Denis Maltez Didn't Have to Die

12-year-old Denis Maltez died almost two year ago, on May 23, 20072009. He was restrained by staff while on a trip to a flea market to get a haircut. Denis lived in a group home, Rainbow Ranches, which has since been shut down by the state of Florida. Denis had lived in a group home since 2003, "after he tried to choke his younger sister." Yesterday's Palm Beach Post reports that, on that May day two years ago, Denis had become

.... aggressive, kicking and biting group home staff. An autopsy report said he became unresponsive shortly after staff restrained him while he lay on his stomach on a bench seat in the van.

The Palm Beach Post also reports that Denis' mother, Martha Quesada, has now filed a wrongful death and medical malpractice lawsuit Monday in Miami-Dade circuit court. It's claimed that Denis' psychiatrist, Dr. Steven L. Kaplan, and the now-closed Rainbow Ranch group home overmedicated Denis and did not properly monitor his medical condition. Denis was taking a number of medications:

Seroquel and Zyprexa, both anti-psychotic medications; Depakote, an anti-seizure drug sometimes used to stabilize moods; and Clonazepam, a tranquilizer.

The Miami-Dade Medical Examiner's office found that Denis had died of a rare condition, serotonin syndrome:

The rare condition, which can be life-threatening, occurs when a combination of drugs - particularly mental-health drugs - causes the brain to produce an excess of serotonin, a chemical produced by nerve cells that regulates mood. The condition can cause rigidity and tremors, as well as confusion and high blood pressure, said Dr. Carlos Singer, a professor of neurology at the University of Miami's medical school.

This story really struck home with me. Charlie is the same age as Denis when he died. Charlie's on some of the same medication as Denis (not so many, certainly) and has had some of the aggressive sorts of behaviors that Denis had. Unlike Denis, Charlie lives with Jim and me at home. Still, there are similarities between Denis and my son. Charlie, when anxious, can become very physical, and has to be kept safe.

Charlie's become a tall, strong, very active boy who thrives on physical activity---all that pent-up energy, frustrations, anxieties---with significant communication challenges. He still spends the majority of his time with Jim and me rather than with his peers. Many of the activities that his same-age peers spend their time in, such as sports teams and anything athletic, are not available for Charlie, who's not yet been able to participate in the Special Olympics. I know that other kids his age are going through adolescence and growth spurts. Charlie, unlike his peers, isn't able to communicate to the kids his age about how it feels for his body to be changing, about how he doesn't feel the same about his two parents, as he seeks to be more independent.

Think of the aggressive feelings and urges that kids work out on the playing field (for better or for worse): Charlie's not able to do this. Charlie can do some of this playing sports organized for special ed kids, but, on the whole, these tend to be less intense and to require Charlie to pay attention carefully to follow the directions. Sports aren't so much a time for him to "let it all out," as another learning situation.

Charlie's been having his share of "outbursts" both vocal and physical. There tend to be more of the latter, due to his limited language and Jim and I are looking to spending large amounts of the summer getting Charlie the physical workout that he needs everyday, be it through bike-riding, swimming, walking, running, shootings hoops. It's not an exact correlation, but getting him involved in steady, aerobic physical activity a couple times of day helps to lessen the physical outbursts, and to keep things more peaceful easy-feeling for everyone.

The Palm Beach Post story notes that Rainbow Ranches did not adequately oversee his medical care---a significant oversight, due to the types and number of medications that Denis was taking. Living in a group home, and one that has been shut down by the state of Florida, were other needs---for physical activity, for a start--of Denis' attended to?