Published On: Thu, Oct 8th, 2020

An audit at Mental Health, but no death investigation

PHILIPSBURG — Health Inspectors from the Inspectorate of Public Health, Social Development and Labor (VSA) performed an audit at the Mental Health Foundation yesterday, and will continue to audit personnel for compliance with workplace policies this afternoon. The Inspectorate does not mention any investigation into the death of a 43-year-old patient.

Six weeks after Caulette Julien was found lifeless in the isolation cell of the Mental Health Foundation on August 25 the cause of death has not been determined. Prior to her admission to the Cay Hill institution, there was no evidence that Julien was physically debilitated. For an appointment at MHF, she covered the distance from her home in South Reward to Cay Hill on foot, a good three miles.

Julien suffered from bipolar disorder, previously known as manic depression, a mental disorder characterized by periods of depression and periods of abnormally elevated mood. The former student of the MAC school and St. Maarten Academy had a gentle character and did not pose a threat to her environment. But her attending physician, Dr. Kitty Amarello-Pelswijk, believed that she could be a danger to herself and recommended solitary confinement. The Mental Health Foundation has one isolation cell. The room measuring no more than 2.5 by 3 meters has been stripped of everything that someone can use to harm themselves. Apart from a mattress on the floor, the cell is empty. There are cameras for surveillance. In case of suicide watch, however, it is mandatory that the nursing staff have personal contact with the patient every hour. Reportedly, this was not the case with Julien. The treating physician should visit a patient in isolation every day. However, Dr. Amarello-Pelswijk was at home in quarantine for two weeks due to alleged COVID-infection. She had not transferred the care of her patient to another psychiatrist.

When she received the message in the morning of August 25 that Caulette Julien had been found lifeless, the under-quarantined Dr. Amarello-Pelswijk left her home and went to Cay Hill. She recorded Julien’s death and signed a death certificate on which she stated that Julien had died of natural causes.

It is unusual for the treating physician to determine a patient’s death; that is the job of medical examiner Dr. Michael Mercuur. He took a re-examination of Julien’s body and came to a different conclusion. According to Dr. Mercuur she died an unnatural death. By law, any unnatural death is reported to the Public Prosecutor’s Office. In the case of an unnatural death, permission to dispose of the body must be obtained from a public prosecutor. At the request of StMaartennews.com, a legal expert explains, “The prosecutor is responsible for the death investigation. He will confiscate the body, as well as medical records and medications administered. The investigation requires a toxicological examination. And an autopsy. This will be done by a pathologist.”

Despite the fact that Dr. Mercuur has determined that Caulette Julien has died an unnatural death, no investigation has taken place. Julien was buried a week after her death.

Inspector General Dr. Earl Best of the Inspectorate of Public Health, Social Development and Labor VSA did not intervene. When asked about the cause of Julien’s death, Dr. Best says the investigation is still ongoing. Caulette Julien died over six weeks ago.


In het nederlands: Een audit bij Mental Health, maar geen onderzoek naar dood van patiënt


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