Nashville Scene, Medical Malpractice NASHVILLE, TN (NASHVILLE SCENE) BY STEVE CAVENDISH – Daniel Cantrell, whose mental breakdown was the subject of a Scene cover story in April, has filed a multi-million dollar malpractice suit against the doctors and nurse practitioner who were treating him. Cantrell stabbed his father to death in April, 2014, during a psychotic episode.

At issue is Cantrell’s transition between anti-psychotic drugs. Michelle Dahl, a nurse practitioner, allegedly switched Cantrell from Geodon to Seroquel without tapering, leaving little or no effective dose of medication in Cantrell’s system. In the middle of this change, Cantrell became increasingly paranoid and eventually came to believe his father was a robot trying to kill him. Dahl was in charge of Cantrell’s care after his psychiatrist, Michael Murphy, left the practice to become national medical director for HCA’s Behavioral Health Services division.

From the story:
This would become a major point of contention in Daniel’s care. Dr. Murphy had been careful to taper his transition from Abilify to Geodon three years earlier, but there is no notation in Daniel’s medical records to taper. In an interview with Daniel’s criminal defense attorney later in the summer of 2014, Dahl would say that she gave the instructions orally.

But the notes of Daniel’s therapist from later in the day on March 31 seem to indicate otherwise, after Daniel called at 7:43 p.m.

“He reports a medicine change from Geodon to Seroquel. I asked if his anxiety might be medicine-related and if Geodon was being tapered off gradually,” Huff wrote. “He said he was instructed to discontinue Geodon completely and begin Seroquel in the evening.”

At 3:28 the next afternoon, April 1, Daniel placed a frantic call to Centennial Psychiatric Associates, trying to talk to someone about his worsening state. The message relayed to Dahl was that “[he] isn’t sure if the Seroquel is making him anxious as this is part of his issue.” Forty-five minutes later, Dahl notes in his file: “25mg didn’t help him sleep. He has stopped Geodon,” a statement that indicates that there was no tapering going on. She increased his Seroquel dosage to a full 50 milligrams and gave him leeway to take up to 1 milligram of Ativan.

By this point, three factors were at work. First, there was no Geodon left in Daniel’s body: The drug has a half-life of about seven hours. Second, the recommended effective dosage of Seroquel by the manufacturer is between 400 and 800 mg per day to treat schizophrenia in adults, so there was very little of any antipsychotic drug in his system. Third, he had hardly slept in 48 hours. He would barely sleep that night.

On April 2, Daniel melted down. He paced around his parents’ house without a shirt. He held his hand in a fist with two fingers outstretched, insisting that they were permanently stuck. Oliver, concerned, did not want to leave his son alone. He decided to take Daniel with him to the new home he was building with Deborah.

If the visit was meant to calm Daniel, it had the tragically opposite effect.
Cantrell’s suit seeks compensatory and punitive damages. At age 31, the economic damages for him could reach into the millions, as he is now committed to Middle Tennessee Mental Health Institute indefinitely and will likely never work as an IT professional again. Punitive damages in Tennessee are capped at $750,000.

“As a result of the Defendants’ recklessness and negligence, Daniel Cantrell — a previously successful, well-respected, high-functioning, and much-loved young husband, son, and professional — has been stripped of his family, his liberty, his career, his reputation, his happiness, and literally every tangible benefit or asset he had worked to that point in his life to acquire. He lives every day with the knowledge that he killed his father and best friend during an entirely avoidable, malpractice-induced psychotic episode. He lives with that knowledge as a lucid, intelligent, and thoughtful young man now confined to the wing of a psychiatric ward and surrounded by scores of truly insane and dangerous individuals,” the suit reads.