Cairus guardianship case extended

Wednesday, March 9, 2016

State, 19-year-old's mother present sides in court

The state of Missouri and the mother of Tyler Cairus spent more than three hours on Feb. 29 presenting their cases in court for who should have guardianship over the 19-year-old with Kleinfleter Syndrome.

Cairus' journey through the court system began on Aug. 20, 2014, when he was charged with attempted statutory sodomy and attempted statutory rape. He was held for nearly three months in the Barry County jail before being sent to Fulton State Hospital to undergo six months of mental evaluations. In June 2015, his charges in Barry County were dropped.

Amy Boxx, Barry County prosecuting attorney, said her office did not drop the charges, Judge Carr Woods did.

"After a preliminary hearing, the judge determined there was insufficient evidence to bind the defendant over to circuit court and dismissed the case," Boxx said.

The end of the case was considered to mean Cairus was coming home, but the state contested the release. Wendy Cairus refused to commit her son, so the state filed 96-hour, then 21-day, then 90-day commitments, feeling it would not be safe to release him.

The reasons for the state's continual holding of Cairus were laid out in the guardianship hearing in Judge Robert Foulke's courtroom.

The state, represented by Assistant Attorney General Ronald Smith, had two main contentions: First, that Cairus has a medical condition that makes it difficult for him to eat certain foods and may require surgery, which Cairus' mother, Wendy Cairus, did not want performed; and second, that Cairus' release may present a danger to the public, or he could be a danger to himself.

Dr. Selbert Chernoff, a 60-year medical practitioner who provides general medical care for patients at Fulton, said Cairus' condition causes the 19-year-old to have a constricted esophagus at times, meaning he cannot eat certain hard food for fear of choking. Chernoff recommended surgery to alleviate the condition, but conceded it is an invasive procedure with possible risks.

The state's second witness was Dr. Colleen Loehr, a psychiatrist at Fulton who has worked with Cairus since June 15, 2015. Loehr and the rest of Cairus' treatment team meet at least once every 30 days, and Loehr meets with Cairus in person at least once per month, but meets with him more when he requests her.

Loehr said Cairus' bipolar and Kleinfelter diagnoses contribute to symptoms of depression, anxiety, aggression, impulse control difficulty, inappropriate sexual behavior, mood swings and self-harming behaviors. It is the combination of the symptoms, along with things Cairus has said he has done in the past, that leads her to contend he could be a danger to himself or the public if released to his mother.

Cairus is on multiple medications related to his diagnoses, some of which Wendy Cairus disagreed with. One of her attorneys in the case, Terry Neff, made the case that the medications have been ineffective, as Loehr said Cairus' behaviors have not gotten consistently better on any of the medications.

Neff also questioned decisions by doctors at Fulton to ignore advice from outside specialists, such as one who recommended testosterone treatments for Cairus' Kleinfelter Syndrome, which is an XXYY chromosome setup that causes a lack of testosterone production. Loehr said Chernoff made the call to not give testosterone in fear of heightening Cairus' sexual behaviors. Neff cited information contending the treatments may have balanced his hormones and lessened the behaviors.

He said the state should have at least tried the treatments, and that it is hypocritical of Fulton doctors to disregard specialists' recommendations, while simultaneously ignoring Wendy Cairus' wishes regarding medications.

Neff also hit the state hard on what he presented as a failure of care. The state believes Cairus would be a danger to himself and others if released, and Neff contends the state is not equipped to keep Cairus safe within its own facility.

Since he has been at Fulton, Cairus has injured himself multiple times, and other patients have assaulted him while in the state's care. The state contended Cairus has said he would harm others if released, and has threatened or attempted to take his own life on occasion.

After Loehr's testimony, the court took lunch recess, and upon return, Judge Foulke held a meeting with counsel, which included Neff and Smith; Duane Cooper, also representing Wendy Cairus; Darlene Parrigon, representing Tyler Cairus' temporary guardian, Pam Modlin; and Sarah Webber, Cairus' guardian ad litem.

After the conference, all parties agreed to extend the case to April, when a pre-trial hearing will be held. During that time, Wendy Cairus may search for another secure, in-patient care facility for her son.

A time and date for the pre-trial will be determined at a later time.

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