The amount of the settlement was not disclosed during proceedings on the wrongful death suit in Suffolk Superior Court. Most of the money is to be put in an irrevocable trust for the man’s two young daughters.
Daniel J. Ryan, 35, died Oct. 29, nearly three weeks after he was restrained by security staff at Cape Cod Hospital when he allegedly became unruly while visiting his wife, Jamie Ryan, a patient there.
Ryan lost consciousness and “sustained grievous personal injuries,” including brain damage and disfigurement as a result of the restraint, according to the family’s civil complaint.
The complaint does not indicate what constituted the disfigurement.
They also said in a written statement released to the Times Friday that Daniel J. Ryan, 35, the father of two young daughters, was held down without being able to breath for “at least seven minutes.”
It’s the first time that Ryan’s family has made any public comments on their ordeal, which began Oct. 9 when Ryan became unruly during a visit to see his wife, Jaime, at Cape Cod Hospital. He was restrained by security staff, lost consciousness and died 20 days later at the hospital.
“Our family has been shattered since the unexpected death of our son and brother, father and husband,” the family statement reads. “One thing is clear, however, and that is the cause of Daniel’s death.
“The medical examiner has ruled it a homicide,” the letter continues, “caused by compression to Daniel’s neck and chest in the commission of a restraint.”
A law enforcement official with ties to the case who has asked to remain anonymous confirmed that the medical examiner’s ruling is homicide. That means Ryan’s death came as a direct result of human hands, rather than a medical condition or other factors, the source said.
The medical examiner’s ruling does not, however, say whether the use of force that led to Ryan’s death was “justifiable” or “allowed within the constraints of the law,” the law enforcement source said. That will be up to the criminal investigation and the courts to decide, the source added.
The source, who has viewed a surveillance video of the incident, agreed that Ryan was held down for a long time, though he couldn’t say exactly how many minutes.
Hospital denies wrongdoing
Cape Cod Healthcare spokesman David Reilly last night called the family’s estimate on the time of the restraint “absolutely false.”
“The medical examiner has not been in communication with the hospital since the incident occurred,” Reilly said.
The hospital contends that Ryan’s behavior posed a threat to himself, the staff and innocent bystanders. They told state investigators that “less restrictive” restraints had caused him to react violently.
After investigating the incident, the state Department of Public Health cited the hospital for a federal violation of patient rights.
The DPH based its finding on interviews with witnesses and the surveillance video.
Three security guards, a security supervisor, nursing supervisor, and two others involved in the incident refused to be interviewed for the DPH investigation. Their refusal was within their legal right, Reilly told the Times last week.
According to the DPH report, which was obtained by the Times following a Freedom of Information Act request, Ryan was visiting his wife at the hospital when he began to behave strangely. He bolted from the emergency room, traversed hospital hallways and eventually had to be restrained.
A hospital staff member pulled one of Ryan’s arms behind him, the DPH report states. Ryan then tripped on a sheet that had been over his head — the report doesn’t explain why he had it over his head — and he fell to the floor.
A security officer put him in a head lock and flipped him, according to the DPH report.
One security officer appeared to get on top of him, while another put his right leg over Ryan. A third positioned himself at Ryan’s head.
In their prepared statement to the Times, the Ryan family expressed frustration with the possible length of the criminal investigation. They say Cape and Islands District Attorney Michael O’Keefe had told them he was “leaning toward bringing the case to a coroner’s inquest, because of the extent of public interest, and that it could take as long as a year to make that decision.”
A coroner’s inquest differs from a grand jury hearing in one major way, according to legal experts. Both are processes in which a jury of citizens hear testimony to decide the manner of death of a person. But while all grand jury statements and evidence remain private information, coroner’s inquest proceedings become public after a finding. “If Michael O’Keefe wants a coroner’s inquest, he wants the information to be out there, so there’s no questions,” the law enforcement source said.
Family wary of D.A.
O’Keefe refused yesterday to confirm details in the Ryans’ letter to the Times.
He would only repeat what he stated last week to the Times regarding the case: “The autopsy has been completed and we are going over it very carefully and will make an announcement in due course with respect to further action we expect to take.”
The family has apparently harbored doubts for a long time about getting fair representation from Cape prosecutors.
In November, they asked that the criminal investigation of the incident move to a different district attorney’s jurisdiction.
In a letter signed by James and Barbara Ryan of Mashpee, they list a number of reasons why they think Cape Cod Hospital is too closely entwined with O’Keefe’s office.
The family wrote O’Keefe a letter on Nov. 16, 2009, two weeks after Ryan’s funeral. They stated that Cape Cod Healthcare is one of the largest employers in Barnstable County. Furthermore, the director of security at Cape Cod Hospital, who was directly involved with the circumstances of Ryan’s death, is a former detective sergeant from the Barnstable Police Department, the letter states. The head of hospital security is Ed Smith, a retired Barnstable officer.
Thirdly, the letter states, a employee who works in the district attorney’s office also works as a hospital security guard.
Lastly, Ryan’s brother, Jeff Ryan and his wife, Randy, work in this county’s criminal justice system, the letter states.
“For all of these reasons, we ask that this matter be reviewed by another prosecuting attorney’s office,” the family stated in its letter to O’Keefe.
O’Keefe denied the request in a letter back to the family on Nov. 20.
The district attorney wrote that none of the facts stated by the family are enough to move the case. He said state police assigned to the district attorney’s office were investigating the Ryan case, not the Barnstable police. O’Keefe also said in his letter to the family that any past connection with a former sergeant turned security chief would not be a factor in his probe. He said a junior level employee works as a victim witness assistant in the district attorney’s office and is also a part-time hospital security guard.
“This young man was not working at the hospital on the date in question,” O’Keefe wrote.
The attorney for the family of a man who died after being restrained at Cape Cod Hospital says the family wants a copy of the surveillance video that allegedly captured the incident.
“The family was promised the video,” said Kerry Choi, the Boston attorney representing the family of Daniel J. Ryan of Mashpee.
The Ryan family was told Oct. 13 the video would be available, Choi said. At that time Ryan, a father of two, was still on life support at the hospital following a scuffle with security guards. He died Oct. 29 and will be laid to rest tomorrow.
“They would like to see the video and know what happened,” said Choi, noting that the video was “yet to be forthcoming.”
Three weeks before his death, Ryan got into an altercation with security guards while visiting the hospital to see his wife, Jaime Ryan, a patient there.
Daniel Ryan, 35, had been acting erratically and was sent to the emergency room for a psychiatric evaluation, a source told the Cape Cod Times. At some point, Ryan left the emergency room, and security guards attempted to restrain him.
The hospital employees were trying to prevent him from harming others while waiting for police to arrive, according to David Reilly, a spokesman for Cape Cod Healthcare, the parent company of Cape Cod and Falmouth hospitals.
It’s not clear what type of hold security guards used on Ryan, although Reilly has denied media reports it was a chokehold. A source said Ryan collapsed from lack of oxygen to the brain.
An investigation into the cause of death is ongoing, according to the office of Cape and Islands District Attorney Michael O’Keefe.
The state Department of Public Health also is investigating.
Robin Lord, a spokeswoman for Cape Cod Healthcare, said yesterday the organization would not comment beyond the two official statements already released by Reilly.
HYANNIS MA Nov 5 2009 – The state Department of Public Health and the Barnstable police are investigating an altercation between a patient and Cape Cod Hospital employees that led to the patient’s death this week.
The hospital released a prepared statement Friday.
“Cape Cod Hospital can confirm that a patient who died in the hospital earlier this week was involved in a altercation in which certain of our employees restrained the individual while waiting for additional assistance,” said David Reilly, spokesman for Cape Cod Healthcare, which owns both Cape hospitals. “Several of those employee were injured themselves although none to the extent of those involved in the event at Massachusetts General Hospital just a few days ago.”
On Tuesday, a psychiatric patient at Massachusetts General Hospital was shot dead by an off-duty security guard because the patient was repeatedly stabbing one of the hospital doctors.
“At the time of this event,” Reilly continued, “the hospital’s employees were trying to prevent the patient from harming others within our facility while waiting for the police to return to the hospital.”
Reilly said the police had been called earlier in the day to assist with the same patient. He said the hospital is fully cooperating with an investigation by the Barnstable police and the Department of Public Health.
Reilly declined to say more, citing medical privacy laws.
On Oct. 16, a 35-year-old man came to visit his wife in the hospital, according to a source with knowledge of the incident. He had been caught on a video camera driving erratically. Once inside the hospital, the man acted irrationally, the source said.
The man ended up in the emergency room for a psychiatric evaluation, the source said. The emergency room employees placed him in “one-on-one observation,” which means a hospital employee was assigned to watch him closely.
At some point, the man bolted from the emergency room and ran through the hospital, the source said.
A short time later, a page came over the loud speaker calling for help in the lobby of the Mugar Building. Then the page announced a “Code 99,” a medical emergency usually requiring cardiopulmonary resuscitation.
Hospital security put the man in a choke hold, rendering him unconscious, according to WXTK radio.
The Cape Cod Times source said the man was placed on life support because of a lack of oxygen in his brain. He was on life support for nearly two weeks before he died, the source said.
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