Nathan Dean Thurman

Richard Gwin/Journal-World Photo Lawrence Police investigate a man's boney found on K-10 highway at 1600 rd. on the north side of the road in the west bound lane around 8:00 am Wednesday July 9, 2014. The body was reported by a diver around 6:00 am.

After nearly a month of receiving help for mental illness, Nathan Dean Thurman, 37, died along the side of Kansas Highway 10 this summer of a lethal dose of prescription antipsychotic medication he’d been prescribed at Osawatomie State Hospital, according to an autopsy report.

Thurman’s body was discovered around 5:45 a.m. July 9 on the westbound side of K-10 near the intersection of East 1600 Road, Lawrence police said. There were no signs of foul play, according to police.

Thurman, whose autopsy report took more than four months, had voluntarily admitted himself to the state hospital about a month before his death for mood disorder, antisocial personality disorder and cocaine and alcohol abuse treatment.

There, a doctor prescribed several medications, including 60 300-milligram tablets of Quetiapine, an atypical antipsychotic drug that ultimately caused his death soon after his July 1 discharge, according to the report.

Lawrence’s Bert Nash Community Mental Health Center Medical Director Dr. Takeshi Yoshida said Quetiapine is used to treat serious mental illnesses like schizophrenia, psychosis or mood disorders and produces a sedating effect, though it is not classified as a sedative.

Providing proper medical care while also trying to prevent abuse is an obstacle health care officials deal with every day, said Angela de Rocha, spokeswoman for the Kansas Department for Aging and Disability Services, which oversees Osawatomie. Thurman’s case is one of many she has heard about involving mentally ill patients who succumb to the risks their care providers fear.

“It’s very sad. You have to balance the care, plus the potential for abuse,” de Rocha said.

Police found Thurman’s Quetiapine bottle empty inside a bag he was wearing the day he died. The bottle indicated the prescription, which was supposed to have lasted him a month, had been filled five days before he died, the report said.

Lab results showed Thurman had 9.7 micrograms per milliliter of Quetiapine in his blood — an amount Douglas County Coroner Erik Mitchell described as a “toxic concentration.” Thurman tested negative for commonly abused substances such as alcohol, amphetamines, marijuana and opiates.

Though prescribing potent medication to mental health sufferers is a “constant worry,” de Rocha said, there is little that state hospitals can do to ensure proper disbursement of medication once a patient is released.

“We can’t follow every discharged patient around,” de Rocha said. “There’s no way to force someone to take their medications properly. We have civil liberties in this country.”

To aid in the transition from a hospital setting where professionals dispense medication, de Rocha said, Osawatomie creates discharge plans, which include direction on how to take their medications and a list of local community health care centers for continuing treatment, de Rocha said.

Bert Nash staff told police Thurman had his initial follow-up care appointment July 7, just two days before his death, the autopsy report said.

Though the autopsy results show how Thurman died, Yoshida said it’s hard to speculate why the man consumed so much of the mood disorder drug. The report did not say that Thurman had intentionally killed himself, only that he died of Quetiapine intoxication.

Yoshida said that when working with an individual like Thurman who is new to the center, an additional danger arises. If Thurman had a long-term relationship with a case manager, Yoshida said, things might have been different.

“We’re already handicapped because we didn’t know him that well. We assume a person is telling you what’s going on with them,” Yoshida said.

Yoshida said that it is difficult to anticipate what a person is likely to do if in need of immediate symptom relief, Yoshida said.

“Erratic behavior is hard to predict,” Yoshida said. “A person may lack impulse control.”

But with Quetiapine, Yoshida said he doubted a patient would take more than prescribed for faster relief because the drug works quickly and induces sleep.

“This medicine reaches the blood and gets to the brain quickly, compared to other atypical antipsychotics,” Yoshida said.

Yoshida said that if Bert Nash had been the hospital to prescribe the medication and suspected suicidality, safety measures would have been taken.

“If somebody has the potential to harm (himself), we try giving small amounts of medicine at a time,” Yoshida said.

The night before his death, Thurman left the Lawrence Community Shelter around 9 p.m. and “did not appear agitated” in surveillance video, the report said.

“Residents of the community shelter told investigators the decedent was not depressed or upset, but said it was ‘time to move on,'” Lawrence police detective Zac Thomas wrote in the report.

Community shelter kitchen volunteer Patrick Quinn told the Journal-World last month that before Thurman left, he had been asking residents how to get to Kansas City. Quinn said Thurman’s spontaneous itch to leave Lawrence didn’t seem suspicious.

“He was a footloose guy; it didn’t feel like he was trying to flee,” Quinn said.