How Could You? Hall of Shame-Steven Unangst case-Child Death and Lawsuit UPDATED

This will be an archive of heinous actions by those involved in child welfare, foster care and adoption. We forewarn you that these are deeply disturbing stories that may involve sex abuse, murder, kidnapping and other horrendous actions.

From Contra Costa, California, 16-year-old youth, Steven Unangst, ” was found dead in his bed” after ” taking psychotropic medications” on December 19, 2014.

“[P]olice and state social services officials are investigating why he didn’t receive medical care after he showed signs of being heavily impaired.

Results of an autopsy and toxicology tests are weeks away, so investigators say it’s still far from clear why the otherwise healthy teen died or what, if any, substances contributed. But Steven Unangst’s alarming stupor and mysterious death underscore ongoing concerns about the care and supervision of California foster children who are prescribed potentially dangerous psychiatric medications — a subject of this newspaper’s yearlong investigation “Drugging Our Kids.”

“Family and friends are now grief-stricken, and simultaneously angered over the Dec. 19 death of Steven, a floppy-haired skateboarder in his third year at Pittsburg High School.

“A 16-year-old child does not just die peacefully in their sleep,” said Steven’s grandmother, Karla Garvey, who had cared for the boy for much of his life and was stunned to see him drooling and staggering around “like a drunken zombie” during a supervised visit the afternoon before he died.

She said she begged the boy’s social worker to take him to the hospital but was told his odd behavior may have been because he was adjusting to an increased dose of Zoloft, his prescribed antidepressant.

While psychiatrists consulted by the newspaper said it’s highly unlikely that a modest change to his antidepressant could alone be responsible for Steven’s death, experts say the tragedy should send a clear message to child welfare workers who care for emotionally fragile kids on psychiatric drugs.

“The caregiver and the social worker, they need to feel the urgency and take action immediately to make sure the youth’s health isn’t in danger,” said Jennifer Rodriguez, executive director of the San Francisco-based Youth Law Center and a former California foster youth who felt neglected when she experienced debilitating side effects from psych meds.

Rodriguez said she often hears foster parents complain that they don’t have enough training about “really scary side effects or how the drugs interact with over-the-counter meds or even street drugs.”

By all accounts, Steven’s death is unusual. An average of three or four children died each year while placed out of their homes in foster care, according to state Department of Social Services numbers from 2008 through 2013.

What is not rare is the questionable overuse of medication in foster care, which is now the subject of a statewide investigation by the California Medical Board, spurred by the newspaper’s ongoing series.

Nearly 1 out of 4 adolescents in state foster care receive psychotropic medications, the newspaper found, more than three times the rate for all teens nationwide. And since foster kids often bounce among caregivers who know little about their medical histories, experts worry they often don’t receive enough monitoring.

Steven had been living in the Antioch foster home of Dorothy Brown since his 16th birthday last August. Three other foster children have been moved from her home since Steven’s death, according to state and county officials.

Efforts to reach Brown and Steven’s social worker were unsuccessful, and the agency that employed both of them — Families for Children, a nonprofit adoption and foster family agency — chose not to comment, as did the psychiatrist who prescribed his medication and had been treating him since 2013.

At the time of his death, Steven had been prescribed Zoloft and the sedating antihistamine Vistaril to treat depression, anxiety and sleep problems, according to relatives and records.

Zoloft is approved for use on children suffering from major depression and obsessive-compulsive disorder. Vistaril is sometimes prescribed with Zoloft to reduce the side effect of tremors, or to help with anxiety or sleeplessness, but it is generally used short term.

Four child psychiatrists consulted by the newspaper about the medications prescribed for the roughly 5-foot-10, 150-pound teen, said they were not uncommon.

But one cautioned that Zoloft and Vistaril together could cause dizziness, drowsiness and impaired thinking. According to the FDA, Vistaril can cause “hypersedation” and “stupor.”

Last year, Steven had been removed from his grandmother’s home after police were called during a sibling’s violent outburst. He had been increasingly missing school and scout meetings since then and told his girlfriend’s father that he yearned to return to his grandmother.

On Dec. 18, the day before his death, he slept until noon and was again absent from school. Later that afternoon, Garvey and Steven’s father (who shares the same name) waited anxiously at a Subway sandwich shop for the teen to arrive for a supervised visit. They had planned to treat him to his favorite meatball sandwich and deliver his Christmas gifts.

But Unangst and Garvey said they were shocked as Steven stumbled across the parking lot into the sandwich shop with his social worker’s help. In a cellphone video taken by his father and shared with the newspaper, Steven struggles to eat his sandwich and keep his eyes open. He tells his father he doesn’t know what’s wrong and said he had taken his pill the night before, fallen asleep at 9 p.m., and slept until noon.

“His eyes were rolling around in his head, he was slobbering, he couldn’t sit up straight,” Garvey said. “I said: ‘This child needs to go to the hospital, something’s wrong.’ ”

Garvey said she convinced the social worker to call Steven’s psychiatrist, but he was able only to leave a message and then took Steven to the foster home.

“If this kid couldn’t go to school and couldn’t walk, why wouldn’t you take him to the doctor?” said Todd Whitmire, Pittsburg High’s principal, who described Steven as bright and highly capable.

On Jan. 2, weeks after the boy’s death, Garvey said she spoke with the boy’s psychiatrist, who was “adamant” that the drug combination he was prescribed could not have been fatal or caused the symptoms Steven displayed in the sandwich shop. Garvey said the psychiatrist told her she had increased the dosage of Zoloft but that after hearing the social worker’s phone message about an “adverse reaction,” she recommended cutting it in half.

Contra Costa County spokeswoman Lynn Yaney said local officials are awaiting results of the Antioch police investigation and autopsy reports. “Our job is to take care of kids and keep them safe, and when something like this happens it is absolutely devastating,” she said.

Meanwhile, Garvey has tried to explain to Steven’s two younger cousins why he wasn’t coming home. “God really, really needed him up in heaven for an important project,” she said. “So the angels came and got him.””

 Contra Costa County foster youth’s mysterious death under investigation[Mercury News 1/12/15 by Karen de Sa]

“State social services officials have moved to revoke an Antioch woman’s right to care for foster children, stating she “failed to provide adequate care and supervision” for a 16-year-old who died in his sleep after showing signs he was heavily sedated.

Police also are investigating why Steven Unangst didn’t receive medical attention before he was found dead in his bed on Dec. 19 in the home of Dorothy Brown, a certified foster mother since 2011. The youth had been prescribed psychiatric medications, and his grandmother said she had begged Steven’s social worker to get the boy help because he was drooling and staggering around “like a drunken zombie” during a supervised visit the afternoon before he died.

Investigators are still waiting for the results of toxicology tests that could determine if substances contributed to Steven’s death, but Sgt. Xavier Shabazz of the Contra Costa County Coroner’s office said Wednesday that an autopsy found no natural causes.

Steven’s mysterious death, first reported by this newspaper on Tuesday, has highlighted concerns about California’s care and supervision of foster children who are prescribed potentially dangerous psychiatric medications — a subject of the newspaper’s yearlong investigation “Drugging Our Kids.”

In a petition dated Jan. 9, obtained by the newspaper this week, officials with the state Department of Social Services who oversee the licensing of foster homes allege that foster parent Brown should no longer be allowed to care for and house children in foster care.

Steven’s grandmother, Karla Garvey of Pittsburg, called the state action a relief.

“I want everybody to know what happened,” said Garvey, who often cared for the boy. “They cannot just say, ‘Whoops.’

“My grandson is dead and you can’t fix dead.”

Garvey visited with Steven the day before he died and pleaded with his social worker to take him to the hospital. During the Dec. 18 visit, Steven staggered and slurred his speech, and could barely keep food in his mouth. Garvey said she was told by the social worker that the teen may have been reacting to an increase the night before in his prescribed dose of Zoloft, an antidepressant. However, psychiatrists consulted by this newspaper said it’s highly unlikely that a modest change to his antidepressant could alone be responsible for Steven’s death.

Efforts to reach Brown and the social worker have been unsuccessful. Both were certified by the nonprofit Families for Children, but neither are still employed there.

The state filing this month states that Families for Children has already revoked Brown of the certificate needed to be a foster parent, but the state action would be more permanent.

“None of them did their job,” Garvey said.

Meanwhile, the Rev. Will McGarvey of the Community Presbyterian Church of Pittsburg is preparing to celebrate Steven’s short life in a memorial planned for Saturday. The teen had been active in the church’s youth group and scout troop, and had recently been confirmed.

Now, a simple, flat grave marker will bear his name and dates of birth and death — along with the word: “Beloved.””

State takes action against Antioch foster mother after youth’s death[Mercury News 1/15/15 by Karen de Sa]

 REFORM Puzzle Piece

Update:“A deadly combination of anti-anxiety and antidepressant drugs, painkillers and alcohol were responsible for the death of a teen living in an Antioch foster home late last year, a county coroner has found, intensifying questions about why no one took Steven Unangst to the doctor when he showed clear signs of being dangerously sedated.

A report released to this newspaper by the Contra Costa County Sheriff-Coroner’s office concludes that the 16-year-old died in his bed Dec. 19 after ingesting a slew of over-the-counter and prescription medications. It isn’t clear where Steven obtained the drugs, because only one of the medications found in his system — the antidepressant Zoloft — was prescribed to him.

There were no signs that Steven “ingested the substances in an attempt to end his life,” the coroner’s report states.

The lanky, curly-haired skateboarder received no medical attention — even though the day before he died, a social worker had difficulty waking him up and relatives later filmed him struggling to walk and even keep food in his mouth. Antioch Police have forwarded their investigation into the teen’s death to county prosecutors, and Deputy District Attorney Bruce Flynn said he will soon review the case for possible child endangerment or related criminal charges.

“Nobody paid attention to this child,” said Steven’s grandmother, Karla Garvey of Pittsburg who had long cared for Steven until social workers removed him from her home in August after a sibling’s explosive outburst. “I don’t care if he drank a gallon of bleach, they ignored a child in physical distress and refused to give him medical attention.”

Although the death of a foster child is extremely rare, an investigation by this newspaper, “Drugging Our Kids,” into the excessive use of psychiatric drugs in foster care revealed the youth are often poorly monitored for health concerns and side effects from the medications.

The state agency that licenses foster parents has moved to permanently prohibit Steven’s foster mother Dorothy Brown from caring for children in the system. Brown has appealed the case, which an administrative law judge will consider in June.

Joan Miller, interim director of the county’s department of Children and Family Services division, said she could not comment on the specifics of the case. But she offered her sympathies. “It’s our job to protect children and when we can’t, we grieve for those children and we grieve for that family,” Miller said. Responding to the ongoing investigations into whether Brown and Steven’s social worker David Schwartz, failed to seek medical help, Miller added: “We share in those concerns.”

Both Schwartz and Brown have left their posts with the nonprofit adoption and foster family agency, Families for Children, and efforts to reach them have been unsuccessful.

Steven had been prescribed psychiatric drugs while in foster care — including Zoloft, Trazodone and Vistaril to treat anxiety, depression and suicidal thoughts, records show. He told friends and relatives in the months leading up to his death that he desperately wanted to return to his grandmother. Zoloft, an antidepressant, was found in Steven’s bloodstream after he died, but not in a fatal dose by itself.

Steven abused prescription drugs, but there were signs of his overdosing well before he died that caregivers ignored, the county reports show.

The day before his death, Steven slept until noon and missed school. Later that afternoon, Brown dropped the teen with Schwartz at a Subway sandwich shop for a supervised visit with Steven’s grandmother and the boy’s father.

His relatives were instantly concerned, when Steven staggered out of Brown’s van and had to be propped up just to enter the restaurant. In a cellphone video reviewed by this newspaper, Steven slurs his words and can barely keep his eyes open. The family members implored Schwartz to get the boy to a nearby hospital just minutes away. Instead, he took Steven back to the foster home.

Other foster boys in Brown’s home told investigators Steven had been using Xanax and pain pills in the weeks before his death, and in his room officers found 80 pills “and a large amount of money consistent with ‘dealing’ pills to other people.”

Berkeley child psychiatrist Ed Levin, who has treated foster youth for decades and reviewed portions of the coroner’s report, said Steven showed clear signs of impairment that required immediate medical attention. “Somebody,” he said, “needed to get him to an emergency department.””

East Bay foster teen overdosed on combination of painkillers, anti-depressants, alcohol[Mercury News 4/16/15 by Karen de Sa]

“A wrongful death claim filed Monday against Contra Costa County centers on missed opportunities to seek urgent medical help for a clearly impaired teen in foster care: The night before he was found dead in his bed at an Antioch foster home, 16-year-old Steven Unangst was “making choking sounds and thrashing in his bed,” when his foster mother Dorothy Brown looked in on him at midnight, according to the claim.

And a day prior to his Dec. 19 death, the Unangst family states in its precursor to a lawsuit, Steven’s social worker David Schwartz brushed aside relatives’ observations that the teenager was “slurring his words, falling over in his seat, unable to focus his gaze and speaking unintelligibly.” Although Steven needed assistance just to walk in and out of a Subway sandwich shop the day before he died, his father and grandmother’s pleas that the boy be taken to a nearby hospital were denied by Schwartz, the newly filed claim states: “Mr. Schwartz said he was taking Steven Gavin Unangst back to the home of Dorothy Brown to ‘sleep it off.’

A Contra Costa County spokesperson said Monday afternoon that officials had yet to review the claim but does not comment on pending litigation. Efforts to reach Schwartz and Brown for comment have been unsuccessful. They have both left their jobs at Families for Children, a state-licensed nonprofit adoption and foster family agency that contracts with the county. An attorney for the private agency, San Francisco attorney Robert Berg, said he was not authorized by his client to answer questions about the case.

Last month, a county coroner determined that Steven died after taking a fatal combination of psychotropic drugs, painkillers and alcohol. In making its claim that the social worker and foster mother failed to get treatment for Steven that could have saved his life, the teen’s family is also relying on his medical records, obtained by the Unangst family’s attorney, Larry Cook of the Walnut Creek firm Casper, Meadows, Schwartz & Cook. No specific damages have yet been specified.

The descriptions revealed in the claim against the county’s Department of Children and Family Services said Schwartz insisted Steven’s erratic behavior the day before he died was a result of “simply adjusting to medication” which had been prescribed to him for depression. Steven’s medical records, according to the claim, also show his foster brother sought help that went unheeded: “At approximately 12:00 a.m., another foster child reported to Dorothy Brown that Steven Gavin Unangst was sick and needed a doctor,” the claim states.

The wrongful death claim comes as lawmakers are focusing scrutiny on the excessive use of psychiatric drugs and whether medicated children are being properly monitored in the foster care system, the subject of this newspaper’s yearlong investigation “Drugging Our Kids.”

“If the social worker and or the foster mother had taken appropriate steps to secure medical intervention for this child,” Cook said, “which they did not do, clearly he would be alive today.””

Family of East Bay foster teen files wrongful death claim against caregivers[Conta Costa Times 5/4/15 by Karen de Sa]

Update 2:“Sixteen-year-old Steven Unangst lay choking and thrashing in his bed the night before he died in foster care in Contra Costa County, a newly filed lawsuit alleges, but his foster parent failed to seek medical attention for the teen later found to have ingested a lethal mix of prescription pills.

In the Superior Court suit, the teen’s family also alleges that the county and a private social service agency should have sought treatment for the distraught boy when a social worker delivered him hours earlier to a visit with relatives in a condition they described as excessively sedated.

Contra Costa County officials reached Friday said they cannot comment on the pending lawsuit.

Steven, a lanky skateboarder who attended Pittsburg High School, died in his bed in the Antioch foster home of Brown on Dec. 19, 2014. In a visit with relatives the day before he died, Steven slurred his speech, had trouble focusing and needed help walking, according to court reports and a cellphone video taken by his father. Steven’s father and grandmother implored Schwartz to take him to one of two hospitals located within a mile of the sandwich shop where the family visit took place.

Despite their demands, according to the lawsuit filed in Contra Costa County Superior Court Wednesday, Schwartz refused, and stated that Steven “was simply adjusting to his medication.”

The suit goes on to state that once Steven was brought back to Brown’s foster home, at about midnight, another foster child informed her that the teen was sick and needed a doctor. “Despite seeing decedent choke and thrash in bed, decedent’s foster mother did nothing,” the suit alleges, “only to find decedent dead in his bed the next morning from an overdose of pills.”

Shortly thereafter, Schwartz and Brown left their posts with Families for Children, the nonprofit adoption and foster family agency that contracts with the county. Efforts Friday to reach them through the agency were unsuccessful. The county coroner later found that Steven died after ingesting a deadly combination of anti-anxiety and antidepressant drugs and painkillers — including the Zoloft the teen had been prescribed.

His family’s lawsuit charges the county and its contractor with failing to properly supervise the teen, who suffered from “a traumatic, abusive childhood and severe emotional problems that resulted in involuntary psychiatric hospitalizations” for suicide attempts and ideation.

It was a mistake from the get-go placing him in a home where there were multiple foster children,” said Larry Cook, a Walnut Creek attorney representing the boy’s family. “He needed to be in a situation where he had one-on-one supervision, and more attention given to him.””

Family of Contra Costa County teen who died in foster care files wrongful death lawsuit [Mercury News 12/4/15 by Karen de Sa]