PHILIPSBURG--L.T. (48) was found dead on Thursday morning, July 22, in a cell at the Philipsburg police station assigned to the Mental Health Foundation. Police spokesman Ethelwoldus Josepha said the man was not being held on criminal charges, but because he had mental health issues and had disturbed the public order.
L.T.’s detention and the man’s surveillance and care were not the responsibility of the St. Maarten Police Force KPSM, but of the prison and the Mental Health Foundation (MHF), Josepha emphasised. Now that the patient has died, the National Detectives are responsible for investigating his death.
KPSM stated in a press release, “On July 22, at 9:30am, police received a notification from the personnel of the House of Detention that during a routine check a detainee in a holding cell was not showing any signs of life. The Ambulance personnel were called and attempted to administer first aid to the detainee; however, it became apparent that the man was unresponsive. Subsequently, the attending doctor pronounced the man dead.”
Attorney Sjamira Roseburg witnessed the initial reactions of officers in the police station: “There was a commotion, and the Emergency Medical Services were called. Upon enquiry with officers, it turned out that the man had died,” Roseburg said.
L.T. was overpowered in St. Peters on July 18 by police officers who cornered him for behaving confusedly and inappropriately. Police were called by acquaintances of the man after he allegedly had harassed/assaulted them and destroyed property nearby. However, a police spokesman said L.T. was not a suspect.
The man in the police cell had received visits from an MHF nurse and psychiatrist Dr. Erik Hoencamp from the clinic, over the past four days. MHF has a mandate from the government to care for psychiatric patients on the island.
The Daily Herald called the psychiatrist involved, a member of MHF’s medical directorate, and Dr. Hoencamp responded: “I don’t know the patient. I don’t know why you are calling me. I don’t know you and I have no comment. You can keep talking to me for another half an hour, but I’m not going to answer you.”
L.T. went to attorney Cor Merx’s office earlier this year to complain about the way he had previously been treated by police and MHF. He allegedly was held to the ground by police officers and had received injections from two MHF nurses against his will. The man protested that he had been given coercive medication on the street and in his home and wanted to hear from the lawyer what his rights were. He also complained that the medication did not make him feel any better, it just made him drowsy.
This newspaper has learned from a source that MHF has a policy of administering injections to patients who engage in psychotic behaviour and/or pose a threat to themselves or their environment, for the purpose of sedating these individuals. The injections are administered outside the clinic by members of MHF’s crisis team. The standard emergency medication consists of haloperidol, often in combination with diazepam (Valium) and promethazine.
The cocktail of drugs is not without danger: intravenous haloperidol prolongs the QT time, the time that the heart chambers take to contract and relax again. Too high a dose can lead to cardiac arrhythmia – at worst, a cardiac arrhythmia that can lead to sudden cardiac death.
The amount of haloperidol reportedly administered intravenously to psychiatric patients by default, 10 milligrams per millilitre (mg/ml), is twice as high as the dose given to psychiatric patients in the Netherlands in crisis situations. According to the guidelines in the Netherlands, the dose is 5mg/ml for injection and an electrocardiogram (ECG) should be carried out after administration so the treating physician can see how the heart reacts.
The other two drugs commonly administered in St. Maarten in combination with haloperidol, diazepam (Valium) and promethazine, also have a sedative effect. Both drugs slow breathing.
The Public Health Inspectorate is investigating two cases in which MHF patients have died. Caulette Julien (43) was found dead in solitary confinement at MHF’s clinic in Cay Hill on August 27, 2020. Examination by forensic doctor Dr. Michael Mercuur found it was an unnatural death.
An elderly MHF patient died at St. Maarten Medical Center in October last year. She had been given intravenous medication at home by MHF nurses and had collapsed in front of her husband. After CPR, she was in a coma in hospital and died after five days.
After L.T. was overpowered by police officers in St. Peters on July 18, he was taken to the police cell complex in Philipsburg on behalf of MHF, according to the Prosecutor’s Office, which said the prosecutor was not involved in this. When L.T. was found dead, he had been incarcerated for four days.