Joy Waguespack was receiving treatment at a Baton Rouge psychiatric hospital when she was found unresponsive in her room and later died from the effects of ketamine — a sedative most often used in medical settings for administering anesthesia. Officials don't know how she obtained and ingested the drug that killed her.
Waguespack, 43, was transported to the emergency room from Seaside Health System after a nurse there called 911 on May 27, according to coroner's records and interviews. Doctors tried to save her but she was ultimately pronounced dead June 1.
The ketamine caused her brain to become deprived of oxygen, which in turn caused her death, according to the East Baton Rouge Coroner's Office. A toxicology analysis also showed marijuana in her system.
Waguespack had been admitted to Seaside just three days before she was found unresponsive. Relatives said she was sent to the facility immediately upon her release from jail and involuntarily committed for mental health treatment — a familiar experience for the woman, who had spent decades bouncing from one treatment center or group home to another, struggling to find some stability within Louisiana's notoriously underfunded mental health system.
Now her family is questioning where the drugs came from.
If authorities determine that a Seaside staff member administered or provided the ketamine, they want that person held accountable. Seaside is an inpatient facility, so patients can receive visitors but cannot come and go as they please. Family members said they don't believe Joy received any visitors during her short stay.
"What if we never know what happened to her?" her mother, Carol Waguespack, said in an interview last week. "I thought she was in the safest place in the world: a hospital. The next thing we know, she's unresponsive."
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Shane Evans, chief of investigations for the coroner's office, said those who investigated her death were not able to determine the source of the ketamine despite their best efforts. He said they interviewed all medical providers who had contact with the woman in the days leading up to her death — including doctors at Seaside, EMS officials and emergency room personnel — and all reported that they had not given her ketamine.
"At this point, we do not know the source," Evans said. "We really worked hard to eliminate any legitimate therapeutic avenues of ketamine being administered."
He said representatives at Seaside told investigators they don't even keep that drug in their medicine cabinet.
Ketamine is most often used for anesthesia in both humans and animals, but at times it is used recreationally for its hallucinogenic properties and recently received FDA approval for treating major depression. It's usually injected, but also comes in a nasal spray and can be laced into tobacco or marijuana and smoked.
Coroner's reports indicate Waguespack had likely ingested THC, the chemical compound in marijuana, at most a few days before she was found unresponsive.
Evans said patients receiving ketamine should always be closely monitored because the drug can slow the person's breathing enough to deprive their brain of oxygen, which is what happened in this case.
The coroner's office turned over the results of their investigation to law enforcement.
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A spokesman with the Baton Rouge Police Department confirmed that detectives looked into the case after receiving information from the coroner but found no evidence of foul play and no evidence that the facility was at fault, so they didn't open a formal investigation. But officials said an investigation could be opened in the future if additional information surfaces.
A spokesman for Seaside declined to comment or even confirm the death, citing medical privacy laws.
By the time Waguespack ended up at Seaside in May, she had already been hospitalized for psychiatric care almost 100 times throughout her life, but had never struggled with substance abuse or been known to experiment with illicit drugs, her family told The Advocate last week.
Joy grew up in the New Orleans area and lived there most of her life. Carol Waguespack said she and her husband adopted Joy when she was 4 because they had two boys but wanted a girl.
Signs of Joy's mental illness didn't surface until she was about 14, and before that she was a happy, outgoing child who loved school, her mom said. She was later diagnosed with a severe case of a bipolar disorder, which caused her to cycle between periods of mania and depression.
During her most stable times, Joy showered her family with affection. She loved to sing and dance, dressed herself in sparkly outfits and dreamed of earning her GED. Relatives said Joy realized she couldn't have children of her own but often imagined a world in which her mental illness didn't dictate her actions.
Carol Waguespack said receiving Joy's diagnosis was the worst day of her life because doctors told her the illness would likely get worse with time, not better. She said her daughter's condition deteriorated during the last few years of her life, leading to more frequent hospitalizations and shorter stays at group homes in between.
Joy spent those years in the Baton Rouge area, in part because she had been banned from most of the group homes in and around New Orleans. She struggled to get along with other residents and couldn't live with her parents because her behavior had become too unmanageable.
But Joy's family said she had never been arrested, despite dozens of interactions with law enforcement, until officers with the Baton Rouge Police Department booked her into jail in April on one count of battery of a police officer.
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It appears Joy had called the police herself, telling officers she couldn't sleep the night before because she found bedbugs at the group home where she was living, according to the police report. The officer wrote that she threatened him and then tried to grab his stun gun. The cop forced her to the ground to prevent her from kicking him, and she started bleeding from her nose and mouth.
Joy was booked into East Baton Rouge Parish Prison and stayed there for several weeks before being admitted to Seaside, which wasn't her first time at that facility. Carol Waguespack said she spoke with her daughter not long after Joy's arrival: "The first thing she said was, 'Mom, I'm sorry for shaming our name by going to jail.' She was so calm. Her medication was working. She sounded so good."
But when her mom called back the next day, she was told Joy was sleeping and couldn't come to the phone. She received the same message the day after that. Then she was told her daughter had been found unresponsive and rushed to the emergency room.
Carol Waguespack said most of all the family wants answers. But they also want to share Joy's story in hopes of highlighting shortfalls in the state's mental health system.
Relatives said they tried over and over again to get her into a long-term care facility, but kept coming up against the state's chronic shortage of beds. That left her without a stable living situation — a common problem facing people with mental illness in Louisiana who often find themselves with nowhere to turn.
"A million times I was on my knees praying that she would get better. My worst fear was that she would end up homeless," Carol Waguespack said. "She called me every day of her life — sometimes 20 times a day. … I used to get aggravated, but now I miss those calls so much. I just sit here waiting for the phone to ring."
Editor's note: This story has been updated to note the recent FDA approval of ketamine to treat major depression.