WAUKEGAN, Ill. (WGN) A patient at the Vista Medical Center in Waukegan, Illinois, died last Thursday after getting locked out on the facility’s roof.

Chelsea Adolphus, 28, of Waukegan, was admitted to the hospital for alcohol rehab on Wednesday, but left her room early the morning of January 23 around 2 a.m., according to her family and local coroner Jennifer Banek.

Around 8:45 a.m. Thursday, she was discovered unresponsive on a second-floor roof, wearing only her hospital gown and suffering from hypothermia. Her body temperature was recorded at around 50 degrees.

She was pronounced dead just after 11 p.m., with a preliminary finding of hypothermia.

Banek, the Lake County Coroner, blasted the leadership at Vista Medical Center in a press conference Monday, claiming they did not have a system in place to prevent such an incident or alert staff.

Banek added that it was only after another patient’s family saw Adolphus on the roof that the staff was alerted and she was recovered. The second-floor door that Adolphus had used did not have an alarm, and locked after closing behind her, Banek told reporters.

The coroner further claimed she has voiced previous concerns about the hospital, which she alleges recently furloughed 69 “sitters.” Those employees are responsible for watching and monitoring patients to make sure they are safe “when they are most vulnerable,” according to Banek.

“A death is not the threshold for by which we should be measuring a necessity for a call-to-action,” she said. “American Healthcare Systems must be held accountable to provide safe, quality healthcare to Waukegan and its surrounding communities. It has repeatedly fallen short by failing to meet its financial obligations to vendors, clinical providers, the City of Waukegan for its water bill, in addition to $1 million dollars owed in back taxes.”

Banek said she sent both Vista Medical Center East and its parent company, American Healthcare Systems, a preservation letter which seeks to assure all paper, digital and electronic evidence is not destroyed or deleted.

Civil rights attorney Ben Crump is also planning to announce a lawsuit against the hospital on behalf of Adolphus’ family, his law firm confirmed.

“Chelsea Adolphus died alone, freezing on the roof of a hospital where she went for help a place that should have protected her,” Crump said in a statement. “Instead, she was left to walk through an unsecured door that locked behind her, sealing her fate.

“This lawsuit is about holding Vista Medical Center accountable for the horrifying negligence that led to Chelsea’s death and ensuring that no other family has to suffer such a preventable tragedy.”

Speaking with affiliate WGN last week, Adolphus’ brother Paul Adolphus claimed that medical staff gave him three conflicting stories about how and where his sister’s body was found. Paul told WGN he met with hospital officials on Friday, and they finally were able to provide him with some answers.

“[They] confirmed to me that my sister’s body was on the roof and that she slept on their roof,” Paul said. “It’s not fair that my sister’s life was in their hands.”

WGN had reached out to American Healthcare Systems for a statement.