Autopsy Yields a Surprise in Clinic Case

A man who authorities alleged died after being tied up and force-fed alcohol at an unlicensed clinic in fact died of chronic liver disease and had no alcohol in his system, a coroner’s report shows.

The finding is troublesome for prosecutors, who have charged four men with involuntary manslaughter and false imprisonment in the May death of Enrique Bravo at Grupo Liberacion y Fortaleza in North Hollywood, a clinic that used alcohol aversion therapy.

In filing the charges in June, authorities alleged that the four men tied Bravo up and force-fed him alcohol in an ill-fated attempt to cure him of his addiction to liquor.

After he died, the defendants, some of whom had just completed the program themselves, allegedly carried the victim out of the clinic and left him sitting in a chair on the sidewalk. They initially denied they had anything to do with him, authorities said.

The case led to the closure of eight unlicensed alcohol rehabilitation centers suspected of force-feeding patients liquor to kill their desire to drink.

The coroner’s report, obtained by The Times on Wednesday, showed that Bravo had ligature marks on his wrists and said that the lack of medical treatment “played a role in his death.” Deputy Medical Examiner Thomas H. Gill listed “alcoholic liver disease and other undetermined inflicted factors” as the reason Bravo died.

“The cause of death was not alcohol poisoning. If he died of chronic liver disease, how can they say my client caused the death?” asked Deputy Public Defender Dror Toister, who represents Alberto Saguache, one of the four men charged with Bravo’s death. “If this guy did get medical care, would that have reversed the course of liver disease? It’s not like a traumatic event.”

But Deputy Dist. Atty. Craig Renetzky said prosecution will continue. Not giving Bravo common medical treatment that licensed clinics give alcoholics during withdrawal “is negligent,” he said. “And if you’re negligent, you can still be held liable for manslaughter.”

John Spillane, head prosecutor in Van Nuys, said it does not concern him that the actual cause of death was liver disease because the defendants “took the responsibility of the care and control of an obviously sick man, professing to give medical treatment and none was provided, and they prevented him from seeking medical treatment.”

Saguache, Armando Saquil, Dante Barrera and Jose Rodriguez are scheduled to face a preliminary hearing next week.

Los Angeles County supervisors called for a crackdown on unlicensed alcohol rehabilitation clinics after the number of suspicious deaths linked to the facilities rose to 11 and allegations surfaced of beatings and whippings at some clinics.

The eight clinics that have closed were not licensed and masqueraded as Spanish-language Alcoholics Anonymous centers, county health officials said. Some patients who say they have recovered from alcohol addiction at the clinics said their stay was voluntary and that they were given the option of drinking some alcohol to help them overcome withdrawal.

In Bravo’s case, police began an investigation after another patient told authorities that the man was carried out of the building and put on the sidewalk when it appeared he was dead or dying. He said other patients who witnessed the actions were bound and gagged and moved to another building when police responded to the defendants’ calls.

According to a police report, the defendants admitted tying up the victim and feeding him alcohol as part of their program.

Saquil, who identified himself as one of the group’s leaders, told detectives he “dried out” at the facility himself after being tied up and fed a mixture of vodka and beer, and eventually became an “overseer” of the program.

He told detectives that Bravo awoke about 6 a.m. May 25 and became “delirious and aggressive.” Saquil said he and Barrera tied Bravo up and “gave him some beer to calm him down,” the report said. About an hour later, Saquil told detectives, someone said Bravo appeared dead.

Saquil said he wanted “to save [Bravo], not kill him.” He said another group member attempted CPR but could not revive Bravo.

Saquil and Saguache said they carried Bravo outside, according to the report. Barrera called paramedics, Saquil told detectives.

Barrera told police that he and others concealed what happened because they wanted to keep the program open, according to the police report.

Death records showed that three other men died at the storefront clinic on North Lankershim Boulevard over the last few years. A death certificate stated that one of the men, Toribio Perez, 38, died of accidental alcohol poisoning Oct. 1, 1996. Emilio Morales, 45, died July 31, 1996. His death certificate said he died of natural causes and noted liver damage. On March 21, 1998, Simon Lopez, 40, of Pacoima died at the facility. A determination of the cause of death was deferred pending further investigation, according to his death certificate.