http://web.archive.org/web/20130202072828/http://ssristories.com/show.php?item=3983

Paragraph three reads: "But Vuong Tran of Vancouver, 43, was dead. He’d somehow overdosed on generic Prozac 13 days into his stay in the jail, county records show."

http://www.columbian.com/news/2010/feb/19/inmates-death-may-spur-lawsuit/

Inmate’s death may spur lawsuit

Man died of intentional overdose in Clark County jail; family filed tort claim

By Michael Andersen
Columbian Staff Writer

Friday, February 19, 2010

Man died of intentional overdose in Clark County jail; family filed tort claim

The first time they saw the small Vietnamese-speaking man lying on his Clark County jail bunk facing the cell’s wall one afternoon last June, custody officers assumed he was asleep.

But Vuong Tran of Vancouver, 43, was dead. He’d somehow overdosed on generic Prozac 13 days into his stay in the jail, county records show.

His family filed a $1.75 million tort claim against the county in January and is considering a lawsuit.

Tran had been accused of malicious mischief against his former business partner but had not yet been convicted. A U.S. citizen born in Vietnam in 1965, Tran had no prior criminal record in Washington.

The mentally ill inmate’s June 18 death raises new questions about medical care in Clark County’s jail, especially with prescription medication. A few weeks before Tran died, Sheriff Garry Lucas’s office had received a scathing external report warning that the jail’s clinic was understaffed and risked “serious medical error” in filling and distributing prescriptions.

Lucas told The Columbian last month that he remains uncertain about the report’s conclusion that the clinic’s problems were systemic.

Dr. Dennis Wickham, the county medical examiner, first thought Tran died of cardiovascular disease, and The Columbian reported that initial finding.

Six weeks later, apparently after further tests, Wickham revised the cause of death to “fluoxetine intoxication” and classified it as “suicide.”

What’s unclear from county records is how Tran who suffered from severe depressive disorder with psychotic features, did not speak English and had attempted suicide before could have obtained a deadly dose of the antidepressant, which should have been under lock and key in the jail’s clinic.

“He had far too much of that medication,” David Meyer, an attorney for Tran’s estate, said Wednesday. “How did he get hold of it, if in fact he had more than the daily amount that he was prescribed?”

Nine different medications

According to county medical information made public by Meyer, Tran had been prescribed nine different medications including Zyprexa, a drug used to treat schizophrenia and bipolar disorder.

Zyprexa can increase the toxicity of generic Prozac, known as fluoxetine, said Dr. Michael Bernstein, director of behavioral medicine at Southwest Washington Medical Center.

Even so, Bernstein said, an adult would require a bare minimum of six grams of fluoxetine, or at least 300 of Tran’s 20 mg capsules, for a fatal dose.

“Usually it would take several hours to die from that,” Bernstein said. “The usual electrical impulses that travel through the heart are disrupted. … The heart rhythm changes, and that can cause sudden death with no warning.”

“It’s a pretty rare event,” Bernstein noted.

According to the county medical examiner’s report after Tran’s death, provided in Meyer’s tort claim, the medication count provided by the medical unit was inaccurate.

When he died, Tran was awaiting a court date in the jail after being committed to Western State Hospital outside Tacoma.

He’d originally been arrested Sept. 29, 2008, for allegedly dumping chlorine powder in a tank of koi fish he’d been raising with business partner Dung Hyung Le in Walnut Grove.

The koi died, an estimated loss of $20,000 for Le, according to court records.

Jeannie Bryant, a senior deputy prosecutor for the county, said the county sent Tran to the mental institution there because it wasn’t sure he was competent to make judgments in his own defense.

Bryant said the county had just received Tran’s medical report from the hospital when he died.

Officials in the sheriff’s office said they couldn’t comment on Tran’s case because of the threat of a lawsuit.

Meyer, the Portland-based lawyer for Tran’s estate, said he’s waiting to obtain more documents before moving the claim forward.

“There’ll probably be more specific allegations,” Meyer said.

Michael Andersen: 360-735-4508 or michael.andersen@columbian.com.