The Associated Press

LINCOLN - Medical negligence at the Beatrice State Developmental Center led to the death last month of an 18-year-old with mental disabilities, the woman’s family says.

David Manes says that his daughter died after at least 10 missteps by staff, and Manes blames the center’s management, according to a copy of the claim obtained Wednesday by The Associated Press. Lincoln attorney Jefferson Downing planned to file the claim against the state on today.

Manes is seeking $1.75 million for his daughter’s suffering and the pain her death caused.

“We’re really adamant that everybody understands that the administrative staff there at the time Olivia was there needs to be held responsible for the actions that led to her death,” David Manes said on Wednesday. “They did not follow federal mandates.”

A spokeswoman with the state Department of Health and Human Services declined to comment on Wednesday. But state officials acknowledged in a report issued last week that Manes’ seizure was mishandled.

Olivia Manes died early on Jan. 16, about three hours after she began having a seizure. Manes and his wife Tina Manes say the death may have been prevented had she not been taken off of seizure medication that she had been taking for nearly a decade or if more trained medical staff had been present that night.

“The biggest thing I want to know is, why did they take away Olivia’s meds?” Tina Manes said.

This claim is the latest in a string of problems for the center. The state is expected to lose $29 million in annual, federal funding to run the center, and it could take two years to regain federal certification.

David Manes’ claim is largely based on the state’s own investigation into the care his daughter received before being transferred to a Beatrice hospital and dying. The state investigation revealed a bumbling response to his daughter’s seizure and led the state’s chief medical officer to declare last week that the center was too dangerous for “medically fragile” residents, 45 of whom have been transferred to hospitals.

Olivia Manes’ death came seven months after the state promised, in a settlement with the U.S. Department of Justice, to provide better care to residents of the center. The settlement was reached after Department of Justice investigators uncovered about 200 cases of alleged neglect and abuse at the center from late 2006 to late 2007 and said the center had a “cultural undercurrent that betrays human decency at the most fundamental levels.”

The State Claims Board is the first stop for residents seeking compensation from the state for allegedly causing injury, death and other civil wrongs covered by tort law. Rejection of the claim related to Olivia Manes’ death, or inaction on the claim, would clear the way for a lawsuit to be filed in district court.

Olivia Manes was mentally retarded, had the mental capacity of a 6-year-old, and lived at the center since 1997, where she was visited at least once a week by her parents. Her parents praise staff of the center, saying they treated her like loving parents. They instead blame bad management for problems at the center.

David Manes says in the claim that the seizures that used to strike his daughter daily stopped in 1999 after she began taking Klonopin. For unknown reasons, the claim says, staff at BSDC stopped giving her the medication on Jan. 12 without consulting her parents.

That medication change is the first in a series of errors outlined in the claim:

n After Olivia Manes’ seizure began at about 11:30 p.m. on Jan. 15, staff waited about 15 minutes before calling for a nurse.

n The nurse erroneously recorded that Manes has taken Lorazepam, not Klonopin, until Jan. 12. The nurse gave Manes Lorazepam. But when trying to administer the medicine, the nurse broke off a needle in Manes’ leg, resulting in a 3 minute to 5 minute wait before the medicine was properly administered.

n The nurse told staff to wait 30 minutes, per doctor’s orders, to see if the medication worked. But the nurse left the medically untrained staff with no other instructions. Manes’ vital signs were not monitored.

n Staff told the nurse that the medicine wasn’t working, so Manes was given another shot of medicine and staff was again left without instructions on how to care for her. It was about 1 a.m. on Jan. 16, roughly 1 1/2 hours after the seizure began.

n Twelve minutes later, staff called the switchboard to report Manes had stopped breathing but no one called an ambulance. Staff started CPR on Manes. A nurse noted that Manes had turned brown, fluid was coming out of her mouth and she was not breathing. Despite the skin feeling warm, no vital signs were taken.

n A nurse discovered an ambulance hadn’t been called, so one was called at about 1:18 a.m. Staff used a defibrillator on Manes three times, but the defibrillator stopped working on the fourth attempt. An ambulance picked Manes up at 1:29 a.m. and she was taken to a Beatrice hospital, where she was found to have pneumonia and a fever of 106 degrees. She died at 2:20 a.m.

The state’s investigatory report shows that not all staff were trained to handle seizures even though 17 of the 18 residents in the unit where Manes lived had a history of them.

The report also says not all staff were aware of the facility’s procedures on handling an emergency.