RALEIGH, N.C. - A mental patient died after workers at a North Carolina hospital left him in a chair for 22 hours without feeding him or helping him use the bathroom, said federal officials who have threatened to cut off the facility's funding.

The state sent a team Tuesday to help Cherry Hospital in Goldsboro draft new procedures to ensure patients receive proper care.

An investigator's report released Monday found that 50-year-old Steven Sabock died in April after he at one point choked on medication and had been left sitting in a chair for close to a day at the facility about 80 kilometres southeast of Raleigh. Surveillance video showed hospital staff watching television and playing cards just a few metres away.

It was not clear from the report exactly how Sabock died. The report states that he was in a hospital bed and later found unresponsive. A phone call placed after business hours to the state Office of the Chief Medical Examiner rang unanswered Tuesday.

Federal officials have threatened to cut off funding because of Sabock's death and a report that a physician punched a patient after the teen bit the doctor.

Department of Health and Human Services spokesman Tom Lawrence said the state team also may investigate what, if any, disciplinary action should be taken following Sabock's death.

Lawrence said the Sabock incident is isolated but that officials are concerned.

"It's not the kind of thing that we in our wildest dreams would expect to happen in our hospitals - in our wildest nightmares, I guess," Lawrence said.

Sabock's father, Nicholas, declined comment when reached by telephone Tuesday evening. A man who answered the phone listed for Susan Sabock, Steven's wife, hung up without commenting.

The investigation released Monday said Sabock died in April after Cherry Hospital nurses left him unattended in a chair and did not feed him or help him to the bathroom.

The report said Sabock sat, unattended, in the room for four work shifts. The report also found that Sabock, formerly of Roanoke Rapids, ate nothing the day he died and had little food in the three days preceding his death. The 47-page report also said workers were supposed to be closely monitoring Sabock's condition and may have forged documents that said they had.

The state has until Aug. 23 to file a report with the Centers for Medicaid & Medicare Services detailing what changes officials are making, Lawrence said.

If the centre rejects the report, federal funds will be cut off beginning Sept. 1, Lawrence said.

Department of Health and Human Services Secretary Dempsey Benton said in a statement that nurses may be reassigned to provide more patient supervision. Officials are also considering better ways to manage staff resources, he said.

A patient in New York died in June after she waited in a hospital's mental ward waiting area for nearly 24 hours. Security video showed her writhing on the floor. It was nearly an hour before someone else flagged down a staff member who got help for the unresponsive woman.