A Pueblo grand jury has found no criminal conduct by Colorado Mental Health Institute staffers in the death of a patient who suffocated after being restrained while face down.
But KMGH-TV Channel 7 in Denver reports the panel did find the staff committed misfeasance and malfeasance, and that they abused their authority, resulting in the Aug. 10 death of Troy Geske.
“The grand jury finds that there was a systematic failure to adequately train staff, to insure staff followed policies for seclusion and restraint and patient safety related thereto, and to disseminate safety information concerning restraint procedures that was readily available, and if put into practice would have prevented the death of Mr. Geske,” the report said.
On the day he died, Geske had refused to take his medication and to be moved to seclusion and restraint, the grand jury found.
Geske, who was overweight, died while face down, with his arms and legs restrained with leather bindings and a leather strap placed over his back to hold him down to a gurney, KMGH reported.
The grand jury found poor execution of the prone restraint.
“The staff member controlling the patient’s torso was using a disapproved control technique by using his forearm to apply pressure to the patient’s back during the entire restraint process,” the grand jury report said.
Last fall, the Colorado Department of Human Services said the mental hospital had eliminated the use of prone restraint.
