Ancora Psychiatric Hospital Pays Its Way out of Civil Rights Suit

November 26, 2018

No one will be held responsible for Tara Murphy’s drastic weight loss, her multiple injuries — broken teeth, cuts, scratches and bruises — or her bouts of pneumonia, or her failure to improve.

A settlement check, funded by New Jersey taxpayers, is in the bank.

And with it, all of the state workers and institutions accused of wrongdoing in her civil rights lawsuit have been released from further demands, claims, damages or future lawsuits.

The state denies its employees did anything wrong while the Toms River woman was a patient for 18 months at Ancora Psychiatric Hospital in Winslow Township.

According to the state, its nurses and physicians provided proper care, though a community hospital documented her dirty bandages and disheveled appearance, her infected wounds and anxious behavior, and a feeding tube that leaked stomach fluids onto her raw, irritated skin.

Her injuries and damages were the result of pre-existing conditions, the state concluded.

The state contended her civil rights weren't violated, though she was often kept in restraints and at least one employee was fired after being charged with assaulting her. That alleged incident was caught on video and turned over to a Winslow municipal court judge, who threw out the assault charge due to lengthy procedural delays.

For her parents, John and Margaret Murphy, there is no closure, no justice, for how their daughter fared while in the state's care at Ancora. They called the settlement check a slap in the face. 

"I don’t care how much you give me," Margaret Murphy said during an interview at the impeccably kept house where Tara lived with her parents. "I want to see them take care of those kids over there.

"I can’t stand the thought of it no more, the way they treat them? I can’t stand that."

The Murphys provided the Courier-Post with several binders of records mostly collected from community hospitals where their daughter was treated at least 16 times for medical complications while a patient at Ancora. They also shared their personal notes documenting their visits. They said they don't have her medical records from Ancora, although they did share a two-page clinical review conducted at the state hospital a few weeks before Tara's discharge.

The Courier-Post also reviewed court records, provided by the state through an Open Public Records Act request.

Together, the records show a woman whose mental and physical health declined rapidly after she entered the state's care.

As a child, Tara was diagnosed with a developmental disability and mild cerebral palsy that her mother suspects was the result of a difficult birth. As an adult, she read at a second-grade level. She had no concept of money, so she lived at home with her parents and her dog, Sandy.

She worked at a daycare center for about a decade, acted in local stage productions and sang at her church, St. Joseph's Roman Catholic Church in Toms River.

She loved teddy bears, children and yellow Labrador retrievers.

She also suffered with anxiety, a problem that resulted in ever-increasing dosages of multiple medications by the time she was 36 years old. In the months leading up to Tara's hospitalization, her mother's handwritten notes detailed Tara's sleepless nights, agitation and aggressive behavior.

In June 2013, medical records from a two-week stay at a regional medical center indicated Tara had bipolar disorder. She heard frightening voices at night. She hit her mother. Stabilized with medication and therapy, Tara returned home to her parents' care.

Two months later, while she was at a short-term behavioral facility to "adjust" her medications, staff determined she needed more care and told her parents she was heading to Ancora, a place they had never heard of.

Overseen by the state Department of Health, the inpatient psychiatric hospital is situated on 680 acres in Camden County, halfway between Philadelphia and Atlantic City. In September, the hospital counted 407 patients with mental illness, including elderly patients, people with traumatic brain injuries, serious criminal records, substance use disorder, and developmental or intellectual disabilities. Most of its patients are South Jersey residents.

The Murphys met the transport ambulance at Ancora, where Tara was involuntarily committed on Aug. 17, 2013. She weighed 195 pounds, according to her parents. There, she was diagnosed with schizoaffective disorder and impulse control disorder.

During the next year and a half, her parents visited her three times a week. Sometimes, Tara pedaled on an exercise bike in the visitors' room and gazed out the window. Sometimes, she ate home-cooked food and pints of ice cream they brought to share.

More often, staff wheeled her to them in a Broda chair, a device akin to a wheelchair.

"They had her legs tied down in it and her hands tied down in it," said John Murphy, who took photos of his daughter in the chair. "It was on casters, big casters. And she would rock back and forth, trying to get out of it, and — bang! — she would tip herself over. That’s how she broke her teeth. That’s how she got seven or eight stitches in the back of her head, tipping out of that stupid chair, because they wouldn’t keep her out of it. They would keep her in it."

During one visit, Margaret Murphy recalls, Tara asked to use the bathroom. Her mother alerted an attendant, who informed them the woman was wearing a diaper.

Margaret and John Murphy battled the state for years over the treatment of their developmentally disabled daughter, Tara, who struggled with mental illness in her 30s. The Murphys alleged Tara's civil rights were violated while she was a patient at Ancora Psychiatric Hospital in Winslow Township, Camden County. They agreed to settle their federal lawsuit this year, and the state denied any wrongdoing. November 5, 2018, Toms River, NJ

"She said, 'Let her go in her pants.' I said, 'No, we can help her,'" Margaret Murphy recalled.

"That's the kind of stuff we were up against," she fumed. "That’s punishment to somebody."

Ancora staff provided no explanation for injuries

The couple often discovered bruises and unexplained injuries. At one visit in November 2013, Tara pulled up her pant leg and showed her mother an injured knee.

"She says, 'Mommy, can you fix this?' I looked at it, it was swollen red," Margaret Murphy recalled. "Just like that, 'Mommy, can you fix this?' I called the supervisor lady over. I said, 'What’s with this knee? This is all banged up, what happened?'"

There was no explanation.

Tara was taken to a community hospital, where she spent the next three weeks for lethargy and tremors, suspected side effects of anti-psychotic medication. Diagnostic images showed the knee was only bruised, though a doctor first thought it was broken. Doctors also discovered she had a urinary tract infection. Medical records also noted a history of chronic obstructive pulmonary disease and high cholesterol.

She returned to Ancora, where she developed a problem with swallowing food and liquids. That led to frequent bouts of aspiration pneumonia and severe weight loss. In March 2014, a surgeon installed a feeding tube that sometimes leaked and that she later pulled out, requiring return trips to the community hospital for repairs.

Between March and September 2014, she returned to the same community hospital eight times for various problems: pneumonia, changes in her mental status, seizures, head and facial injuries, diarrhea and "failure to thrive."

In notes summarizing her case, doctors at the community hospital frequently referred to her as an "unfortunate" patient who was well-known to them. 

Medical notes from the community hospital noted "multiple old bruises" and, six days after receiving stitches on her chin, that the "same dressing is still in place, dirty."

By October 2014, records show, Tara weighed less than 100 pounds. Medical notes from a visit to the community hospital that month indicated she was malnourished and dehydrated.

Throughout her stay at Ancora, Tara remained agitated, moody and anxious, with behaviors that resulted in injuries to herself and staff, according to a clinical review taken a month before her discharge. She suffered repeated infections and seizures. By then, her psychiatric diagnosis was listed as separation anxiety disorder and possibly generalized anxiety disorder.

'If she got treated right, she'd be sitting here with you and me right now'

On April 15, 2015, her 39th birthday, Tara was discharged to a behavioral group home.

In a federal lawsuit filed on Tara's behalf, the Murphys alleged their daughter was physically and emotionally abused by state employees while she was a patient at Ancora.

They argued the hospital did not protect their daughter from frequent falls that occurred while staff improperly restrained her. They also alleged the hospital's "negligent care" led to permanent injuries.

On Dec. 8, 2016, Tara died in a Philadelphia hospital after she was found unresponsive in her group home. She was 40 years old.

This past March, the Murphys agreed to settle their lawsuit with the state for $50,000. After their attorney deducted their legal costs, they received a check in September for $31,000.

According to the agreement, the state denies every claim made by the Murphys.

In August, the state Department of Health released a report summarizing the findings of an outside review of New Jersey's psychiatric hospitals. The report pointed to a "lack of proper space configuration" and the "absence of sufficient skilled staff" as factors contributing to aggression among patients with intellectual or developmental disabilities. 

Health Commissioner Dr. Shereef Elnahal promised reform was already underway, with additional staff and new programming to improve care for patients with disabilities at Ancora.

During an interview then with the Courier-Post, Elnahal said he expects an increase in patients with disabilities who also need psychiatric care. About 4 percent of patients in state psychiatric hospitals have a developmental or intellectual disability.

"What we’re trying to do is to make sure that we put in best practices to address these patients well," Elnahal said. 

The Murphys said they are sharing their daughter's story because they don't think New Jersey's psychiatric hospitals are appropriate for people like Tara. They believe the state should build a psychiatric facility for patients with intellectual and developmental disabilities. They said staff should be better trained to handle patients with special needs, and perhaps offer a campus setting with home-like cottages for two people. 

"Most of the time, they use all kinds of drugs on them, and they change their drugs," Margaret Murphy said.

"They need to close the special needs unit at Ancora," she added. "They need to do that, because it's not working — and then they're releasing them in maybe worse condition than (when) they went in, because of the abuse and neglect that they're getting there."

The Murphys hope their daughter's story will help avert another tragedy.

"If she got treated right," said Margaret Murphy, "she'd be sitting here with you and me right now."

Source: “The sad story of Tara Murphy, 'unfortunate' Ancora patient, Cherry Hill Courier-Post, November 26, 2018, URL: https://www.courierpostonline.com/story/news/local/south-jersey/2018/11/21/ancora-psychiatric-hospital-new-jersey-mental-health-care-treatment-lawsuit/1894621002/