By Elaine Silvestrini
Tampa Tribune (Florida)
Copyright 2007 The Tribune Co. Publishes The Tampa Tribune
TAMPA, Fla. — After Martin Lee Anderson fatally collapsed at a Bay County boot camp, officials at the facility started calling other boot camps to ask how they used ammonia capsules, newly released records show.
Officials from at least three different boot camps told the Bay County officials that only medical personnel used the capsules, also known as smelling salts.
The use of the capsules at the Bay County camp became a focus of the criminal investigation that led to manslaughter charges against a nurse and seven drill instructors.
The Hillsborough County medical examiner ruled in May that Anderson, a 14-year-old newly arrived inmate at the boot camp, suffocated when guards covered his mouth and stuffed his nose with ammonia capsules that produced irritating fumes.
Then-Gov. Jeb Bush assigned Hillsborough County State Attorney Mark Ober in February 2006 to investigate Anderson’s death, which created a firestorm that led to the closure of all boot camps in the state.
This week, Ober’s office released more than 20,000 pages of records in the case. Reports show that prosecutors and investigators homed in on the use of the capsules at the camp, questioning medical experts and camp employees about them.
The capsules — once a mainstay in funeral homes that kept them to revive fainting mourners — have fallen out of favor in the emergency medical community, said an expert who has researched the issue. A legal expert said the rarity of their use is likely to become an important factor in the manslaughter case.
Anderson collapsed Jan. 5, 2006, and died the next day.
The day Anderson died, Bay County Sheriff Frank McKeithen called the Pinellas County boot camp, according to a report contained in the newly released documents.
The Pinellas commander, Lt. Kimberly Klein, told investigators that she told the sheriff her camp had no policy regarding ammonia capsules “because that would be a procedure for medical staff only,” the report states.
Officials at boot camps in Martin and Manatee counties had similar responses when contacted by other Bay County camp officials, reports show.
According to records, Bay County drill instructors used the capsules on Anderson three different times for a total of nearly seven minutes, covering his mouth to force him to breathe in the fumes.
Nurse Kristin Schmidt later investigators that she gave instructors at the camp ammonia capsules that were purchased at a drugstore.
Article Finds Fault With Capsules
Generally, use of the capsules dates back decades and is not supported by any scientific research, according to Bryan Bledsoe, professor of emergency medicine at George Washington University.
Bledsoe authored an article published in the Journal of Emergency Medical Services in 2003 that argued the capsules should not be used.
“There’s absolutely no role for those in modern society,” Bledsoe said.
Bledsoe said the capsules have fallen out of favor in medicine but occasionally are used by emergency medical technicians and some doctors as punishment for patients who do not comply with directions.
The ammonia fumes from the capsules displace oxygen and attract water, Bledsoe said, making it difficult for the patient to breathe. Anyone with a medical condition that compromises the ability of the blood to take in oxygen — such as sickle cell trait or asthma — could be particularly vulnerable when the capsules are used, Bledsoe said.
Anderson had sickle cell trait.
The fact that the practice of using the capsules has been discredited and is unusual likely will play a central role in the manslaughter prosecution, according to defense lawyer Patrick Doherty, who is not involved in the Anderson case.
“The more unusual the practice, the more likely it was not legal,” Doherty said. “The reason it’s unusual is there are certain risks involved.”
The guards, Doherty added, “clearly don’t know or don’t appreciate the gravity of what they’re doing. Isn’t that what someone does who steps into a car when they’re drunk or shooting off guns in crowded places? It’s not like you intentionally killed this person. You just did something so unusual and so reckless that it ended a person’s life.”
A Bay County drill instructor who was not charged in Anderson’s death told investigators that the capsules were carried at the camp by those with the rank of corporal or above. The instructor, Cpl. Steven Adamczyk, said he had used the capsules twice.
Typically, he said, a youngster would run a mile and a half and then slow and complain of being tired and unable to breathe. “We’d walk up, grab him and put him in the escort position, give him the opportunity to catch his breath and get going,” Adamczyk said.
“If they feel like, ‘Oh, I’m gonna pass out,’ we’d pop one and run it under their nose. They’d wake up. ‘You feel better now?’ ‘Sir, yes, sir.’ ‘Well, go, finish your run.’ ... You snap one of those under their nose. It’ll fix ‘em.”
Adamczyk began working at the camp in 2002. Asked when the ammonia capsule practice began, he said, “That was in place before I started there. ... I never got formal training on it. I just know, I just went from what I seen other folks using it.”
A Hillsborough County sheriff’s investigator reviewed surveillance videotapes at the camp and found six instances of ammonia capsules used in 2005, according to records. There is no indication in the records whether any medical problems arose as a result of the use of the capsules.
Commander Reviewed Usage
The boot camp commander, Capt. Michael J. Thompson, told investigators he wanted to know why so much ammonia had been used on Anderson. To his knowledge, the capsules usually were held under the nose for four or five seconds.
After the incident with Anderson, Thompson reviewed old intake tapes and saw that other instructors had held their hands over youths’ mouths while administering ammonia to resuscitate them.
Lt. Charles Helms explained to him that “they put the hand over the mouth because the child will breathe through their mouth and not through their nose and not get the effect of the ammonia,” Thompson said. Helms is among the instructors charged with manslaughter.
Ammonia was never approved as a “compliance tool,” Thompson said.
It wasn’t until the incident with Anderson, Thompson said, that he learned ammonia capsules had been distributed to all supervisors at the rank of sergeant and above “for convenience purposes or time issues” — not distributed through the nurse as they had been in the past.
Ammonia was used, as far as he knew, only on “intake day,” because that’s when “you find your kids that were in the least physical condition” and fainting, he said.
On Feb. 6, 2006, Thompson responded in writing to questions from the sheriff. Thompson said the camp had no written policy for the use of the capsules “other than basic first-aid requirements.”
“The technique that Lt. Helms used in this case was of his own decision,” Thompson wrote.
Thompson was not charged in connection with Anderson’s death.