Families left to deal with painful scars
'Why wouldn't they tell us?'
By Sarah Sacheli, The Windsor Star January 22, 2011
Kim Laporte's mentally ill brother committed suicide in 2006 the morning after he was briefly seen at Hotel-Dieu Grace Hospital's emergency department.
Photograph by: Scott Webster, The Windsor Star
When Steve Kokotec committed suicide, Kim Laporte's heart sank.
The two had never met, but the circumstances surrounding Kokotec’s death triggered memories of the day in 2006 when Laporte’s brother took his own life.
“I thought, not again.”
Danny Laporte was a loving father to his then 16-month-old son.
He was a funeral director and had chosen that career because, to him, it was a way to help people in a time of need. He volunteered with the Special Olympics and the Goodfellows, raising money for both charities and handing out food baskets to needy families at Christmas.
He had a lawn care business on the side, and on the morning he killed himself, he first cut an elderly woman’s grass for free.
Kim, a social worker, knew her brother was battling depression. His family doctor had prescribed Prozac, and within days of beginning the new medication, Danny became suicidal. He tried twice to kill himself in the three weeks before he ultimately hung himself in the laundry room of his Belle River home.
The day before, Danny locked himself in the garage after taking a bunch of sleeping pills. There was a standoff that ended with police taking him forcibly to Hotel-Dieu Grace Hospital, this area’s only acute-care psychiatric facility.
“He was there maybe 10 minutes,” said Kim. “We were never allowed to go in and talk to the doctor.”
Twelve hours later, Danny was dead. He was 35.
Kim said the doctor who sent Danny home the previous night unable to walk straight because of the sleeping pills may not have known about his previous suicide attempts. He may not have known about the Prozac or that fact that suicide ran through both sides of his parents’ families. He may not have known to examine Danny’s body for “hesitation marks” the scars left by the knife Danny used in his first suicide attempt.
“The doctor should have talked to us,” Kim says emphatically.
Steve Kokotec’s sister, Barbara, couldn’t agree more.
“We felt shut out by the hospital.”
Provincial legislation preventing hospitals and doctors from divulging patient information without permission has come under fire by the numerous families of people with mental illness who have contacted The Windsor Star since news of Kokotec’s death hit the front page.
Tanja Theriault pulls no punches. She calls the rules “ridiculous.”
Her 33-year-old sister has a mood disorder and is manic depressive. The first time her sister tried to commit suicide, she swallowed a bunch of pills. She was assessed at Hotel-Dieu’s emergency room and released. She then walked to the Detroit River and jumped in.
Police fished her out and brought her back to the hospital. When she was released days later, neither Theriault nor her parents were advised. “They didn’t tell us,” Theriault said incredulously. “The last time they released my sister without telling us, she jumped in the river…. Why wouldn’t they tell us?”
The reason, say hospital administrators without addressing any case specifically, is Ontario’s Personal Health Information Protection Act. “We try to involve families wherever and whenever we can,” said Sonja Grbevski, director of mental health at Hotel-Dieu. Family conferences can improve patient outcomes, she said. But they can only happen with the patient’s consent.
“We have to be sure we don’t violate a patient’s rights,” Grbevski said.
Under the law, Grbevski said, mentally ill patients have the same rights to privacy as physically ill patients.
Ontario’s Personal Health Information Protection Act, enacted in 2004, has long come under fire on that very point. In 2008, Ontario’s information and privacy commissioner recommended that the legislation be changed so health information can be disclosed without permission to reduce the risk of “serious psychological harm.” That same recommendation was echoed in August by an all-party committee charged with charting a new course for mental health treatment in the province. After hearing from frustrated caregivers of mentally ill people, the Select Committee on Mental Health and Addiction included the privacy commissioner’s recommendation in its final report.
Ontario Health Minister Deb Matthews declined to be interviewed on the topic. She instead emailed the following comment:
“My heart goes out to Steven Michael Kokotec’s family. I know this must be a very difficult time. In Ontario, we have the difficult job of balancing a patient’s right to privacy with a family’s desire to be involved in helping an individual get the treatment he or she might need. This is something our government will look at as we continue to develop our 10-year mental health and addictions strategy.”
Barbara Kokotec said the government should act now.
“People have been dying while they’re sitting there still thinking about it.”
“How many people have died because of this ridiculous law?”
Barbara’s brother had been hospitalized for nearly a month leading up to his death. Hotel-Dieu assessed him but didn’t admit him the first time police brought him in after his family got a court order to get him assessed. Kokotec’s mother had to get another court order to have him brought there again. The second time, another court order, accompanied by a letter from the family’s lawyer, resulted in three-week stay.
Kokotec’s family, who’d worked so hard to get Steve admitted, were never notified when he was released on Jan. 6. His parents had a warm bed waiting for him in their Riverside home. Instead, Kokotec, an engineer with a master’s degree, may have spent one night on the street before taking shelter at the Salvation Army.
In what his sister believes was a cry for help, Kokotec returned to the hospital every day, including the day he threw himself off the 10-storey roof of a Pitt Street parking garage.
The morning of Jan. 9, Kokotec wandered by the downtown police station. Disoriented and confused, he stood around until an officer approached and convinced him to take an ambulance to Hotel-Dieu. The emergency room doctor put him on a Form 1, meaning the hospital could hold Kokotec against his will for up to 72 hours. The ink was barely dry when a psychiatrist set him free.
Kokotec’s final hours had him at the police station about 9 a.m. By 11:12 a.
m., he was dead.
He was 51.
Barbara Kokotec said her brother had a family who loved him and wanted him to get better. To help his doctors, she typed five pages of notes about Steve’s yearlong battle with mental illness that began around the time he was laid off from the auto industry. She doesn’t know if anyone at the hospital ever read them.
“Anytime we called, the nurses couldn’t tell us anything because of the privacy laws.” Learning of Danny Laporte’s fate and those of others whose families contacted The Star, she said, “What a stupid law. I’m sorry, but I think it’s stupid.”
Barbara is demanding a coroner’s inquest into her brother’s case. Regional coroner Dr. Rick Mann confirmed an investigation is underway, but he would not say whether an inquest would ensue. The hospital was anticipating a search warrant into medical records related to the case.
Windsor lawyer Samuel Mossman said it’s always hard to prove a hospital or doctor did anything wrong.
“Of course, any clinical psychiatrists will have notes and records that support their decision to release the person,” he said.
Besides, he said, “We’re all in a position to be a Monday morning quarterback.”
Christine Epp approached Mossman about a possible medical malpractice suit over her son’s 2009 suicide. Two days before her 34-year-old son hung himself, he’d been assessed and released from Hotel-Dieu’s ER.
“Something has to be done,” said Epp.
“If you’ve got someone who’s mentally ill, you have to talk to the families. Forget privacy. You have to.”
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