Posted in Mental Health

Two WA men were arrested in mental health crises. Only one survived

   Published Date: October 6, 2024
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This story contains descriptions of mental health crises, including suicidal thoughts.

IN CRISIS

Jim Curtice is yelling.

Tussling with sheriff’s deputies on his lawn in rural Yakima County, Curtice is begging them to kill him and threatening to kill them.

His words are slurred and his breath smells like alcohol, according to Sheriff’s Office reports. Curtice had gone to a local bar after arguing with and kicking his wife, then tried to fight the man who drove him home, and said he was going to stab himself.

Now the deputies are putting Curtice in handcuffs. As they walk him away, Curtice sweep-kicks one in the leg, bringing him down.

“It was apparent that Curtice had been consuming alcoholic beverages and was experiencing a mental health crisis,” the deputy reported last year.

Eight months later, Hien Trung Hua is yelling.

He wants to buy alcohol but he’s not supposed to be drinking. Arguing with his mother in their small Yakima apartment, he kicks her in the leg and a neighbor calls the police.

Hua asks one of the officers to handcuff his mother and spray her with perfume, according to police reports. He blames kicking her on “the witch.” The officers place him under arrest.

His mother says he has bipolar disorder, among other conditions. She gives them medications to take with her son to jail.

“It was very clear to me that Hien was struggling from a mental health crisis,” one officer reported.

A man has died while incarcerated in the Yakima County Jail, resulting in an investigation by the county coroner and an autopsy by a forensic pathologist.

When the man became unresponsive, he was held face down, in violation of a jail policy, with his hands and ankles chained behind him and a hood over his face. He had been pepper sprayed, wrestled with guards and been hit with fist and knee strikes.

But the coroner and pathologist conclude he died from health problems that began hours prior. They record the cause of death as an irregular heartbeat and narrowed arteries, and the manner of death as natural, meaning the guards weren’t responsible.

The dead man is Hien Trung Hua. The coroner is Jim Curtice.

This is a story about what went right for Curtice, what went wrong for Hua and how Curtice’s investigation of Hua’s death helped obscure what happened in jail last year.

Pieced together by The Seattle Times using police reports, jail documents, medical notes, video recordings and interviews with more than a dozen experts, the story shows how decisions by police, jails and health care providers can — in cascading steps — yield disparate outcomes for people in crisis.

It also illustrates how dangerous jails can be for people with mental illnesses, even when there are policies in place to protect them. And it reveals gaps in oversight of jail deaths in Washington, which has been uncommonly plagued by such incidents.

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Curtice declined interview requests for this story, and jail officials declined to comment on Hua’s death.

But after The Times interviewed pathologist Jeffrey Reynolds this summer, he watched videos of Hua’s death for the first time and revised his autopsy findings. In an extraordinary decision, Reynolds changed the manner of death in his report to “negligent homicide,” deciding Hua was killed by his struggle with the guards and prone restraint, in combination with his underlying health problems.

Today, Hua’s family and independent experts are raising questions and concerns about how the jail cared for Hua, how the guards restrained him and how his death was investigated.

The family is also haunted by the idea Hua might still be alive if he had been treated with as much care as Curtice, who was hospitalized rather than jailed, wasn’t criminally charged and retained his job as coroner, only to end up in trouble again.

Last month, Yakima police accused Curtice of taking illicit drugs from dead people in the course of his work and lying about it. After failing a polygraph test, he admitted to taking the drugs and snorting them in his office, according to police reports.

Curtice didn’t respond to additional requests for comment last month. Hua’s family is reeling from the news.

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This is a story about life and death in a community at the confluence of two rivers. Where the Naches meets the Yakima amid sunbaked orchards, and only the Yakima tumbles on.

UNDER ARREST

Curtice is riding in the back of a Sheriff’s Office vehicle, under arrest. He’s still yelling.

First elected in 2018, it’s his job to investigate suspicious, untimely and violent deaths.

The 55-year-old coroner coordinates with police, liaises with relatives and directs pathologists to perform autopsies. Unlike medical examiners, who are appointed based on their medical expertise, coroners don’t need to be doctors. Curtice previously served as an emergency medical technician and paramedic.

On this night in March 2023, the deputies take him to Yakima Memorial Hospital, where he hollers until he’s medically restrained and sedated.

The next day, a mental health responder meets with Curtice, The Yakima Herald-Republic reports. He’s subsequently released and checks into a private rehabilitation center for post-traumatic stress disorder.

The kicked deputy requests Curtice be charged with felony assault, but the county prosecutor declines to pursue the case, saying Curtice was intoxicated and in crisis. Curtice’s wife says he kicked her accidentally.

In an interview with a local TV station, Curtice attributes his PTSD to childhood trauma and first-responder work, saying he used alcohol to cope. He plans to start a support group to help reduce stigma.

People with PTSD are “suffering in their own little prison inside their mind,” he says.

Less than two months after his arrest, in May 2023 Curtice returns to his job.

“I am doing very well,” Curtice tells the Herald-Republic, praising his time at the rehab center. “I did some hard work.”

Hua is riding in the back of a police vehicle, under arrest. He’s talking to himself.

He says retired officers are trying to assassinate him because he was looking for a Triple Whopper at Burger King.

This is unusual behavior for Hua, 41, who’s managed his mental illness for almost 20 years with medications and his mother’s vigilant care.

Although he was born in Vietnam and grew up partly in Seattle, Yakima is his home. This Central Washington city is where he spent his teenage years, working in his aunt and uncle’s restaurant. It’s where he returned with a business degree from the University of Washington and an accounting degree from Central Washington University, hoping to launch a career.

That hope was derailed in 2005, when police said he fought them during a traffic stop. His eye socket was broken and he was detained in a psychiatric hospital, where a doctor described him as extremely psychotic and delusional upon entry.

Since then, Hua has built a quiet life. He’s visited relatives in Vietnam, worked on computers, become a regular blood donor and adopted a stray cat named Lucky.

But he remains traumatized by the 2005 incident and his symptoms are back with a vengeance, aggravated by the recent death of a cousin. Hua has been shutting himself in his room, chatting with online scammers and skipping his medications.

On this night in November 2023, the city jail won’t admit him, due to mental health concerns. He’s booked into the county jail for misdemeanor domestic violence assault.

Tim Hall, an attorney whose firm was representing Hua when he died, sees injustice in how Curtice and Hua were each detained.

Hua’s mother hoped the police would take her son to the hospital. The officers said no.

In contrast, the deputies who arrested Curtice knew him and made coaxing remarks such as, “This isn’t like you, buddy,” before taking him to the hospital, according to body-camera recordings. Curtice was a white elected official tied to law enforcement, noted Hall, who’s working with Hua’s family on a lawsuit.

“They could have done [with Hua] what they did with the coroner,” Hall said.

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Experts say the arrests highlight how people in crisis may be treated differently and say it could have helped for the police to take Hua somewhere other than jail. Yet across the country, jails have become “the default placement” for people in mental crisis, said Craig Haney, a University of California, Santa Cruz, psychology professor.

“In worst-case scenarios, that can have fatal consequences,” because mentally ill people “oftentimes react badly to the oppressive nature” of jail environments, Haney said.

Yakima police have several mental health responders who can accompany officers on calls, Lt. Chad Stephens said. It’s up to the officers to decide when to deploy those specialists and where to take suspects.

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Although Washington has a system whereby people can be detained in medical settings on psychiatric grounds, there’s a high legal bar and beds are scarce.

“It’d be really hard for me to speculate” about Hua’s arrest in particular, Stephens said.

Yakima desperately needs more resources for people in mental crisis, Stephens said. Hua visited the hospital the day before his arrest but left without treatment, a record shows.

“One of the problems in this community is we are down to one hospital for a city of 100,000 people,” Stephens said.

IN JAIL

Hua is sitting by himself in the county jail, barefoot in a blue jumpsuit. It’s the day after Thanksgiving.

Some other men in his bunk room have pushed an emergency button because they want Hua moved. He’s been keeping them up at night talking to himself and acting odd during the day. They’re worried someone is going to beat him up, they say.

When he was booked, Hua refused to speak with a mental health screener, had an altercation with guards, told the jail he was taking psychiatric medications and exhibited signs of paranoia, according to jail and medical records, leading a nurse to refer him for mental health services.

Still, jail staff classified Hua for general population placement and categorized his mental health referral as “routine,” records show, giving staff up to five business days to respond. They’re nearing that deadline and Hua has been refusing his medications, including those meant to treat his bipolar disorder and psychosis.

Yakima County’s dark, dilapidated jail boasts a more robust approach to mental health care than some others. But Hua’s death shows how a person can slip past those protections.

The jail signed an agreement in 2018 with Disability Rights Washington to improve conditions for people with mental illness. The legal and advocacy nonprofit had alleged constitutional violations, arguing the jail was failing to provide incarcerated people with proper screening, care and housing.

The plan said the jail would staff mental health professionals and create specialized units for people with mental illnesses. It also said the jail would train guards on how to avoid the use of restraints.

In a recent interview, jail Chief Bill Splawn expressed pride about Yakima County’s accomplishments. The jail maintains 24/7 mental health services and specialized units. Guards receive half-hour trainings on policies like suicide prevention, de-escalation and cognitive disabilities once a year, added Whitney Gregory, the jail’s mental health manager.

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“I think we’re pretty far ahead” of other jails, Splawn said.

And yet, Hua could have benefited from receiving services quicker, said several independent experts. “To me,” Hua’s behavior would “warrant a mental health contact sooner rather than later,” said Kathy Lanthorn-Cárdenas, a longtime Yakima mental health evaluator who’s worked in the jail.

Although the jail tracks mental illnesses, individual guards like those called to move Hua don’t necessarily know which people in general population units may be ill or what their diagnoses are, Gregory said.

IN CONFLICT

Multiple guards are entering Hua’s unit, asking him to leave.

Instead, he stands up and backs away. One guard approaches Hua and points at the door. Next, the guard advances, shaking a bottle of pepper spray and telling Hua to exit or turn around to be cuffed. Less than a minute into the interaction, with Hua still backing away and his hands in his armpits, the guard sprays Hua in the face.

Hua wipes his eyes with a rag. Running away as the guard sprays again, Hua trips over a table and falls. Getting up, he holds his hands out from his body for a split-second in a defensive posture and then continues wiping his face.

The guards grab his arms, and Hua tries to hit one of them with the rag. They take him down. It’s all captured on video.

The incident illustrates the hazardous nature of incarceration for people like Hua.

In the jail’s internal investigation, the guards said they didn’t know what was going on with Hua, though his odd behavior made some think he was on drugs. Guards said they had to quickly remove Hua from his bunk room for his own safety.

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The officer who pepper-sprayed Hua said jailed people who reject handcuffs are usually preparing to fight. Hua got up in a “bladed stance … commonly used in sports and martial arts as an attack position,” the jail’s investigation said.

In certain situations, the jail’s guards are supposed to consider seeking help from mental health or medical staffers. But this was an emergency, the investigation found, determining they used reasonable force as Hua became combative and committed no policy violations.

A number of experts who watched the jail videos questioned those findings.

While the guard who sprayed Hua said he hoped to gain compliance, his action had the opposite effect, said Lanthorn-Cárdenas, the mental health evaluator.

“To pepper spray someone who’s already agitated, off meds, difficult and uncooperative doesn’t really make any sense from a mental health perspective,” Lanthorn-Cárdenas said.

Cliff Akiyama, a Pennsylvania mental health professional who previously worked in law enforcement, said people with acute mental illness can’t always respond to commands like others. Last month, a national think tank for police chiefs advised officers to view people in crisis as medical patients, rather than as willfully noncompliant.

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Hua, who was 5-foot-6, looked scared and posed no obvious, urgent threat, said Akiyama, a fellow of the American Academy of Forensic Sciences. Linking Hua’s posture to “martial arts” suggests possible racial prejudice, he added.

“I have witnessed trained behavioral health workers de-escalate and restrain people who have been much more violent,” said Anna Nepomuceno, policy director for the National Alliance on Mental Illness — Washington.

Some of the other incarcerated men said Hua was gasping for air and screaming for help.

HELD DOWN

Hua is lying on the floor of the jail.

A half-dozen guards have been grappling with him for about 10 minutes, first on the floor of his bunk room and then en route to a different part of the jail.

The “state chains” the guards would have normally used to connect Hua’s wrist and ankle cuffs were missing from a cabinet, so they used a second pair of ankle cuffs for that, according to the jail’s investigation. Then they carried Hua out, holding him horizontally in the air, videos show.

The improvised restraints gave Hua a greater range of motion than state chains, according to the jail, and he continued to struggle in a hallway, clinging with his feet to one guard’s leg and grinding his ankle chains, a video shows. The guards responded by delivering fist and knee strikes to his legs and chest. 

A nurse watched with alarm and cried out for them to stop, she later said. The guards set Hua down on his stomach and held him, with one kneeling on his legs, the nurse and guard said. He was spitting, the guards said, so they placed a hood on his face.

Now the guards have noticed Hua is no longer moving or breathing, according to the jail’s investigation. They remove his hood and turn him over. The nurse starts CPR.

Soon, Hua is dead.

The jail’s custody manual says “restrained inmates shall not be placed facedown or in a position that inhibits breathing.” But witness accounts indicate the guards did just that in handling Hua.

Ideally, they would have moved Hua in a “WRAP” restraint device that keeps a person sitting upright, the jail’s internal investigation found. The device assigned to Hua’s area was being used for training, so it wasn’t available.

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The investigation didn’t address the jail’s prohibition on facedown restraint, and the investigator didn’t ask nurse Kathleen Silverstein about it, she told The Times. Instead, the investigator told Silverstein, “These are really good guards we have here,” the nurse recalled.

The union for the guards didn’t respond to a request for comment. In an internal email, the jail’s investigator described Hua’s death as traumatic for several staffers.

Hua likely died from the struggle and prone restraint, or they at least contributed to his death, agreed seven experts, including two who’ve specifically researched such deaths. When a person held on their chest during a struggle can’t breathe in enough oxygen or out enough carbon dioxide, their heart may stop pumping, said Victor Weedn, a former Maryland chief medical examiner, and Alon Steinberg, cardiology chief at a California hospital.

“It seems highly likely that Mr. Hua wouldn’t have died but for the prone restraint in the hallway,” said Eric Jaeger, an emergency medical services educator and paramedic from New Hampshire who speaks nationally on in-custody deaths.

Experts have debated the lethality of prone restraint in court cases over police killings, like that of George Floyd in Minneapolis. But federal authorities have long cautioned law enforcement about the practice, warning officers to place people on their sides or upright as soon as they’re cuffed.

In an investigation by The Associated Press and partners earlier this year that documented more than 1,000 in-custody deaths involving uses of force not intended to kill, most involved prone restraint.

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A telltale sign of prone-restraint cardiac arrest, Weedn and Steinberg said, is a defibrillator initially advising “no shock.” That’s what happened with Hua, according to medical records and videos.

DEAD AND GONE

Curtice is watching Reynolds conduct Hua’s autopsy.

Reynolds retired in 2021 but has returned to help cope with a shortage of forensic pathologists. He initially tells Curtice that he’s labeling Hua’s death an accident.

Three days later, after looking at samples of Hua’s organs under a microscope, he sees serious disease in Hua’s enlarged heart, plus fluid and inflammation in Hua’s lungs. That implies Hua’s heart began failing “at least hours prior,” Reynolds writes in a report, recording the manner of death as natural.

Curtice tells news reporters that Hua died during a “minor confrontation.” He writes his own report based on the autopsy, recording the cause of death as cardiac arrhythmia and atherosclerotic cardiovascular disease, with diabetes and hypertension and contributing conditions.

Curtice puts “natural” on Hua’s death certificate and calls Hua’s sister, Jennifer Hua, in Seattle. She remembers Curtice attributing Hua’s death to a bad heart, saying he could have died “just walking up the stairs,” and she recalls Curtice suggesting she get her heart checked.

A number of entities looked into Hua’s death, including police. Still, experts say the case points to inadequate oversight, especially in jurisdictions without multiple pathologists to watchdog each other.

A half-dozen experts interviewed by The Times said Reynolds and Curtice shouldn’t have overlooked Hua’s struggle with the guards as a potential contributing factor in his death.

“From what I saw” in videos, “it was clearly a homicide,” said J.C. Upshaw Downs, a former chief medical examiner for Alabama, among other jurisdictions.

“This case exemplifies poor practices in death investigation,” said Michael Freeman, an Oregon-based professor of forensic medicine and legal expert on in-custody deaths.

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Furthermore, their death reports bolstered subsequent investigations that held the jail blameless, said Nicole Jackson, director of autopsy and after-death services at UW Medicine in Seattle.

The jail’s investigation cited the Reynolds-Curtice reports, concluding Hua’s heart “was already in dysrhythmia” before the guards arrived. A police investigation also cited the reports. So did a county committee convened to review the case, as required by a 2021 state law covering jail deaths.

The review committee, which consisted of leaders from the jail and its contractors, decided the overall handling of the incident was unfortunate but “professional and appropriate.”

A homicide determination usually makes people “pause and reflect,” whereas a natural death is easier to dismiss, Jackson said, noting the county’s committee included no independent death investigation experts.

When The Times questioned Reynolds about Hua’s death, he said he’d mistakenly relied on the jail’s description of the incident as a brief struggle. After watching the videos, he changed his mind.

That Hua was able to wrestle for 10 minutes means, “his demise, without struggle, was not imminent,” even with his underlying heart disease, Reynolds wrote in a July addendum to his report.

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It took a long time for officers to notice Hua’s medical distress, Reynolds wrote in changing the manner of death to negligent homicide. Using force against someone acting irrationally “is always risky” and best avoided, Reynolds also wrote. The medical-legal “homicide” classification doesn’t necessarily imply criminality.

It’s a best practice to review any relevant videos when certifying an in-custody death, Jackson said. The ultimate responsibility lies with the coroner or chief medical examiner, she said.

“When I first referred to this as a ‘natural death,’ anyone who viewed that video knew I was wrong,” Reynolds added in an email to The Times. “But nobody called to inquire. They were now ‘off the hook’ and that’s the way they wanted it.”

NOT FORGOTTEN

This summer, Hua’s mother is gazing at a photo of her son on an altar in their apartment.

During his healthy periods, he was gentle and kind, Loan Duong says. Duong lost one baby in a refugee camp and a second baby after settling in Yakima. Now a third child has died and she feels implicated, because she let the police take him away.

“When I lost my son, I never be happy for anything,” she says.

Duong sometimes thinks about killing herself so she can “see my son on the other side,” she says. As a Buddhist, she’s relying on prayer to keep her strong.

Disability Rights agreed to terminate its 2018 consent decree with Yakima County about three weeks before Hua died, citing improvements for people with mental illness.

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By June 2023, the jail had reduced solitary confinement by more than 90% and ensured that 99% of incarcerated people who needed mental health care were seen by providers within agreed timelines.

Although consent decrees can make incarceration safer, jails are “punitive spaces that are inherently dangerous for people with mental health needs,” an attorney for Disability Rights said when asked about Hua’s death.

Washington’s jail death rate was fourth worst in the country in 2019, the latest year with federal data available. At least 50 people have died unexpectedly in the state’s jails since 2022, including five in the Yakima jail.

That’s why Disability Rights supported a bill in the Legislature this year to establish an independent office to monitor jail conditions and practices.

The bill also would have required jail-death review committees to include a representative appointed by the new office. Opposed by police chiefs and sheriffs, it failed to advance.

Hua’s mother doesn’t want to know all the details about how her son died. She doesn’t think she can handle that.

But Hua’s cousin, Celyna Ly, has watched the videos. She wants the truth to come out, she says, so her cousin can rest in peace.

“They should have waited for backup. They should have waited for professionals to talk to him,” Ly says. “It could have gone differently.

That thought haunts the family. It haunts the guards, who watched Hua slip away. It haunts Silverstein, the nurse who tried to resuscitate Hua. It may haunt Curtice, too.

In this community at the confluence of two rivers, where only the Yakima tumbles on.

“I’ve watched a lot of people die,” Silverstein says. “But I will never forget this guy because it just never felt right to me. It felt like a senseless death.”

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Staff reporter Sydney Brownstone and news researcher Miyoko Wolf contributed.

Where to find help

If you are experiencing suicidal thoughts or have concerns about someone else who may be, call the 988 Suicide & Crisis Lifeline at 988. You will be routed to a local crisis center where professionals can talk you through a risk assessment and provide resources in your community.

This coverage is partially underwritten by Microsoft Philanthropies. The Seattle Times maintains editorial control over this and all its coverage.

Daniel Beekman: 206-464-2164 or dbeekman@seattletimes.com; Seattle Times staff reporter Daniel Beekman covers politics and communities.

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