Inclusion Daily Express -- Coroner: Krystyniak Died From Restraint, Not Drugs (Sept. 7, 2004)

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Coroner: Krystyniak Died From Restraint, Not Drugs
By Dave Reynolds, Inclusion Daily Express
September 7, 2004

PITTSBURGH, PENNSYLVANIA--Paul Krystyniak died on December 10, 2002 at Allegheny Valley School, an institution housing people with mental retardation in Coraopolis, a few miles northwest of Pittsburgh.

The 41-year-old man with Down syndrome and intermittent explosive disorder died while being restrained on the floor by staff who were trying to control him after an outburst during dinner.

Last Wednesday, Allegheny County Coroner Cyril H. Wecht ruled Krystyniak's death an accident, and cleared the facility of any wrongdoing or negligence in the case.

The initial autopsy revealed that Krystyniak died of positional asphyxia -- that the way he was restrained caused him to suffocate. It also showed that he had mitral valve prolapse, a condition in which the blood vessels leading to his heart were smaller than they needed to be.

Doubt was raised, however, by Chief Deputy Coroner Joseph Dominic when large amounts of the antidepressant Fluvoxamine, an SSRI (selective serotonin reuptake inhibitor) in the same family of drugs as Zoloft and Prozac, was found in Krystyniak's blood.

Recent analysis of those toxicology tests revealed that he was not overdosed. Fluvoxamine, Wecht said, is a drug that gathers in the person's heart, and then disperses into the blood stream when the person dies, distorting the results of the toxicology tests.

Wecht said the restraint was "medically necessary" to keep Krystyniak from assaulting other residents at the facility.

Krystyniak had been a resident of Allegheny Valley School for about a month before his death.

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