ECT at Cypress Creek Hospital, Houston, Texas

In a recent post about the use of electroconvulsive therapy (ECT) in Texas, United States, I mentioned the fact that Cypress Creek Hospital in Houston is the heaviest user of ECT in the state. In 2016, for example, Cypress Creek was responsible for nearly one-fifth of all treatments given in Texas, although they are just one of 22 hospitals using ECT. And they were responsible for nearly one-third of all reports in Texas for ECT given to people under the age of 25 years.

In spite of the fact that they use so much ECT, there seem to be no psychiatrists at the hospital with a particular academic interest in ECT. I have never come across a published article where one of the authors is affiliated to Cypress Creek Hospital. On their website the hospital has only a brief  section on ECT, which contains several misleading statements. It talks about a “small amount of electrical current” although in fact ECT involves a current of about 800 milliamps flowing for, usually, several seconds – a very powerful electric shock which would knock you out immediately if the anaesthetic hadn’t done it already. “It is often safer than no treatment at all” we are told. What does that mean? It may be an “appropriate treatment option” for patients who are 18 years of age or older, the hospital says, although, in 2016, they submitted 9 reports of ECT use on people aged under 18 years (out of a total 15 for the whole of Texas).

In Texas, psychiatrists are supposed to report any deaths that occur within two weeks of ECT. In the March-May quarter 2006, Cypress Creek reported one death occurring within two weeks of treatment. That, presumably, was the death of 22 year old Jayme Rachelle Cox, whose mother later sued the hospital. The case is reported on the FindLaw website:

“On April 26, 2007 [sic], Jayme Cox voluntarily admitted herself to Cypress Creek. She had been diagnosed with bipolar disorder, post-traumatic stress disorder, and attention deficit hyperactivity disorder, and she was determined to be a suicide risk. At the time of her admission, Cox’s medications included Effexor XR, Eskalith, Adderall, Campral, Zyprexa, Provera, Topamax, and Xanax. After admission, her medications were changed slightly and Ambien CR was added to her regimen. Cox was also treated with electroconvulsive therapy (“ECT”). During her admission, Cox injured her left knee and, on May 2, she was prescribed hydrocodone for the pain. On May 3, she was also prescribed Oxycontin for one night, in addition to her routine medications.”

Jayme Cox died the following morning. “An autopsy was later performed, and the toxicology results showed that Cox died as a result of Zyprexa toxicity.”

The case brought against Cypress Creek Hospital by Jayme’s mother was thrown out  of court because the author of her expert-report was not a physician. It is not clear exactly why a report by someone who wasn’t a physician was submitted, but I am left wondering if she could not find a physician who would write a report critical of Jayme’s treatment. Is the amount of drugs Jayme was prescribed, with, in addition, ECT,  considered normal or acceptable practice in the United States?