January 19, 2012 NC police investigate death of psychiatric patient at hospital www.privateofficer.com
Fayetteville NC Jan 19 2012 Andre LeMar Walker needed help when he went to the emergency room of Cape Fear Valley Medical Center in Fayetteville complaining of voices only he could hear.
Within hours, the 27-year-old was dead, strangled as he was restrained by hospital police officers in a psychiatric unit known as the “red zone.”
Security camera footage of the April 17, 2011, altercation and medical records obtained by The Associated Press provide a window into missteps that have brought one of North Carolina’s largest medical centers to the brink of losing $23 million a month in payments from Medicare and Medicaid.
Cape Fear Valley administrators have until Thursday to convince federal regulators that they can fix serious violations found during a series of reviews triggered by Walker’s autopsy report, which was completed in September. If they can’t, federal funding will be terminated at midnight.
Fayetteville Police detectives opened a homicide investigation after the medical examiner sent them his report. Hospital administrators said they had seen no need to report the death to law enforcement.
Valerie Walker says her son’s death was avoidable. A retired Army sergeant, she works in the accounting department at Cape Fear Valley.
“My son died horrifically,” Valerie Walker said. “What happened to him was wrong.”
Administrators at the hospital say they cannot discuss the details of what happened that night, citing patient privacy rules and a pending lawsuit. None of the staff on duty when Walker was killed has faced disciplinary action, they said.
Diagnosed with schizophrenia, Walker struggled with hallucinations and paranoid delusions. Unable to work or live on his own, he focused on his music.
Walker rapped in local clubs under the stage name Tré Day and was recording a studio album. Among the 12 songs finished before his death is “Take a Dosage,” in which Walker compares the side effects of his antipsychotic meds to being abducted by aliens.
Medical records show Walker had stopped taking his medication after the drug’s manufacturer changed the color of the pills and packaging. After a brief visit to the emergency room at Cape Fear Valley, he was sent home.
Seven days later, Valerie Walker called 911 again. Her son had jumped out of the second-story window of their apartment.
When police officers and paramedics arrived, Walker agreed to go back to Cape Fear Valley. An ambulance report lists his condition as uninjured and says he was cooperative and nonviolent.
Arriving at Cape Fear Valley shortly after 4 p.m., Walker was escorted to the ER’s locked nine-bed psychiatric unit. His mother said she was told to return the following morning.
Over the past decade, North Carolina has attempted to reform its mental health system while cutting costs and downsizing state-run psychiatric hospitals. The results have been widely criticized, with patients unable to find adequate outpatient treatment often facing days-long waits in the emergency rooms.
At Cape Fear Valley, administrators have seen a 49 percent increase since 2005 in the number of people coming to the ER with a primary diagnosis of mental illness. The hospital now treats more than 500 such patients a month.
The response has been to staff the “red zone” with uniformed security officers supplied by a private contractor, AlliedBarton. The hospital also operates an internal police force supplied by the security company.
Under North Carolina law, these private police are granted the same authority to wear a badge, carry a gun and arrest citizens as government law-enforcement officers.
Security cameras in the psychiatric unit record much of what happens there. The lawyer for Walker’s family, James Rogers of Durham, provided the AP with hours of footage from the night of the death. Rogers would not disclose how he obtained the video, which includes no audio. The footage provided by the attorney matches written moment-by-moment descriptions of the video’s contents included in a federal report.
The video shows Walker pacing in a corridor as he waited. Around 7 p.m., records show, a staff psychiatrist interviewed him and prescribed him a combination of drugs intended to calm his nerves. Though Walker came to the hospital voluntarily, records show the doctor also initiated legal paperwork to commit him against his will.
Over the next two hours, video footage and medical records show Walker grew more and more anxious. He repeatedly asked for his mother and said he wanted to go home.
Shortly after 9 p.m., two armed hospital police officers entered the darkened room where Walker was waiting and switched on the lights. They were accompanied by two security officers and a nurse.
Walker asked for a cup of water, according his medical records. After taking a few sips, he threw some of the water at the police officers and tried to leave through the door.
The nurse turned her back and walked away as one of the police officers grabbed Walker and wrapped his arm around the patient’s neck, according to the medical examiner’s report. The four uniformed men then tackled Walker and pinned him to the ground.
After about 3 minutes Walker stopped moving. The officers lifted his body onto the bed and secured his arms and legs with wide leather straps.
Another 3 minutes passed before anyone began measures to save Walker’s life, according to his medical records. He was officially declared dead at 10:11 p.m.
As required when someone dies while in restraints or in the custody of law enforcement officers, Walker’s body was sent to the medical examiner’s office in Chapel Hill. Rogers, the family’s lawyer, said he provided the security camera video to the medical examiner.
After reviewing the footage and finding physical evidence that included hemorrhages in the tongue and larynx, the medical examiner ruled Sept. 6 that Walker died of asphyxiation due to restraint.
On Oct. 17, regulators from the North Carolina Department of Health and Human Services went to Cape Fear Valley to review records from Walker’s death and other instances in which the hospital’s police and security officers restrained patients.
Following the state’s report, the federal Centers for Medicare and Medicaid Services issued an immediate jeopardy finding against the hospital, indicating inspectors found conditions so deficient as to put patients in immediate threat of physical harm.
Among the federal agency’s findings was that Walker had been improperly restrained and that the hospital’s police officers had never received critical training in methods for safely restraining psychiatric patients or de-escalating confrontations without resorting to force. The regulators also cited the hospital’s medical staff for not adequately supervising the security officers to ensure patient safety.
As the hospital worked to resolve the issues cited in the Walker case, a second notice of violation was issued against Cape Fear Valley on Dec. 5, after relatives of a 30-year-old cancer patient said hospital staff discharged him against his will and he died on his way home. Regulators returned Dec. 22, issuing a third immediate jeopardy notice. Federal officials have not yet released their findings from the most recent violations.
Cape Fear Valley administrators said they do not expect to lose the $275 million in federal funding they get each year. They said significant improvements have been made following Walker’s death, including a new requirement that all medical and security personnel working in the “red zone” be trained in nonviolent crisis intervention techniques.
Officials for both the hospital and the security firm stressed they are fully cooperating with the ongoing criminal investigation.
“We share his mother’s sadness over the loss of her son but have a different understanding of the events surrounding his death,” said Mike Nagowski, the hospital’s chief executive officer.
Valerie Walker has watched the video of her son’s final moments.
“I miss his presence,” she said last week. “When I come home, it’s to an empty house.”
She sometimes breaks the silence by playing her son’s music. On one track about what it’s like to be schizophrenic, he raps, “I ain’t dead, I ain’t dead.”
Rather than be haunted by the chorus, Valerie Walker is working with her lawyer to find a music company interested in releasing the songs.
Source:AP NEWS
Tags: Andre LeMar Walker, Cape Fear Valley Medical Center in Fayetteville, NC police investigate death of psychiatric patient at hospital
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