This male nurse faces about seven more years of incarceration for his crimes against an incapacitated San Carlos Apache patient —who was found giving birth to the child of rape before anyone at the healthcare facility even realized she was pregnant.
But the full over-30 year history of the case shows he was far from alone in guilt, if chronologically perhaps the last.
He is, however, the only individual criminally charged, although among those facing civil suits, the person most responsible —a respected physician— appears to have died, perhaps of natural causes.
The case will sound familiar because media reported on it in 2018 and at key moments since. This post compiles reportage from multiple sources in depth, showing innumerable individuals, predominantly men, complicit in viciously treating a Native American child-later-woman as a Medicaid-profitable piece of meat safe for them to exploit and abuse further.
It didn’t happen out of the blue. It happened step by step, across decades.
What’s on the surface at this step is that Nathan Sutherland has been sentenced to 10 years in prison for a possible 6 years of sexual assaults upon a severely disabled woman in the residential care facility where he was her primary caregiver 2012-2018. He received credit for time served, about three years, and after prison will be on lifetime probation and have to register as a sex offender.
The situation
triggered reviews by state agencies, highlighted safety concerns for patients who are severely disabled or incapacitated, and prompted the resignations of Hacienda’s chief executive and one of the victim’s doctors
together with reports of disciplinary actions toward managers and key staff at Hacienda Healthcare — a Phoenix, Arizona private, nonprofit, long-term 60-bed “intermediate” facility with state Medicaid contracts for “clients with intellectual disabilities” (i.e., not for comatose, vegetative patients). This and other issues there are being investigated by the state, to the anger of some families confident these are isolated incidents and their own members there well cared-for and happy.
Even taking into account the vulnerability of this “isolated” victim, and the fact that her newborn was blue as he emerged, requiring “frantic” resuscitation efforts by staff —an infant death is something Arizona is serious about— that sentence was the maximum allowed according to a deal in which Sutherland pleaded guilty in September 2021 —after pleading not guilty 6 months earlier— to sexual assault and vulnerable adult abuse.
<big><big>But testimony and reportage suggest that assaults upon this patient began at Hacienda at least as early as 2002, when she was 13 years old.</big></big>. Public interest was only drawn December 29, 2018 — the by-then 29 year old, bed-ridden on ventilation whose only nourishment had been by a feeding tube, was found groaning in the process of delivery, severely dehydrated and without pain medications, bleeding heavily and the baby partway born when a staffmember happened to to change her clothes.
The patient had been at Hacienda since age 3 —1992— because of seizures starting at two months of age. Initially, and despite assertions of her last doctor there, she seems not to have been in a comatose nor unresponsive/vegetative state, if with a seizure disorder causing severe cognitive disabilities, brain damage, and psychomotor retardation. According to reportage and expert assessment, even though she could not speak, she could make facial gestures, evinced some ability to move limbs such as flailing with her arms when being put on ventilators, could react to sounds, and, in expert opinion, to pain.
Hacienda staff making the 911 call on December 29 said no one had known she was pregnant. Instead, for weeks or months, she had been “treated” for constipation and weight gain, and her caloric intake reduced until she weighed only 125 lbs, pregnancy included.
The infant’s DNA was eventually found to match Sutherland’s through police DNA testing of all male nurses there. In Sutherland’s 6 years there, he reportedly often was her sole caregiver at night, with few other employees present at the facility. According to a biography on a webpage promoting Sutherland’s Christian rap music, he and his sister were Haitian originally, adopted to the US. He had lived in Arizona since 1993, completed certified nursing assistant training in Tempe in 2005 and licensed practical nurse training in Phoenix in 2011, licensed for healthcare beginning in 2008 with no marks against him at the state nursing board. Beyond one traffic ticket, he had a clean police record and had passed Hacienda’s hiring checks without a hitch. Documents from the Arizona Corporation Commission showed he’d tried to start a charitable organization to help with the homeless and developmentally disabled in 2007. He was married with four children; his wife had filed for divorce at some point prior to public attention. In court at the end, he apologized gravely to his victim, saying nothing about his own life should have brought suffering into hers.
<big><big>Does any of this matter about the admitted rapist</big></big> a person of color with a possible physical disability of his own, if noticed by co-workers to show signs of a troubled outlook for months?
It might, because police may NOT even have considered testing all male staff such as the two doctors who ceased working there soon after the news hit.
Yet her Hacienda doctors had been responsible for her “care” since 1992 — pediatrician Philip Gear Jr MD initially until Sept. 13, 2018, when he “treated her for a cyst” (type of cyst not stated but she was about 6 months pregnant at the time) and then “transferred her care to” internist Thanh Nguyen MD. (There’s no reason reported of why her care in particular was transferred, but some articles say it actually occurred the previous spring, coincidentally right around the time she was impregnated.)
"It's hard to imagine a more vulnerable adult than the victim in this case," said Superior Court Judge Margaret LaBianca when she handed down the sentence, according to the Associated Press. Sutherland, 39, who surrendered his nursing license after his arrest, apologized to his victim at the sentencing, saying, "You didn't deserve to be hurt no matter what was going on in my personal life and the demons I was fighting. I had no right to put you through that."
<big><big>Neither Gear and Nguyen were charged for anything in criminal court. Not even criminal negligence</big></big>, even though, after the “fact”, they missed even such obvious signs that the victim was pregnant, as a swollen belly and no menstrual periods in the months before she gave birth.
Surely these doctors, besides site administrative staff, might be presumed to have stood in supervisory role over Sutherland and all prior and parallel nursing staff before “the fact” of impregnation proved rape. HOW ARE THEIR HANDS SO CLEAN IN THIS CASE?
Yet, merely besides themselves, their outside medical practices —Gear’s Just 4 Kids pediatric office, and Internal Medicine Consultants where Nguyen was employed— and their wives were named as defendants in <big>the civil suit</big>, no charges far less indictment or penalty.
In June 2021, Arizona civil court approved a $15 million settlement between the woman's parents ——enrolled members of the San Carlos Apache community, who are raising the baby, a boy who may develop serious health issues, given the many drugs long administered to his mother, and no pre-natal care—— and representatives of Gear, who was found to have rarely performed required monthly physical exams, just occasional superficial ones, and none of the annual mental health assessments. Some of Gear’s students said he didn’t accompany them into patient rooms when he was training them, and the state Medical Board found Gear's records for at least the San Carlos Apache patient "incomplete, inaccurate and, at times, unsigned."
...In declaring the $15 million settlement reasonable, Judge Theodore Campagnolo concluded Gear’s treatment of the woman had fallen below the standard of care by failing to diagnose her pregnancy and regularly examine her.
The judge said requests by the woman’s mother to have only female employees tend to her daughter weren’t followed. Campagnolo also said <big><big>evidence that the incapacitated woman was the victim of numerous sexual assaults was undisputed</big></big> in the civil case….
Nguyen, the later doctor 2018 onward, characterized the patient in terms contradicting most other descriptions, saying she was “vegetative and on ventilation”, adding,
Pregnancy was inconceivable… {sic}
hence the diagnoses and treatment for constipation and weight gain, including removing her feeding tube, effectively imposing malnutrition akin to starvation and dehydration, on top of all else that had been done to the lifelong medical prisoner dependent upon him for her safety.
Nevertheless, if by a narrow vote, the state Medical Board cleared him to return to practicing, in part because of upgraded medical communication courses he took following the explosion of the case, and his expressions of deep dismay that any absence of recorded detail by him might have contributed to the situation. In summer 2020, he and his medical group settled claims in this case for an undisclosed amount.
<big><big>For Gear’s part, his insurer stated in court papers that it has no obligation to pay the the $15million, saying the policy covered no claims arising from “a sexual act.”</big></big> Gear meanwhile died December 20, 2020, prior to the settlement agreement. (His father, an east-coast physician and surgeon of high attainment in the field of Obstetrics & Gynecology, died in 2002 … the same year the patient’s family first complained of sexual assault...)
Also sued by the victim’s parents/baby’s grandparents in late 2019 was the state of Arizona. It contracts with “providers” like Hacienda for Medicaid services to people with intellectual/developmental disabilities. The state settled last summer for $7.5 million.
Hacienda, however, was not sued. Before the victim’s family filed their lawsuit, Hacienda Healthcare agreed to settle for an undisclosed amount. Perhaps because of already knowing that the
<big>...victim was believed to have been sexually assaulted, <big>along with four other disabled residents, in 2002,</big></big> according to the lawsuit. After that she was only supposed to be cared for by female staffers or males accompanied by females.
However, unaccompanied men, including Sutherland, were assigned to take care of her without her parents’ knowledge, the suit says….
Sutherland was hired in 2012, ten years after the family’s first complaint of rape. Which may not even have been the first rape she endured (after the baby was born, there were medical findings of longterm extensive vaginal and anal and other bodily damage, including mentioned possibility of past unrecorded pregnancies, artificially or naturally aborted).
Yet male staff continued to be assigned to her care after 2002.
The pattern of negligence and abuse MAY suggest that the victim’s original condition became vegetative due to over twenty years of cumulative impacts of medical negligences, medical abuses, casual neglects, disregarded injuries, and battery in repeated sexual assaults. Upon a helpless Native American female treated as less than human from childhood onward, by the professionals entrusted with and by-their-oaths committed to her care.
<big><big>A 2018 report by NPR found that people with intellectual disabilities are sexually assaulted at a rate seven times that of people without disabilities,
The National Congress of American Indians has found more than half of Native women (56.1 percent) experience sexual assault in their lifetime...</big></big>
This 2019 news report includes a number of photographs portraying members of law enforcement and other officials involved, a video of the 911 call and so on. Some details in this article conflict with those in others and some are in accord, just as there’s some degree of contradiction among other articles as well. We may never have exact precision on the facts, but we can see how this terrible sequence transpired, step by step, year by year.
Her family and the courts have withheld her name from press for her privacy and protection, likewise her location since rescue from HaciendaHealthcare. Whether there is the slightest hope of any recovery for her, from anything she has suffered, seems utterly in doubt. She was born in April 1989; she is now over 32 years of age, nearly all of it in a hell nothing of her making, but only because she is a woman, Native American, disabled, poor — lethally marginalized in America.
Even though there is no name to say, remember her.
And take what actions you can, at whatever times you can, to turn the tide.
