Colorado state hospital – Citizens Commission on Human Rights of Colorado

Patient Allegedly Kidnapped by State Hospital Staff

Civil Rights Lawsuit Filed in Denver Federal Court

A lawsuit has been filed in U.S. District Court in Denver alleging that a woman languishing in legal limbo at the Colorado Mental Health Institute at Pueblo (CMHIP) was kidnapped by CMHIP staff and forcibly transported to a Denver area hospital to undergo a surgical procedure against her will.

Gabriele Gundlach, 57, of Boulder, was found incompetent to proceed by Boulder County Court in October 2011 in cases involving minor traffic-related offenses and was sent to CMHIP.

While there, physical conditions requiring that she receive medical treatment were detected, including possible breast cancer. Gundlach, who has never been found incompetent to make decisions concerning her own body, researched treatment options and medical facilities. She arranged to receive treatment at Rose Medical Center and lined up funding to cover the cost.

However, Gundlach was told by CMHIP staff that University Hospital was the only facility to which CMHIP patients can be taken for medical treatment, and that patients are treated there at state expense. These are “bare-faced lies,” according to the complaint filed in the district court by Gundlach’s lawyer, Boulder civil rights attorney Alison Ruttenberg.

Gundlach told CMHIP staff she would not consent to undergo treatment at University Hospital, explaining that for continuity of care reasons, Rose Medical Center would refuse to treat her if she received any part of the treatment for her condition at any other facility. It also would not meet federal guidelines for funding her long-term care. She also explained she had chosen a less invasive treatment option available only from a doctor at Rose.

In direct opposition to Gundlach’s wishes, CMHIP staff allegedly scheduled a surgical procedure for her at University Hospital without her consent or knowledge. When Gundlach was finally informed, she cancelled the appointment. Ruttenberg called CMHIP Assistant Superintendent Beverly Fulton, who allegedly assured the attorney that CMHIP would never transport Gundlach to a medical procedure she did not want.

But that is exactly what happened on the morning of January 3, 2013. According to the lawsuit, CMHIP charge nurse Pamela Jones forced Gundlach to get out of bed and prepare to be transported. Gundlach was driven under guard and against her will to University Hospital for a surgical procedure that had been cancelled and that, if administered, would have destroyed her chance to receive her preferred treatment from her chosen doctor at Rose Medical Center and to receive federal funding for her long-term care.

Because the CMHIP staff had no court order or other authority to transport her against her will, the civil rights complaint asks the U.S. District Court for damages from those responsible for kidnapping her and unlawfully seizing her body (under the color of law) for the purpose of having a surgical procedure performed that she did not want or consent to. Color of law refers to an act done under the appearance of legal authority, when in fact no such right exists. It further asks the court to declare it a violation of her Fourteenth Amendment right to be free from unlawful seizures of her body without due process of law.

Gundlach alleges she suffered enormous emotional distress. She also says she was informed at University Hospital that she would have had to pay for the procedure herself if it had been done there.

According to Ruttenberg’s civil rights complaint, “Ms. Gundlach has a Constitutional right to refuse any medical procedure she does not want, and the bullies at CMHIP have no right to force her to undergo invasive surgical procedures that she refuses, for their financial convenience or otherwise.”

The complaint continues: “She has the capacity and ability to make an informed decision regarding what is going to happen to her body and who is or is not going to have the privilege of cutting into it. Her decisions regarding the course of care for the suspected breast cancer are reasonable, rational and hers alone to make.”

When Gundlach arrived back at CMHIP, her psychiatrist, Myra Kamran, M.D., allegedly threatened Gundlach with having a guardian appointed who would agree to Gundlach being forced to have the medical procedure either at University Hospital or on-site at CMHIP.

(Myra Kamran is not currently listed on the Colorado Department of Regulatory Agencies website as a licensed physician or listed under any other licensed profession. The Citizens Commission on Human Rights of Colorado has asked the Colorado Medical Board to investigate the matter.)

Again in violation of Gundlach’s rights, the medical procedure was scheduled to be performed on-site at CMHIP. According to the lawsuit pending in Boulder County Court, on the morning of Monday, January 7, 2013, the charge nurse allegedly told Gundlach to get ready to be taken to the CMHIP clinic for the procedure. Gundlach was left with the clear impression that she would be put in restraints to receive the procedure if she refused to cooperate.

It was only cancelled by last-minute intervention by a member of the Colorado chapter of the Citizens Commission on Human Rights, who called the Superintendent’s office to draw their attention to the civil rights lawsuit that had been faxed to the Superintendent the previous Friday evening.

The legal complaint alleges that the psychiatrist for Gundlach’s ward at CMHIP, Thomas Ingraham, M.D., admits Gundlach is not gravely ill, is not a danger to herself or others, and that he is not treating her for any illness or condition.

It further alleges Gundlach’s continuing, unlawful confinement at CMHIP is not only a violation of the due process and equal protection clauses of the Fifth and Fourteenth Amendments, but is also life-threatening, and asks the court to order the woman’s immediate release.

Troubles Began with Minor Traffic-related Offenses

Gundlach’s troubles began when she was arrested in Boulder in 2010 and charged with minor traffic-related offenses after allegedly being involved in an auto accident.

After telling Boulder County Court she did not want to be represented by the public defender with two large black eyes and a large lump on her forehead who visited her in jail, she was not provided with another public defender and subsequently represented herself pro se in court proceedings. The lawsuit alleges that she never was properly advised of the charges against her or her right to a new attorney.

In September 2011, the Court ordered a competency evaluation. Based on a CMHIP psychiatrist’s report, the Court found Gundlach incompetent to proceed in her court cases and sent her to CMHIP in October 2011.

Six months later, during which time Gundlach refused psychiatric drugging, another evaluation at CMHIP found that Gundlach was competent to proceed and had a good understanding of her legal situation.

Inexplicably, however, her Boulder County public defender asked for yet another competency evaluation to be done. Gundlach refused this and all subsequent attempts to re-evaluate her because she already had received a finding of competency.

Nevertheless, two subsequent competency reports, one by a psychiatrist and the other by a licensed psychologist at CMHIP, were sent to Boulder County Court, each concluding Gundlach was not competent to proceed. According to the lawsuit, neither doctor ever interviewed or even met with Gundlach, who continued to refuse to be re-evaluated.

In October 2012, a third Boulder County public defender moved to terminate all criminal proceedings against Gundlach. The motion was denied in December in Boulder County Court when the Boulder District Attorney wrongly represented to the Court that Gundlach was no longer refusing treatment, including medications, at CMHIP.

Not only was Gundlach continuing to refuse to be medicated at the time, but CMHIP in November 2012 sought a court order to forcibly drug Gundlach against her will. The lawsuit alleges that the list of drugs Gundlach’s psychiatrist wanted to give her were variously at a dangerously high dosage, meant for mental or physical conditions for which Gundlach had never been diagnosed, or prescribed solely for the purpose of patient control, which is a violation of ethical standards for physicians. The motion for a hearing in Pueblo County Court on the issue of involuntary drugging was eventually withdrawn.

During this time, Gundlach contacted the Colorado chapter of the Citizens Commission on Human Rights, which started an investigation of her complaint, following which three legal pleadings were filed in separate actions by Ruttenberg.

A petition filed in the Colorado Supreme Court for Gundlach’s immediate release was denied, apparently on jurisdictional grounds.

A renewed motion to dismiss charges against Gundlach is currently pending in Boulder County Court. This motion additionally challenges the constitutionality of the state law [C.R.S. 16-8.5-116(1)] that permits a defendant to be incarcerated at the state hospital up to the maximum amount of time the person could be sentenced if convicted, when in actual practice a maximum sentence would not be imposed on each of multiple charges and would not be imposed consecutively. Therefore because Gundlach is being held as mentally ill, CMHIP is interpreting the law to allow them to involuntarily incarcerate her for 33 months, which is from 21 to 30 months longer than for someone who is not held at CMHIP.

Gundlach’s plight has been made worse by the fact that neither she nor her attorney have been given access to legal records relating to her court cases. The civil rights complaint pending in U.S. District Court in Denver cites Debra Cross, Clerk of the Boulder County Combined Courts, for her unconstitutional policies of denying Ruttenberg, as Gundlach’s counsel of record, access to any portion of Gundlach’s prior court file, and asks the court for relief. It further asks the court to declare that Crosser’s refusal to ensure that Gundlach’s legal mail is sent to her at CMHIP instead of her prior home address, then throwing it into the court file when it is returned as undeliverable, violates Gundlach’s constitutional rights to due process and access to the courts.

The complaint pleads that Gundlach’s “continued incarceration at the CMHIP without due process, without a hearing, given the fact that she is competent, is not only unconstitutional, it is life-threatening.”

If you or someone you know has experience with the Colorado Mental Health Institute at Pueblo, we want to talk to you. You can contact us privately by clicking here or by calling 303-789-5225. All information will be kept in the strictest confidence. We welcome your comments on this article below.

Man Died in Restraints at Colorado State Psychiatric Hospital

CMHIP withholds data requested by the district attorney and county coroner

An obese man who died in the custody of the Colorado Mental Health Institute at Pueblo (CMHIP) suffocated while being restrained face down on a table. He may have been hog-tied.

Troy Allen Geske, 41, died August 10 at the psychiatric institution. An affidavit for a search warrant says that Geske died after he was put in four-point restraint, in which the feet are attached to the hands behind the back.

A spokeswoman for the Colorado Department of Human Services, which oversees the psychiatric facility, denied Geske was in four-point restraint. But Pueblo County District Attorney Bill Thiebaut said the information in the affidavit is corroborated by evidence that has been collected, including video of Geske in restraints, according to the Pueblo Chieftain:
http://chieftain.com/news/local/article_f75a23c2-b72f-11df-9494-001cc4c002e0.html
http://chieftain.com/news/local/article_59e5ca9c-b653-11df-8d64-001cc4c002e0.html

At 5-feet-8 and 265 pounds, Geske was at greater risk of “positional asphyxiation” when he was restrained on his stomach with his own weight pressing down on his lungs and diaphragm. Federal law requires constant, close monitoring of anyone face down in restraints to prevent suffocation.

The results of an autopsy and toxicology tests have not yet been released.

After Geske’s death, hospital police could have called in the 10th Judicial District’s critical incident team (CIT) for an independent investigation of the incident by a team of investigators from outside law enforcement agencies, but did not do so, according to the Pueblo Chieftain: http://chieftain.com/news/local/article_b4e5d92e-b7f1-11df-abf2-001cc4c002e0.html

The CIT investigates serious incidents involving police officers under an agreement to which CMHIP is a party. Hospital police were reportedly present when staff attempted to revive Geske.

CMHIP has also refused to turn over certain information requested by investigators. District Attorney Thiebaut says he will go to court if necessary to get information he believes his office is entitled to, according to the Chieftain.

For more than 40 years, the Citizens Commission on Human Rights has advocated against any form of psychiatric treatment that is torturous, cruel, inhuman or degrading, as laid out in its Mental Health Declaration of Human Rights.

Another Death at Troubled State Psychiatric Institution in Pueblo

Facility received 1,100 patient complaints in 2008-09, reported 11 patient deaths in 2009

Another person has died while in the custody of the Colorado Mental Health Institute at Pueblo (CMHIP), according to the Denver Post: http://www.denverpost.com/news/ci_15822489. The cause of death of 41-year-old Troy Allen Geske, who died several days ago, will not be known until an autopsy is complete.

His death is being closely followed because of recent revelations of other deaths at the psychiatric facility, including the suicide of Sergio Taylor. An autopsy report indicated 23-year-old Taylor died of asphyxiation in September 2009 after complaining about conditions at the CMHIP. He was found by law enforcement officers under blankets with a plastic bag over his head in a supposedly high-security area of the psychiatric facility. About a month earlier, Taylor and 19 other patients had signed a petition that said, “The sense of hopelessness has set in…. History has shown here…that when patients are feeling bored, hopeless and warehoused, …assault and suicide attempts transpire.”

As a direct result of Taylor’s death and citing concerns that other patients could die, the Colorado Department of Health conducted an immediate investigation of CMHIP in October 2009, according to The Denver Channel (KMGH): http://www.thedenverchannel.com/print/24085289/detail.html. In its report, the health department found patients at the state hospital in Pueblo to be in “immediate jeopardy” and detailed serious errors by the institution’s staff. The department conducted an unannounced inspection of the facility again this past May.

CALL7 investigators from The Denver Channel, who have been reporting on deaths at the state hospital for months, also uncovered the death of another patient of the CMHIP, whose death was never reported to the state health department by CMHIP. Josh Garcia died after being overdrugged and neglected by staff at the psychiatric institution. According to his family, Garcia was given a number of powerful psychiatric drugs and suffered serious adverse effects, including severe abdominal pain. He complained to the staff but was ignored, according to his family. By the time Garcia was taken to a hospital, it was too late. His bowels burst, severe infection set in, and he was brain dead within hours. His family sued and recently received a settlement from the state over his death.

The Colorado Legislative Audit Committee has also called for repeated investigations of the CMHIP in recent years, due to complaints it receives. In a report released in December 2009, the Office of the State Auditor found numerous deficiencies in the operations of the CMHIP that compromised safety and proved costly to the state. Among these deficiencies, the institution did not adequately record, investigate or resolve patient complaints. For 25 percent of the 1,100 patient complaints relating to staff behavior and quality of treatment issues the facility recorded in fiscal years 2008 and 2009, the database did not even contain the names of the 270 staff members who were the subject of the complaints. The report also revealed that there were 11 patient deaths at the facility last year, the highest number in the three years covered in the report. How many of those were suicides, besides the suicide of Sergio Taylor, is unknown. Another audit is underway currently, again at the request of state legislators, to determine if there are other patients who have died of neglect at the state psychiatric hospital.

The CMHIP also has a history of failing to keep the public safe from the mentally ill housed there who have been found not guilty by reason of insanity in connection with serious crimes. Nine such patients escaped in 2009, with patient escapes at a three-year high.