The following people are among 82 who have died since December 2000 under circumstances that raise questions about their care while patients or immediately after discharge from a state mental institution, according to a News & Observer investigation aided by several medical professionals, including Harold Carmel, a psychiatrist and the former clinical director of Umstead Hospital.

The following information is drawn from death certificates and autopsy reports, as well as redacted copies of state death reports and regulatory reports where deficiencies in care were found. The manner of death cited is from the state's death certificate database, but, in some cases, the finding does not match the circumstances of death. Doctors at the hospital where the individual died typically designate the manner and cause of death unless there is a subsequent autopsy.

Investigations are conducted by the state Division of Health Service Regulation, which oversees medical facilities in North Carolina.

CASWELL DEVELOPMENTAL CENTER
Residential facility for patients with developmental disabilities, Kinston
Opened 1914
Annual Budget: $80.6 million
529 patients
1,584 employees


REBECCA ANN LANE, 61
Died: Dec. 27, 2000
Hometown: Address listed as that of center
Manner: Accident
Investigation: Yes, deficiencies cited
Autopsy: Yes
Causes: Pulmonary embolism; bone fractures
Summary: Lane, who was born with cerebral palsy and was in a wheelchair, was one of three patients injured when a Caswell Center van in which she was riding collided head-on with another vehicle. She died less than two weeks later. The hospital employee driving the van was charged with misdemeanor death by vehicle but was later found guilty of the lesser charge of reckless driving. The employee kept her job, however. An investigation determined Lane was not properly secured in her seat at the time of the crash.


AUDREY JUNE GLOVER, 67
Died: March 4, 2003
Hometown: Address listed as center
Manner: Unspecified
Investigation: None indicated
Autopsy: No
Causes: Septicemia; pneumontis due to food and vomit
Summary: Glover, who had Down syndrome, had lived at the center since 1971. The center's report says she did well until Feb. 23, 2003, when she was noted to be lethargic at mealtime. Semiconscious, she was taken to a nearby emergency room with a 104.2 degree fever and abnormally low blood pressure. She was diagnosed with a urinary tract infection that had spread to the blood and triggered shock. She was treated with antibiotics but continued to decline until she died March 4.


JOAN EVETTE GALLOP, 42
Died: July 20, 2003
Hometown: Address listed as center
Manner: Unspecified
Investigation: No
Autopsy: No
Cause: Surgical operation with formation of external stoma
Summary: Blind and mentally retarded, Gallop had lived at the Caswell Center for 34 years. Fed through a tube inserted into her stomach through a small incision in the abdomen, she developed a type of hernia often associated with gastric reflux disease. On June 26, 2003, she was sent to a hospital for surgery to repair the hernia and replace her feeding tube. Returned to Caswell, two days later she began to leak intestinal fluids. She was returned to the hospital but died July 20.


JIMMY LAWRENCE EDWARDS, 65
Died: July 4, 2004
Hometown: Address listed as the center
Manner: Unspecified
Investigation: No
Autopsy: No
Cause: Septicemia; pneumontis due to food and vomit
Summary: Edwards, who was mentally retarded, had lived at Caswell since 1973. On June 28, 2004, he was having difficulty breathing. He was transferred to the center's medical unit and then to a nearby hospital where he died. The cause of death listed suggests he inhaled food or vomit into his lungs, causing a bacterial infection that killed him.


TINA MAE BAKER, 76
Died: Aug. 7, 2004
Hometown: Address listed as center
Manner: Unspecified
Investigation: No
Autopsy: No
Cause: Urinary tract infection; acidosis
Summary: Baker was admitted to the Caswell Center in 1950 from Wake County. On Aug. 4, 2004, she was having difficulty breathing. Transferred to a nearby hospital, she was diagnosed with urosepsis, a bacterial infection that had spread from the urinary tract. She died Aug. 7.


STEPHEN HAROLD JOHNSON, 56
Died: Aug. 9, 2004
Hometown: Address listed as center
Manner: Unspecified
Investigation: No
Autopsy: No
Cause: Septicemia
Summary: Admitted to the Caswell Center in 1954 from Guilford County, Johnson was his "usual smiling self" on Aug, 7, 2004, when a nurse injected his morning medications through his feeding tube. Two hours later, a nurse noticed he "didn't look right." He was transferred to a local emergency room where he underwent emergency surgery for a perforated bowel. By Aug. 9, he was bleeding from his nose and mouth and his abdomen was severely swollen. He died of infection.


MARK DAVID BRINSON, 52
Died: Oct. 10, 2004
Hometown: Address listed as center
Manner: Unspecified
Investigation: No
Autopsy: No
Cause: Intestinal obstruction; septicemia
Summary: A Caswell resident since 1982, Brinson was noted to be pale, cool and clammy on Sept, 29. 2004. He was holding his abdomen. Transferred to a nearby emergency room, emergency exploratory surgery was performed the next day. It was determined Brinson had twisted intestines, which likely indicates long-term and painful constipation. He died Oct. 4.


REGINALD MAURICE HAWKINS, 33
Died: Feb. 2, 2006
Hometown: Address listed as center
Manner: Unspecified
Investigation: No
Autopsy: No
Cause: Renal failure; pneumontis due to food and vomit
Summary: A resident of the Caswell Center since 1986, Hawkins received feedings through a tube inserted into his small intestine. As liquid food flowed in on Feb. 1, 2006, Hawkins began gagging. The feeding was turned off and he vomited. He vomited again about four hours later and the level of oxygen in his blood became depleted. He was transferred to a local emergency room, but died early the next morning.