Deaths Linked to Costs, Denial of Care

Richard Keener thought the patient was in bad shape. The man couldn’t sleep. He couldn’t work. He spoke disjointedly. He claimed his boss was the Archangel Michael out to destroy him.

“I felt he was a threat to others and to himself at the time and wanted him immediately to go to the hospital,” Keener, a therapist for an employee assistance program, later recalled in a court deposition.

The patient, a 31-year-old computer draftsman named Larry Megge, never got into a hospital. American Biodyne refused to approve hospitalization that would have cost the company several hundred dollars a day.

In a lawsuit against Biodyne, its therapists and the principal insurance company recently settled out of court for $715,000, Megge’s family contended that the decision cost the man his life.

The refusal to pay for hospitalization came despite Megge’s vague talk of suicide and recommendations from Keener, the benefits officer at Megge’s job and emergency room doctors that he be hospitalized.

“It was a bureaucratic snafu,” said Dr. Lynn Blunt, a forensic psychiatrist at Michigan State University who was an expert witness in the lawsuit. “The bottom line is that he needed to be treated and treated in a hospital. I don’t see there was any alternative.”

The lawsuit contended that 17 days after Megge first sought help, he secretly finished a rambling will on his home computer in the Detroit suburb of Mt. Clemens.

“My wife is plotting to kill me,” he wrote, then closed with: “Please remember me & pray for me & visit my grave.”

He then left with his wife to see a movie.

A short time later, witnesses saw the Megge van suddenly veer off the highway and plow into a sign pole at 75 m.p.h. The April 11, 1990, crash killed the couple, leaving their two children orphaned.

The police report did not list a cause, but noted the weather was clear and the traffic was light. There was no indication that Megge tried to brake or steer the car out of harm.

Biodyne officials deny that the accident was a suicide and stand by the treatment Megge received.

“It is our position that he received the appropriate care,” said Michael Padden, an attorney representing the company.

The company also questioned the authenticity of the will, discovered a year after the deaths by the new owner of the Megge home, and noted that the family collected on an insurance policy after stating the deaths were accidental.

An attorney for the insurance company said the no-fault claim would have to be paid in either case.

Megge had been hospitalized at 18 for a breakdown. He also carried a dark secret: He had sexually abused his stepdaughter for 10 years, stopping, at her insistence, three months before he began to have his religious visions.

Soon after, Megge began to talk of plots by his co-workers and neighbors. According to sworn interviews, he cried often and paced the floor at night. At his boss’s suggestion, Megge went to see Keener, who sent him to the emergency room of a nearby hospital.

The hospital psychiatrist recommended admission, in part, he said, because he thought Megge needed closer observation in the event he became homicidal or suicidal.

But a Biodyne social worker refused to authorize the hospitalization. Instead, Megge was told to report to another social worker the next day. She placed Megge under the supervision of his wife and mother and made another appointment for him.

In the following days, Megge and his family saw three other Biodyne therapists. A psychologist repeated that there would be no hospitalization; a psychiatrist prescribed medication. Megge was assigned to yet another psychologist, Gary Stuck, who had a limited license for therapists with less than a year’s experience.

According to court papers, Stuck was required to be supervised by a Biodyne psychologist, but the two never discussed Megge. Stuck never probed Megge’s feelings of guilt over his stepdaughter. Instead, he made an appointment for three weeks later, prescribed “marital relations” between the Megges and told him to call him each morning.

Five days later, after leaving a message with Stuck, Megge was dead. The psychologist called back a few minutes after the crash.

Stuck declined comment for this story. In a sworn interview for the lawsuit, he said that while he didn’t share the family’s fear that Megge might be suicidal, he thought the patient should not be left alone.

“I felt it best that somebody be there for him. . . . A responsible individual,” he said.