|
CPR, 911 call for youth were
delayed Bowling Brook staff believed boy feigned sleep while
unconscious, school reports
January 31, 2007
By Gadi Dechter and Greg Garland
 Isaiah
Simmons III, age 17, died January 23, 2007 after being restrained at
Bowling Brook Prepatory School in Maryland.
Isaiah's mother and daughter. When
a youth at the Bowling Brook Preparatory School lost consciousness
last week while being restrained by staff, workers delayed
administering CPR or calling for an ambulance because they believed
he was pretending to be asleep, according to a report sent by the
school to the Maryland Department of Juvenile Services.
When the paramedics were finally
summoned, 17-year-old Isaiah Simmons was rushed to Carroll Hospital
Center, where he was pronounced dead.
Bowling Brook's account of the
efforts by staff to restrain Simmons for at least three hours is
contained in a required report to the juvenile services agency,
which placed Simmons in the residential program for juvenile
offenders. The report, released yesterday, describes in clinical
terms the hours of restraint and what happened when Simmons lost
consciousness.
 "
[In] time, [Simmons] stopped struggling and became nonresponsive,"
the report says. "The collective thinking of intervening staff and
students was that [Simmons] was feigning sleep.
"[Simmons] was then raised from the
prone position to the seated and brought outside, for staff to
assess and check vital signs. Within minutes, [Simmons] was returned
back in to the house for staff to administer CPR as the ambulance
was simultaneously called."
Medical experts say it can be
dangerous to delay even for few minutes beginning cardiopulmonary
resuscitation or calling an ambulance.
"It's been well documented that the
sooner you start CPR, the better the chances are that patients will
survive," Eric J. Beauvois, an emergency room physician at St.
Joseph Medical Center in Baltimore, said yesterday. "The sooner you
can get the paramedics involved and the sooner you can get the
patient in the hospital, the better. All those will increase your
chance of resuscitation. A matter of minutes can make a difference."
Bowling Brook's report provides the
first detailed description by the school of the Jan. 23 incident
that ended with Simmons' death. It differs significantly in tone
from the vivid account given by Ronnell Williams, 18, one of at
least six Bowling Brook students who witnessed the incident.
"They grabbed [Simmons] and slammed
his ass down," Williams said yesterday in an interview. "He was face
down ... eagle-spread, his arms was out and his legs, too," he said.
"There were five staff. One on each leg, one on each arm, and one
had his knees on [Simmons'] back."
"He told them he was hurting,"
Williams said. "He told them he couldn't breathe. Nobody wanted to
believe him."
At least three other student
eyewitnesses have given similar accounts to their lawyers, including
statements that staff "sat on" Simmons as they restrained him,
according to the Maryland public defender's office.
Bowling Brook, through its public
relations agency, released a statement last night expressing
confidence that the Carroll County sheriff's investigation into the
death "will reveal that Bowling Brook's procedures were appropriate,
that our staff acted in accordance with our procedures and in a
manner consistent with Maryland law."
In response to allegations that
staff have restrained students by sitting or kneeling on them, the
school "categorically" denied that workers ever sat or knelt on the
"head or torso" of Isaiah Simmons. The statement did not address
allegations that staff sat on Simmons' back, as Williams and others
have claimed.
School officials said that their
staff training program meets or exceeds legal requirements in
Maryland, including in the use of physical restraint, and that the
"vast majority" of staff have four-year college degrees. The
counselors involved in the incident with Simmons were "senior staff
of the highest caliber with advanced training," the statement said.
While the state medical examiner
has not determined the cause of Simmons' death, one medical
authority says it appears to fit the general pattern for what is
known as "positional asphyxia."
That can occur when a person is
being restrained after a period of intense physical exertion, and is
positioned on his stomach with weight applied to the back, said
Harry J. MacDannald, a pulmonary and critical care physician at John
Muir Hospital in Walnut Creek, Calif.
"What happens is when individuals
struggle for long periods of time, their muscles become fatigued,"
said MacDannald, who has studied positional asphyxia. "They get
respiratory muscle fatigue. If they are then placed face down, when
the person breathes, their chest is compressed. It takes even more
work to breathe under those circumstances. Eventually, they just
stop breathing."
Authorities yesterday continued to
remove students from Bowling Brook, for decades a well-regarded
residential program outside Westminster. As of yesterday, 15 of 72
young offenders placed there by the Department of Juvenile Services
had been removed from the school, said Edward Hopkins, a department
spokesman. All but one of the 15 were sent home to parents or
guardians, he said.
Many of the youths were removed at
the request of their lawyers in the Maryland public defender's
office.
In Annapolis, youth advocates and a
deputy public defender urged the Senate Judicial Proceedings
Committee to expand the state's supervision of privately run
programs such as Bowling Brook by giving the state's independent
monitor authority to oversee their operations. State Sen. Bobby A.
Zirkin, a Baltimore County Democrat, said he planned to introduce
legislation today that would give the independent monitor that
authority.
Simmons was the first youth in the
custody of the Department of Juvenile Services to die since 2001,
when a girl committed suicide at another center. The department
placed Simmons at Bowling Brook after he was found responsible in
juvenile court for an armed robbery.
The Department of Juvenile Services
released Bowling Brook's written account of the hours before
Simmons' death in response to a request by The Sun.
The school's report says the
confrontation and prolonged physical restraint started at 4:45 p.m.
and ended when an ambulance was called more than three hours later,
at 8:15 p.m.
The incident began when a school
counselor overheard Simmons say he would "spaz out" if staff
confronted him, the report says.
A Bowling Brook staff member
questioned Simmons about that statement. Simmons responded by
threatening to fight or even "shoot" another student, according to
the report.
Believing that Simmons' comments
and body language were potentially "explosive," staff tried to calm
the situation by using techniques described in the report only as
"touch, proximity, and other para-verbal methods of de-escalation."
The youth was then restrained in a seated position.
When Simmons continued to resist,
more staff members and several students joined in the restraining
efforts. Four staff members then "rolled" Simmons into a "more
restricted prone position," according to the school's account.
Because Simmons continued
threatening to hurt others and himself, he was moved to another part
of the school to "redirect the dynamic of the interaction." There,
in the presence of several other students, Simmons continued to
struggle and threatened "to urinate and defecate."
Simmons then began to cooperate,
the report says, though he was still in the "restraint position."
When one staffer tried to engage him in conversation, the teenager
spoke of his 22-month -old daughter and of his absent father. But he
later resumed struggling and making threats.
After an unspecified period of
time, the report says, "Simmons stopped struggling and became
non-responsive."
The school's report draws this
conclusion: "Actions of all staff were in compliance with Bowling
Brook policies. Staff followed procedures in dealing with
unfortunate medical emergency."
One of the staff members who called
911 told the dispatcher that nothing was unusual in the way workers
restrained Simmons.
"We're trained in that," the worker
said, according to tape of the 911 call released by Carroll County
authorities. "It was the same thing we do all the time when we have
an aggressive kid. I don't know what happened. He was in a
restraint, and then he stopped responding."
|
