MUSKEGON, Mich. (WOOD) — The death of inmate Paul Bulthouse at the Muskegon County Jail was ruled natural.
The cause of death: seizures. That’s what the death certificate says. That’s what the sheriff said in a news release.
But a Target 8 investigation found the jail had deprived the inmate of a critical medication prescribed by his doctor, and that Bulthouse suffered 15 seizures over more than three hours, all unnoticed by guards, while in a close-observation cell.
Bulthouse died in his one-man cell, at the age of 39, on April 4 from status epilepticus, or seizures. The medical examiner deemed his death natural after an autopsy.
Sheriff Mike Poulin closed his internal investigation.
But Target 8 obtained the autopsy report and the sheriff’s internal investigation, and spoke with Bulthouse’s family doctor to piece together the days and hours before his painful death.
“I was shocked. I was just shocked,” said his physician, Dr. Ruth Walkotten. “I couldn’t believe what had happened.”
MISSED MEDICATION, CHECKS
A timeline based on police records shows Bulthouse suffered most of his 15 seizures during five long gaps where nobody checked his cell — one gap as long as an hour.
The supervision gaps happened despite the fact that Bulthouse was wearing an anti-suicide smock and using an anti-suicide blanket. He had been held with other suicidal inmates before his hallucinations started bothering them. He was then moved to a one-man observation cell.
Shortly after his death, sheriff’s officials said the one-person cell is designed so guards can continuously monitor an inmate.
In an earlier interview, his father, John Bulthouse, told Target 8 his son was suicidal.
“That would be a side effect of not getting the proper medication,” he said.
According to the American Correctional Association, suicidal inmates should be checked at least every 15 minutes, or even have constant face-to-face supervision.
His doctor said she had prescribed Bulthouse Klonopin, a drug related to Xanax and Valium, to treat the effects of an overdose years ago of Ephedra.
“He had high blood pressure, and if his blood pressure got high, he would have an irregular heart rate, and he had a lot of anxiety, a lot of social anxiety,” his doctor said.
Bulthouse also suffered from fibromyalgia, a disorder that causes widespread pain.
“The Klonopin slows the autonomic nervous system,” his doctor explained.
That’s the part of the nervous system that controls breathing, heartbeat and digestion.
“It was working. It was keeping him stable,” the doctor said.
The doctor said the jail knew Bulthouse had been taking Klonopin. Jail records confirmed that.
“The nurse called, apparently when he was taken to prison, and asked for his medical sheet, of all the medications, and we sent it over right away,” Walkotten said.
The list, she said, included Klonopin. She said the jail nurse never told her they would not give him Klonopin.
But the jail has a policy against giving that drug, according to the autopsy report.
“The medical department will not dispense Klonopin,” the report states. It didn’t say why.
“It is a controlled substance, but I would think they would also have a protocol on which to reduce the medication if someone comes in on it,” the doctor said.
DRUG WITHDRAWAL DANGERS
The American Addiction Centers says quitting Klonopin without consulting a doctor is dangerous — that it can lead to hallucinations, thoughts of suicide, seizures and death.
“You can’t stop cold turkey,” Bulthouse’s doctor said. “It’s a very strong medication.”
With the high dosage he was taking, she said, the jail should have expected him to suffer seizures. She said she had never had to treat him for seizures in the past.
Across the country, there have been reports of inmates dying because jails cut off their Klonopin or other benzodiazepines.
In Macomb County near Detroit, the death of an inmate in 2015 led to an FBI investigation, but no criminal charges.
Bulthouse is not a sympathetic character. He was convicted in February for possession of child pornography at his home and got probation, but that’s not what sent him to jail.
Police sent Bulthouse to jail on March 22 after he kept violating his probation by drinking, using the internet, contacting his victim and refusing sex offender treatment.
Jail records show guards and nurses were monitoring him for alcohol withdrawal.
Jail records indicate that two days after his arrest, Bulthouse called his grandmother, complaining the jail wouldn’t give him his meds and that he was “going to snap.” He called his grandmother several days later to ask for an ambulance.
On April 1, three days before his death, he tried to escape — an attempt his doctor said could have been triggered by his withdrawals.
In the autopsy report, jail officials said guards handled him gently when they took him to the ground and handcuffed him.
“Sgt. Griswold explained to me the decedent was not roughed up at all and was easily brought under control,” medical examiner investigator Darric Roesler wrote in his report. “In fact, Sgt. Griswold said he was impressed with the level of care and lack of violence that was used to subdue the decedent during his escape attempt.”
It’s not clear if that’s what left Bulthouse with the bruises and abrasions all over his body described in the autopsy report.
The escape attempt led to charges of assaulting a jail officer and a jail EMT, and escape.
Target 8 filed a public records request for surveillance video of the escape attempt, but the jail’s initial response said it did not exist.
Target 8 filed a new request after the video was described in detail in the autopsy report. The request also includes video from the morning Bulthouse died. Jail officials said technical problems have delayed the release of the videos.
RED FLAGS MISSED AND DISMISSED
In a police report, a jail sergeant said it appeared Bulthouse was suffering a seizure right after the escape attempt, “twitching his left leg and flailing about.” But a nurse told him she thought he was faking.
It was the first of several incidents involving what they believed were fake seizures, records show.
“He’s not the kind that would fake a seizure,” his doctor said.
About four hours before Bulthouse’s death, a jail sergeant, after watching Bulthouse “making several spontaneous utterances and clenching his fists,” asked a jail nurse if they should send him to the hospital.
The nurse said it wasn’t necessary and that “we would continue to monitor Bulthouse here,” the report states.
REPORT: 3 HOURS, 15 SEIZURES
During that early morning on April 4, staff checked on Bulthouse 21 times, mostly looking through a window.
But a Target 8 review of reports shows five long gaps without anybody checking on him — 30 minutes, 29 minutes, 27 minutes, an hour and 42 minutes. According to a sheriff’s review of jail video, Bulthouse suffered 11 of his 15 seizures during those gaps.
Bulthouse died more than three hours after the first seizure.Jail officials said they didn’t realize he’d suffered seizures until watching them later on surveillance video.
During his first seizure at 2:12 a.m., “His body stiffens up and his right arm reaches up in the air while his left arm bends with his hand over his chest,” an internal investigation report states.
“While watching the video, after each seizure it appears Bulthouse has difficulty breathing and stops breathing 15-30 seconds each time,” Detective Sgt. Tom Johnson wrote in his report. “He also urinates himself numerous times.”
Bulthouse’s doctor is left with unanswered questions.
“Why they didn’t watch him. Why they didn’t ween him carefully. Why didn’t they take him to the emergency room? I just don’t understand,” she said.
“I think at the first sign, they should have taken him to the emergency room where he could have been treated.”
In an email, Sheriff Michael Poulin told Target 8 he could not comment because of possible litigation. The family has hired an attorney.