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CQC Reports / Document

In the Matter of Ramon Luz - A Patient at Rockland Psychiatric Center

Date:

July 1988

Category:

Description

This case revealed a failure of psychiatric treatment and of supervision in the clinical care of a voluntary patient at a state psychiatric center who was subjected to polypharmacy despite his objections. The death was due to drug intoxication from multiple drug interactions, and facility supervision of his psychiatrist was faulted for failure to detect and address the physician's lack of attempts to determine the cause of his symptoms or to review and modify his treatment plan.