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Anczak's mother finds no happy ending in settlement in mental health case

Woman died after stay in the Milwaukee County Mental Health Complex

Nov. 24, 2011

A financial settlement has ended a five-year legal fight by the parents of a Greenfield woman who died after a stay at the Milwaukee County Mental Health Complex and helped spark a re-examination of the county's system of care for those with mental illness.

The outcome has left Myron and Jean Anczak deeply dissatisfied and conflicted, as their grief lingers over the 2006 death of their daughter. The $125,000 payment can't bring back Cindy Anczak, who died at age 33, or provide much consolation that other patients' care at the complex is any better, her mother said.

The money - or what's left for the Anczaks once their lawyer, an outstanding hospital bill for Cindy and other bills are paid - won't amount to a windfall. Attorney Robert "Rock" Pledl gets about $44,000 for his work on the lengthy case.

The family filed a legal claim against the county but never actually filed a lawsuit.

"It's not a happy ending," said Jean Anczak. "I don't think we are getting anywhere and doing any good for the people." She later amended that, saying that perhaps her daughter's death saved the life of another county patient who was found to have been suffering from lack of nourishment.

Others credited Cindy Anczak's case with helping to launch reforms that have added staff and improved training. The case also could lead to a shift to community vs. inpatient care.

"To me personally, it made a huge difference," said Supervisor Lynne De Bruin. The Anczak case provided the impetus to move a giant bureaucracy on "how someone should be treated humanely within the system," De Bruin said.

"It was absolutely pivotal in changing hearts and minds" about the need for reform at the county complex, De Bruin said.

The settlement the Anczaks reluctantly signed in mid-October says Cindy Anczak's death and the state's subsequent investigations caused the Mental Health Complex "to re-examine its systems, policies and procedures and make improvements with respect to nutritional care."

The document notes that the family and the county disagree over whether the county was at fault in Cindy Anczak's death. The county specifically denied that any of the care deficiencies turned up by the state "in any way affected Ms. Anczak's care," the agreement says.

According to a medical examiner's report, Anczak's death was caused by complications of blood clots, with "self-induced" starvation, dehydration, exhaustion and immobility as "other significant conditions" in her death.

Anczak, who was diagnosed with bipolar disorder, lost 22 pounds during her stay at the complex, according to the medical examiner's report.

Medical records Anczak's family allowed the Journal Sentinel to review in 2006 detailed notes about her lack of nourishment during four weeks of her five-week stay there in July and August of that year. Jean Anczak said she's still haunted by the way a psychiatrist at the Mental Health Complex tried to discharge Cindy to her parents on Aug. 4, 2006. Cindy was refusing to eat, but Karl Strelnick, the psychiatrist, had obtained a court order to allow him to give her anti-psychotic medication against her will that day.

Strelnick told the Anczaks to pick up Cindy at a back entrance to the complex, Jean Anczak said. But Cindy refused to go home with her father, who drove there.

"She was out of it, almost totally," Jean Anczak said. "At one point, she was almost catatonic."

Cindy Anczak continued to refuse food at the county complex and was transferred to Froedtert Hospital after she was found unconscious and gasping for air, according to her medical records. She was revived and placed on life supports but died eight days later on Aug. 16, 2006.

The settlement includes some discrepancies with the medical records. For example, it states that Anczak lost 15 pounds, rather than 22. The agreement also says Anczak didn't die from starvation, as some accounts suggested, but from blood clots that were "an unpredictable catastrophic event . . . unrelated to her mental health care needs."

The settlement also says her death was "not reflective of any neglect" by the county's Mental Health Complex.

Lawyers for the county recommended the $125,000 settlement, saying a trial "might result in a substantial judgment against the county" for which the county was not insured. The County Board approved it, 18-1, on Sept. 29.

Jean Anczak said the couple wanted to take the case to trial but felt they couldn't afford to do battle with the county.

"They are using my tax money to fight against me," she said.

Complicating a legal case was the difficulty in connecting actions of various county staffers as causal factors in Cindy's death, said Jean Anczak. Some Mental Health Complex staffers her lawyer had wanted to call as witnesses also refused to testify at a possible trial for fear of losing their jobs, Anczak said.

County officials have never publicly discussed the case, though circumstances surrounding Anczak's death led to probes by state and federal regulators, as well as a criminal investigation by the state Justice Department. That was closed with no charges filed.

Mark Cameli, the private attorney hired to defend the county, wound up collecting a total of about $410,000 from the county, said Deputy Corporation Counsel Mark Grady. The majority of the sum was for work indirectly related to the Anczak case as well as a 2009 case of the sexual assault and resultant pregnancy of another patient, such as the follow-up with investigations by hospital regulators, Grady said. The settlement is a relief, but only because the legal case is over, Jean Anczak said.

"It was sinful; I feel it was sinful," she said. "It compromised my ideals and what I wanted to accomplish."

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