–Dave Ranney- KHI News

OLATHE — Since he was a teenager, Calloway “C.J.” Brazee, 36, has lived with schizophrenia. He’s been in and out of the state psychiatric hospitals more times than he can remember.

His most recent stay nearly killed him.

According to family members, Brazee was rushed to Olathe Medical Center on Jan. 4 after a nurse at Osawatomie State Hospital (OSH) realized he was unconscious.

At the emergency room, he suffered a seizure and started vomiting and choking. Doctors soon discovered he had an impacted bowel.

“They said his feces had petrified and there was baseball-size blockage in his intestine,” said Cuinn Brazee, the oldest of C.J. Brazee’s three brothers.

C.J. spent the next four days in an induced coma as doctors and nurses in the medical center’s critical care unit worked to relieve the blockage and minimize brain damage from his inability to breathe.

Cuinn said C.J. had called him twice earlier from the wall phone on his unit at OSH, saying he was dying and begging Cuinn to call an ambulance for him.

“I didn’t know any better,” Cuinn said. “I told him, ‘No, C.J., you’re OK. You’re in a hospital. There are doctors there. They’re taking care of you. You’re OK.’

“So he knew something was wrong, and I didn’t believe him,” he said. “That’s something I’ll have to live with for the rest of my life.”

Cuinn said OSH officials have denied family members access to information about the events that led to C.J. being taken to the emergency room.

“I’ve not gotten a single call returned from anyone down there (at OSH),” said C.J.’s mother, Nancy Brazee. “And when I call, I can’t get anybody who answers the phone to even tell me their name.”

Nancy has been assigned ‘durable power of attorney,’ which allows her to be involved in C.J.’s medical and other affairs

Cuinn, who lives in Lawrence, said C.J. was admitted to OSH on Aug. 21 after a third brother, Andy Brazee, reported that C.J. had been acting suicidal and was harming himself. At the time, C.J. was living with Andy in Bonner Springs. He was admitted to OSH voluntarily.

When C.J., who is 5 feet 11 inches tall, arrived at OSH, he was mentally ill but physically healthy, Cuinn said. He weighed 200 pounds. Four months later, he weighed 160 pounds.

“I just don’t understand how someone who’s under medical care and supervision can lose that much weight and not cause alarm,” Cuinn said. “It had to have been obvious that he was in medical distress and that this was an emergency.”

Olathe Medical Center records, Cuinn said, show that C.J. was taking nine prescription drugs while at OSH: Benztropine, Citalopram, Clozapine, Duloxetine, Etodolac, Lithium carbonate, Mirtzapine, Trazadone, and Diphenhydromine.

According to several pharmacological websites, constipation is a potential side effect for five of the nine drugs.

Angela de Rocha, a spokesperson for the state Department for Aging and Disability Services, said OSH officials would not comment on the Brazees’ concerns.

“We can’t talk about his because of HIPAA and other confidentiality laws and regulations,” de Rocha said, referring to the Health Insurance Portability and Accountability Act, a federal law that ensures medical privacy.

It’s possible, she said, that some information would be shared with their mother, Nancy.
State pays 50 percent

Typically, de Rocha said, OSH patients are first transported to Miami County Hospital in Paola, a distance of about seven miles.

Those found to have “more serious problems,” de Rocha said, usually are taken to Olathe Medical Center.

The Olathe and Miami County hospitals are owned by Olathe Health Systems.

“We pay Olathe Medical Systems 50 percent of the (OSH patient’s) bill,” de Rocha said.

At this point, it isn’t clear who might cover the other 50 percent of the cost. Olathe hospital officials said in cases involving OSH patients they often end up with no payment from anyone for the remaining balances due.

It’s not yet known how much C.J.’s stay — which includes 10 days in the medical center’s critical care unit — will cost.

OSH was the subject of a consultant’s report last fall that proposed an overhaul of the hospital’s administrative structure so that doctors, nurses and other staff could spend more time with patients and less time in meetings.

Kansas Department for Aging and Disability Services Secretary Shawn Sullivan has said the agency intends to phase in the recommendations over the next two to three years.

KDADS, he said, also is looking for alternative placements for patients whose conditions may not be serious enough to warrant hospitalization but who have nowhere else to go.

OSH has a licensed capacity of 176 beds but can accommodate as many as 190 patients.

According to the consultant’s report, the hospital often exceeds its licensed capacity because many patients need more services — especially residential services — than their community mental health centers have the resources to provide.

KDADS reports show that since July 1, the average daily patient count at OSH has been 182 patients, which is six patients beyond the facility’s licensed capacity.

The consultant’s study was one of a package examining four of the state hospitals with an eye toward improved efficiency. The consultant, The Buckley Group, concluded that more than $8 million could be saved at the four hospitals by shifting duties and eliminating staff positions.

KDADS officials later said they thought changes resulting in about $3 million in savings would be more prudent, realized mostly through staff reductions at Larned State Hospital and at Kansas Neurological Institute in Topeka.

The consultants did not examine the quality of medical care at the facilities, but with respect to the Osawatomie hospital noted that they found the staff “to be dedicated and intent on providing quality services.”

OSH’s catchment area includes 46 counties in eastern Kansas.

‘Very medically dangerous’

Susan Crane Lewis, executive director with the Kansas City-based advocacy group, Mental Health America of the Midwest, said it was unusual for an OSH patient to be referred to an acute care hospital such as Olathe Medical Center.

“It doesn’t happen very often,” she said, “because when someone’s admitted to one of the state hospitals they’re screened and their medical conditions are supposed to be addressed from the start.”

But KDADS officials said seven OSH patients have been taken to Olathe Medicaid Center alone since July 1.

Lewis said she was surprised that C.J.’s condition hadn’t been addressed earlier.

“Bowel problems are a common side effect of a lot of psychotropic medications, so (OSH staff) really ought to be watching for it,” she said.

“I know (patients) don’t like being asked all the time about their bowel movements, but it’s like I tell our folks here, ‘If your bowel and bladder ain’t working, it’s very, very medically dangerous. It’s not some minor deal’,” Lewis said.

“The (state) hospitals are constantly over census,” said Rick Cagan, executive director of the National Alliance on Mental Illness-Kansas, “and the only way for them to deal with that is to either run the staff ragged by making them put in all kinds of overtime hours or by shorting patient care. They both have negative consequences for the patients, which is what I’d say this case illustrates.”

Lawsuit pending?

C.J. left Olathe Medical Center last week. His family refused to allow him to return to OSH.

“He’s living with me now,” said Cuinn, who lives in Lawrence. “We’ll be working with Bert Nash (community mental health center) to see what kinds of services are available.”

Cuinn said the family likely would sue the state.

“I’m not a sue-happy person, but when someone is denied medical care because they’re disabled — no, this never should have happened. Somebody has to be held accountable,” he said. “The other thing is we don’t want anybody else to ever have to go through what we’ve been through.”