ms. Seelig for malpractice, but they lost after an emotionally grueling four-week trial in the spring.
Asked what her daughter's biggest mistake might have been, Ms. Gibson said it was being young, carefree, adventurous and trusting.
"She had a wonderful innocent quality about her," said her friend Erin Durant, an aspiring songwriter who worked as a waitress with Ms. Seelig. "I don't mean that in a naïve way — that's a terrible word to use, innocent, but she was very, like, kind but real."
SABRINA was the younger of two sisters, and when she was little, her family lived in Philadelphia, where her parents taught at the University of the Arts. When she was 11, they moved to Rockland, Maine, a lobster town and artists' colony. She and her sister, Ashley, went skinny-dipping in the granite quarries. Their mother designed and sold clothing. Their father taught art and made ethereal sculptural forms that have been installed at places like the Pennsylvania Convention Center and the new American Embassy in Monrovia, Liberia.
When she was 13, she wanted to start an ice cream stand. Her father helped her build it, and they named it Lulu's, after their dog. The stand became a real business, a local phenomenon, and her sister still runs it today, with a small altar to Sabrina. "It has an authenticity about it, and Sabrina loved that kind of thing," Mr. Seelig said. "She is an old soul," he added, speaking of his younger daughter, still, in the present tense.
As a teenager, she directed plays, and her best friend, Caitlin FitzGerald, now an actress, starred in them. She graduated from high school a year early, in 2001, and took time off to travel before spending two years at Hampshire College in Amherst, Mass., attracted by its reputation for creativity. Then, restless again, she moved to New York, where her sister was in art school.
Ms. Seelig found an apartment at 70 St. Nicholas Avenue, five blocks from Wyckoff Hospital, and filled it with inspirational quotations from literature, shells from Maine and two paintings by her sister — "the only ones she ever liked," Ashley said, adding, "It was, like, extremely bohemian, like, oh, come on."
She drank Earl Grey tea with steamed milk, and wore flowing thrift-shop dresses.
Ms. Durant took her to the office of The Brooklyn Rail, a free, nonprofit journal of arts and politics based in Greenpoint, in a building just over the Pulaski Bridge from Long Island City, Queens, on a street so desolate it belongs in film noir. For Ms. Seelig, it was a sanctuary, almost like going home.
The Rail's publisher, Phong Bui, would let her visit in the middle of the night, after a shift as a waitress, so she could have a quiet place to write. "She would bring a bottle of wine or make coffee, depending on her mood," he said.
To David Varno, then The Rail's production editor, now getting a master's degree in creative writing at Columbia, it felt like a salon. "We would read books, talk about Walter Benjamin's 'Illuminations,' Dore Ashton's 'New York School,' " Mr. Varno said.
He went to her apartment for a couple of parties and saw her for the first time surrounded by her friends from Hampshire College, worldly, sophisticated and promising.
"They were all wearing these kind of fancy party dresses," he said. "I felt almost out of my element, but also happy to see that side of her, to see her in a more festive atmosphere."
Waiting on tables at the Pink Pony, on the Lower East Side, she met a regular customer, Jan Baracz, a Poland-born artist who was 25 years older than she was, and they started dating.
ON May 29, the day after Memorial Day, Ms. Seelig worked the dinner shift at Tree, a new restaurant in the East Village started by Colm Clancy, an Irish immigrant who had talked her into working for him.
She told Mr. Baracz that she could not see him because she had to go home to Bushwick to write her Latin paper. When her roommate, Colin Barry, left for work around 8 a.m. the next day, she was still at the kitchen table, papers spread out around her.
About 10:45 a.m., she called 911.
"I, I, I think I'm poisoned," she says on the recording of the call, which was provided to her parents after her death.
"I think after taking Ephedra, I looked online but I took Valerian, which is maybe poison, but I am having a hard time," she went on. Valerian is an herbal sleep remedy, which some toxicologists believe is a kind of placebo, with no medicinal qualities.
She added, "I've been vomiting for the past while, and my limbs feel heavy."
She hesitated only when asked her age. "Ah, 20-, 22, 23, no!" she cried. To her family, her confusion was understandable. Her birthday was two weeks away, on June 15.
The dispatcher asked if her door was unlocked, and she said she would go downstairs and unlock it.
When the ambulance did not come right away, she called the health department's Poison Control Center.
The Poison Control operator, a woman, told her to sit down and wait for the ambulance.
Ms. Seelig: When will they come?
Poison Control: When did you call them?
Ms. Seelig: I don't know. A while ago.
The operator, who seemed to be putting her off, asked if she could call a friend.
Ms. Seelig: I can, I did; they didn't answer.
Poison Control: Your mom?
Ms. Seelig: No. My mom is in a different state. I don't think it will help.
Poison Control, dismissively: Well maybe you could just talk to her for right now until the ambulance comes.
Ms. Seelig: O.K.
Poison Control: O.K. All right. Bye.
As the woman hung up and the line clicked, Sabrina could still be heard saying, "But help ..."
THE missed calls are part of the legacy of guilt and regret.
Before going to the hospital, Ms. Seelig called Mr. Baracz and a friend, Rebecca Green, but they did not pick up. She left no messages.
"Sometimes I think I have vibes," her mother said. "But I definitely had no vibes that morning or that day that anything was wrong. It just came out of the blue."
None of her friends had any inkling that anything was wrong until that night, when Ms. Seelig was supposed to host a dinner party. That afternoon, Mr. Baracz began calling about the menu. When she did not answer by 6 p.m., he sent a friend, Joanna Spinks, who lived around the corner, to look for her. The door to her apartment was unlocked and her laptop was on her bed, showing the Poison Control Web site. By calling 311, Mr. Baracz tracked her down at Wyckoff.
Ms. Spinks got to the hospital first, around 8 p.m., and then was joined by Ms. Green. They found Ms. Seelig in a small bed with a curtain around it. "She was there unconscious with all the tubes in her," Ms. Spinks said.
Her face looked normal, as if she were sleeping. "We were cutting up, like 'Earth to Sabrina,' " at her bedside, Ms. Green said, aghast at the memory.
Quickly, the guests from the canceled dinner party converged on the hospital.
Mr. Baracz, now 53, remembers asking a nurse what had happened. "You know what happened," she replied.
"Every hour they gave us a new explanation of what was happening," Ms. Green said. "When she was still asleep at 5 a.m., we knew something was wrong."
Mr. Baracz called Ms. Seelig's mother, who remembers being told by hospital staff that she should not rush to New York, that her daughter would come out of it by morning. Ignoring that advice, she and Mr. Seelig drove two hours to the airport in Portland that night and got to the hospital Thursday morning, where they were told that a constellation of specialists was being consulted.
Frustrated by a lack of clarity, Ms. Seelig's parents had her transferred to the Weill Cornell campus of NewYork-Presbyterian Hospital in Manhattan that evening; there, doctors tried a cooling therapy. Her friends held hands and sang. But it was too late. On June 4, 2007, Sabrina Seelig was declared brain-dead, and she was taken off life support the next day.
Ms. Seelig was an organ donor, so by the time of the autopsy, her body had already been carved up. The medical examiner concluded that she had died of "water intoxication," which usually means becoming overloaded with water without enough salt.
NO one is left to tell what Ms. Seelig was thinking or feeling before she died. The medical record, a jumble of handwritten notes, offers the only insight into her death. It came out over four weeks in May this year, at the trial for malpractice.
In 2007, when Ms. Seelig was a patient, the state ordered Wyckoff to hire a management consultant to improve its governance and finances. Five years later, it is still struggling. The Brooklyn district attorney has been investigating allegations of mismanagement. A three-month investigation by The New York Times, the results of which were published in March, found a history of insider dealing and positions being given to people with political ties. The hospital officials involved denied any wrongdoing. The hospital does not carry malpractice insurance.
In a pretrial deposition, an emergency-room doctor, Dali Mardach, remembered asking Ms. Seelig, "What's a nice-looking girl like you doing in Brooklyn?"
Dr. Mardach gave her two anti-nausea drugs, Phenergan and Tigan, which experts said can be sedating. As Ms. Seelig thrashed on the stretcher, Dr. Mardach ordered two doses of Ativan, a strong sedative, given intravenously at 1:15 and 1:45 p.m., for a total of four milligrams. She also ordered wrist restraints so that Ms. Seelig would not rip out her IV or hurt herself.
Much of the trial was a blur of technical detail. There was conflicting testimony as to whether Ms. Seelig was ever given oxygen. Her first blood test, which showed she was low on salt, was compromised; another test was not performed for hours. She was put in the care of a junior physician in training, Sameer Kaul, who found that she was "barely arousable." Dr. Mardach and the nurse, Joyce Smith, disagreed about which of them had found her when she crashed.
Most telling, all the witnesses agreed that there were no new vital signs entered in her chart for more than three hours, from 2:35 to 6:10 p.m., when she was found in a holding or overflow area with a racing heartbeat and foaming at the mouth. Ms. Smith said she had been watching Ms. Seelig's cardiac monitor constantly, so there was no need to write down her vital signs.
The plaintiffs' expert, Dr. Kelly Johnson-Arbor, argued that Ms. Seelig had been ignored while she suffered an agonizing death of hypoxia, or lack of oxygen, which if she were awake would have led to a feeling of being "suffocated," from the combined effects of the sedative drugs she had been given.
The defense argued that she had had a heart attack brought on by taking at least three Ephedra pills and whatever other drugs she might have taken. (The chart notes that she was "known" to take Focalin, an attention-deficit disorder drug commonly abused by college students to study.)
Late in the trial, as the plaintiffs' lawyer, Alan Fuchsberg, realized that it was going badly, he tried to suggest that the low salt level cited by the medical examiner should have been urgently treated, but a defense objection was sustained.
Dr. Johnson-Arbor stood alone against three defense experts, one for Dr. Mardach, one for the nurse and one for the hospital and its intern, Dr. Kaul. She was hugely pregnant; they were all middle-aged men in suits.
In his closing, the hospital's lawyer, Michael B. Lehrman, blamed Ms. Seelig for bringing about her own death with whatever cocktail of drugs she had taken. "You heard how confused she was," he said. "She couldn't even say her age. She was already in the process at that point of dying."
After a day and a half of deliberations, the jury of four men and two women returned its verdict: Wyckoff and the individuals working there had not been negligent.
The jury did not seem to identify with Ms. Seelig.
One juror, Marat Leychik, 23, an unemployed graduate of John Jay College of Criminal Justice who lives with his parents in Coney Island, said he had never had to use any stimulants, not even caffeine, to write a paper. "She, in my opinion, overexerted herself," he said.
Another juror, Irene Katzos, 39, a homemaker turned breadwinner from Bay Ridge, said that unlike Ms. Seelig she was "not artsy." When the Poison Control call was played, Ms. Katzos saw tears streaming down the face of Ms. Seelig's father, who was hearing the recording for the first time. "I swore I would never look over there again," she said.
After the trial, Dr. Eric D. Manheimer, former medical director of Bellevue Hospital Center in Manhattan, where he oversaw one of the busiest and most highly regarded emergency rooms in the country, reviewed Ms. Seelig's chart at the request of The Times and concluded that she had not been properly monitored.
As a precaution, doctors should have put a tube in her airway to keep her from breathing her own vomit and stomach acid and to provide oxygen, he said. And they should have moved her to intensive care. Her low salt could have been an additional "metabolic cause of stupor and coma," he said.
"It's not rocket science," Dr. Manheimer said. "Once your mental status is going down, you don't know when the person is going to stop breathing."
Ms. Seelig's parents are left with a July 2007 letter of condolence from Dr. Thomas R. Frieden, then New York City's health commissioner, whose office turned over the Poison Control recording.
"I wept after hearing the recording," Dr. Frieden, now head of the Centers for Disease Control and Prevention, wrote.
"As a parent, physician and fellow human being, I was deeply disturbed by the interaction of the Poison Control Center with your daughter," he wrote. Dr. Frieden said that the person who took the call "no longer works for the Poison Control Center," and that he was working on better coordination with 911.
For Mr. Seelig and Ms. Gibson, the letter serves as evidence that their daughter's death did matter to someone, and made some difference.
Asked what lesson might be taught by Sabrina's death, Ms. Gibson said there was one. "No one should go to a hospital without someone with you — no one," she said. "Don't go unless somebody at least knows you're there."
