State doctor arranged for one mental health patient to attack another, federal judge rules
Virginian-Pilot - 8/6/2018
Aug. 06--NORFOLK -- A doctor at a state mental hospital arranged for one patient to violently attack another at least three times, a federal judge has ruled.
In return, according to court testimony, the attacker was rewarded with extra food, alcohol and drugs.
Following a seven-day trial in Norfolk, U.S. District Judge Henry C. Morgan Jr. ordered two former staff members of Central State Hospital in Petersburg to pay $385,000 in damages, plus interest.
In a 31-page opinion, he ruled Dr. Sridhar Yaratha and nurse Nitaya Barnette -- who fabricated an assault report -- did not act in the best interests of Brian Farabee, now 39, of Portsmouth.
"In sum, and in light of all the testimony at trial, it is clear that the mental health and criminal justice systems have failed Mr. Farabee," Morgan wrote, singling out Yaratha's actions in this case as both "egregious" and "horrifying."
He dismissed allegations against three other doctors at Central State, including its director, Rebecca Vauter.
Farabee's attorney said medical staff should never treat a patient like Yaratha and Barnette treated his client.
"This speaks volumes to the type of care that can happen in the state system," attorney Jeremiah Denton III said. "It's an outrage."
Private attorneys hired by the state attorney general to defend the case said Yaratha and Barnette did nothing wrong and plan to appeal if the state agrees.
"Dr. Yaratha always acted in the best interests of his patients, and he denies any suggestion otherwise," said his attorney Lynne Blain, who described the trial in court documents as a "travesty."
A spokesman for the Office of the Attorney General said no decision had been made regarding an appeal.
Neither Yaratha nor Barnette still work at Central State. According to deposition transcripts, Yaratha left in January 2016 for a job with the U.S. Department of Veterans Affairs. Earlier this year, he said he worked at the VA Medical Center in Richmond.
A VA spokesman said the department was reviewing the judge's decision "closely," as it contained "serious allegations."
"If warranted, VA will not hesitate to take appropriate personnel actions," James Blue said.
Barnette was fired after she falsely claimed Farabee kicked her before he sat down in a wheelchair in November 2013. The false report prompted hospital staff to place Farabee in restraints for about an hour, a move Morgan said likely reinforced his "disordered thinking as to why he cannot trust anybody."
Following her termination, the state nursing board reprimanded Barnette. Earlier this year, she said she worked for Encompass Home Health.
Encompass officials did not respond to requests for comment.
In 2004, Yaratha's license to practice medicine in West Virginia and Iowa was suspended amid allegations engaged in an inappropriate sexual relationship with a patient and was an alcoholic in need of treatment. Virginia followed suit the next year.
Yaratha, however, sought help and the VirginiaBoard of Medicine reinstated his license in March 2006. He started at Central State the next month.
Blain said Yaratha "has been sober for 13 years."
Mental health problems are a fact of life for Farabee, who was diagnosed in the late 1990s with borderline personality disorder -- an illness marked by often impulsive behavior that can strain personal relationships.
Farabee -- currently an inmate at Marion Correctional Treatment Center -- was first hospitalized when he was 9, after he threatened to kill his mother. According to Morgan's opinion, he has been almost continually confined in an hospital or correctional facility since he was 13.
In September 2012, Farabee was transferred to Central State for mental health treatment after he finished serving 10 years for felony assault. That's when he met Yaratha, who recommended different treatment than a previous doctor had.
In 1998, Dr. Kevin McWilliams recommended Farabee receive "dialectical behavior therapy," which includes one-on-one counseling. But Yaratha believed Farabee needed to learn how to control himself before getting that therapy.
Yaratha made a diagnosis of antisocial personality disorder with borderline traits and recommended group therapy and antipsychotic drugs.
In his ruling, Morgan said Yaratha, a psychiatrist, had no experience with dialectical behavior therapy and didn't consult a clinical psychologist with experience before deeming it inappropriate for Farabee.
Denton's star witness at trial was the patient who repeatedly assaulted Farabee at Central State: Justin Evans. The two patients had known each other for about 20 years in hospitals and prisons and never got along.
But, the judge said, their disputes never turned violent until they both found themselves in 2015 under the care of Yaratha.
At trial, Evans testified Yaratha and another doctor encouraged him to attack Farabee. And he said he would receive extra food, alcohol and drugs from other staff members after the attacks.
In his ruling, Morgan said police were called to investigate how Evans came to be intoxicated while on Yaratha's ward, but that people on the ward did not cooperate with police or hospital administrators. Drugs were found on the ward, though not alcohol.
Yaratha took the stand in his own defense, arguing he tried to protect Farabee from Evans.
Morgan, however, said he didn't find the doctor credible. He noted Evans was transferred to another ward following the first assault, and that Yaratha successfully petitioned to get him moved back. He added that Evans was assigned to a room only one away from Farabee even though the ward was 85 percent empty.
Rhonda Thissen, executive director of the National Alliance on Mental Illness of Virginia, expressed shock when informed by The Virginian-Pilot about Yaratha's case.
"It's treatment you would expect from a poorly run prison, not a state hospital," she said after reading Morgan's opinion.
While Thissen said there are many talented people who work in the state's hospitals, she said Farabee's case "demonstrates everything that can go wrong in an institutional system."
"If the court's opinion is accurate, Mr. Farabee likely spent many years institutionalized in both penal and psychiatric facilities because he wasn't provided the care he truly needed," she said.
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