The hospital’s fault, and the fault of caregivers who didn’t deal properly with a mentally ill man. That’s the gist of a new lawsuit filed by the estate of Hiram Marrero, the knife-wielding psychotic man who was killed by a New Haven cop in a case that plunged the city into a reexamination of how police deal with the mentally ill and led to a recommendation to arm officers with Tasers (pictured). Jane Mills reports.
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By Jane Mills
When Hiram Marrero was killed by New Haven police officers almost two years ago, shocked mental health workers questioned the way police responded to their psychotic, knife wielding client. Some proposed renewed efforts to extend police training for dealing with people undergoing a health crisis; the city formed a task force to address it and other shootings by police that year.
They also expressed concern that warnings they issued to Marrero’s doctor about his deteriorating psychiatric condition were unheeded, according to a new lawsuit filed on behalf of Marrero’s estate.
An investigation by the state’s attorney’s office issued in January found that the shooting, on December 16, 2004, was justified but Marrero’s estate sued police and his doctors in January. (Click here to read that report.) The case is still pending.
Earlier this month, his estate filed another suit focusing their ire on the Hospital of Saint Raphael, Marrero’s psychiatrist Roberto Norniella and the Hispanic clinic where Marrero was an outpatient.
Roger Calistro, the New Haven attorney who filed the suit, said medical negligence precipitated Marrero’s death.
The legal papers, filed in New Haven Superior Court, state that Marrero’s case workers at Continuum of Care Inc., a nonprofit mental health agency that operates the apartment complex on Ella Grasso Boulevard where Marrero lived and died, repeatedly requested medical attention for Marrero because of his deteriorating condition. The response to their requests was so inadequate, the suit alleges, that Marrero, who had been stable for years and was well liked and sociable, was left to descend into a violent delusional state.
“What I found is that Continuum of Care did a great job,” Calistro said. “They were constantly sounding a warning to Norniella, Saint Raphael’s and the Hispanic Clinic” he said.
Police fatally shot Marrero in late 2004 after he threatened his roommate with a long kitchen knife and wounded a caseworker who tried to intervene. Witnesses said police shot Marrero after he threw down the kitchen knife and pulled another one from his sock while approaching police, according to the report issued in January by New Britain State’s Attorney Scott J. Murphy.
The suit claims Marrero was improperly enrolled in a pilot program that was studying Hispanic psychiatric patients’ ability to administer their own medication — in Marrero’s case, antipsychotic medication — when his history of failure at this made him a poor candidate, Calistro claims.
Norniella changed his medication twice, on Oct. 25 and again on Dec. 6, 10 days before he was shot, according to the suit.
On Dec. 10, suffering from “an acute psychiatric decompensation” with “hallucinations” Marrera was seen in the emergency room at the Hospital of Saint Raphael, where he was held for four days without being admitted as an inpatient. Emergency room records list his diagnoses as paranoid with fears of being poisoned, and paranoid schizophrenia with an acute exacerbation, Calistro said.
His medication dose was increased and he was discharged to administer his own medication on Dec. 14, in no condition to do so, the suit said. Between Dec. 14 and Dec. 16, his community caregivers notified Norniella that the medication wasn’t working, and that Marrero might not be taking his medication, the suit says.
An order allowing others to administer the drug lay dormant and a meeting of all his caregivers was cancelled, according to the suit.
Calistro alleges that Marrero’s statutory patient rights were violated when he and caregivers at Continuum of Care were not informed of the risks of changing medication, depriving Marrero of the opportunity to give informed consent to the changes and further failed to obtain informed consent for the pilot project.
Norniella no longer practices medicine in Connecticut. He did not return a call seeking comment left on the telephone number for an Alabama address listed in legal papers.
Few parties involved in Marrero’s care, now facing lawsuits, were willing to comment.
Hospital spokeswoman Bonnie Lukacs declined to comment, citing a hospital policy that precludes public statements on pending litigation.
Wayne F. Daily, spokeswoman for the Connecticut Department of Mental Health and Addiction Services, which oversees the Connecticut Mental Health Center and the Hispanic Clinic, declined to comment on the pending litigation but said the agency has an internal incident and review policy. The policy requires the agency to investigate the care Marrero received leading up to his death.
A representative from the Hispanic Clinic could not be reached.
Patti Walker, chief executive of Continuum of Care, which was named in the lawsuit filed in January, did not return a call seeking comment.
Maybe St. Raph's should put as much effort into following through with patients as it does in its ongoing advertising campaign to delude people into thinking it's just as cutting-edge as Yale-New Haven.