Death at West Oaks Hospital

Asked for an assessment of both men, Smith describes Williams as a soft-spoken man with dreadlocks who works the night shift. "Fred's a good person."

He says that Mario spent the short time he was in the West Oaks facility "constantly throwing punches" as he walked around and telling both staff and other patients, "I can kick your ass."

Asked by police if he thought the fight was over before Williams kicked and stomped Mario, Smith says he doesn't know. At the same time, he says he couldn't see any attempt by Mario to start the fight up again.

Mario was rushed to Memorial Hermann Southwest's emergency room, where they were unable to revive him. His death certificate and autopsy report say that he died as a result of "multiple blunt force injuries" and that his death was a homicide.

At death, Mario was 5'11" tall and 143 pounds. The drugs Cyclobenzaprine, Haloperidol and Olanzapine were detected in his system. The pathologist reported multiple rib fractures; laceration of the heart; and injuries to his intestines, back, abdomen, chest, wrist, face, neck, buttocks, shoulders, both forearms and both knees.

Muhammad Aziz, who is representing Chazz in the possible civil case, is in the process of assembling his evidence now. Both he and Wes Tribble, the civil attorney representing West Oaks, say that under Texas law, this would play out as a medical malpractice case.

"If Mr. Williams acted in self-defense, he went a bit far," says attorney Aziz. "There is no doubt that this is a violation of policy, even their policy, whatever it was."
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On the afternoon of June 11, there was a seclusion/restraint order placed on Mario. He was apparently put in a locked room, and emergency medication was dispensed after he refused to follow directions and hit a staff member. He was given another emergency injection after he attacked a patient from behind later in the day.

Dr. Steven Schnee, executive director of the Mental Health and Mental Retardation Authority of Harris County, who is not acquainted with Mario's case, spoke to the Press hypothetically about mental health care procedures. Schnee says seclusion/restraint is part of a commonly used training method called "Prevention and Management of Aggressive Behavior." PMAB, as it is usually referred to, is used by most public mental health facilities in the Houston area in training staff to deal with patients who are going out of control, he says.

"Staff are trained to use verbal interventions to try to talk down an individual, decompress a situation. Try to find a way of calming the individual who might be in a kind of more critical, agitated state," ­Schnee says.

If that doesn't work, then there's a physical intervention process that is supposed to minimize the risk of the patient or staff being injured in the process, ­Schnee says. Depending on how that goes, the treating doctor may be brought in and asked for an order for an emergency injection, Schnee explains.

"Each hospital is expected to have its own policies and procedures," Schnee says. "So what you would look for is: Do they have those, and do they offer their staff training, and was that implemented, and do they have a process for reviewing where there would be multiple instances with the same patient?"

Alex Azzo, the attorney who represented Frederick Williams in his appearance before the grand jury, says, "It's just unfortunate that Mr. Vidaurre died. My client feels horrible about that. He feels horrible that he wasn't able to control Mr. Vidaurre in some way after he, my client, was attacked. He tried the methods that he was taught to use and it just didn't work."

"Does the same thing work with all patients all the time? No, the answer is no," Schnee says. A patient being placed on one-to-one — as Mario was — shows a level of caution, but Schnee says he can't comment on whether that was sufficient because he doesn't know the case.

West Oaks, a private hospital, is accredited with the Joint Commission on Accreditation of Health Care Organizations. All facilities have some training programs, but Schnee says he can only speak about the public ones using the PMAB process.

"Physical intervention, my recollection is that it involves two people, not one, because you're trying to avoid being in a scuffle," Schnee says. "My recollection is that there is a single-person PMAB takedown, but wherever possible you would want to use two people because it's just a safer environment for everybody."
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The image Chazz Vidaurre holds of his brother is at odds with Mario's chaotic end days. Chazz remembers his brother as a beautiful person and a talented jewelry maker, and the younger Mario as someone who liked to fight but always legally, in the ring. "At 17 he was featherweight champion of the Southwest," Chazz says. He refers to him frequently as "a skinny, good-looking guy." He says the doctors and personnel at IntraCare always liked Mario.

But his fond memories don't always hold up under closer scrutiny.