Months after a suicide, a forthcoming lawsuit against CHOMP alleges negligence.

The wife of former Salinas Valley Memorial Hospital chief executive Sam Downing filed a claim against Monterey County, alleging that negligence on the part of Community Hospital of the Monterey Peninsula staff led to her husband’s suicide last March.

The county rejected Paula Downing’s claim a day after it was filed on Sept. 17 because it was lodged against the wrong entity – the hospital is not a county facility. But Downing’s statement of facts with the filing lays out the sad details of Sam Downing’s final days leading up to his death on March 22.

Paula Downing took her 73-year-old husband to CHOMP’s emergency department on March 19 believing he might be having a stroke. In the claim, she writes: “He was ‘delusional, paranoid, suffering from anxiety and what I called ‘crazy talking.’” After testing, though, medical staff determined Downing was experiencing “serotonin syndrome,” a condition that can occur when too much of the chemical serotonin, which helps regulates mood and social behavior, accumulates in the body. Hospitalist Mikko Helenius M.D., said the syndrome was caused by a combination of two drugs – tramadol, a narcotic painkiller, and citalopram, an antidepressant – that Sam Downing had taken, and admitted him to the hospital.

Two days later, on March 21, Sam Downing woke up agitated, removed his IV and took off his hospital gown, saying he was going home. A therapist gave him a cognitive test, which he failed; when Helenius came in, Paula Downing told him her husband was still “crazy talking, but not as bad.” The doctor told her he would be fine as soon as the drugs worked their way out of his system, according to the claim.

CHOMP released Downing that day.

“The doctor never informed me that Sam needed to be watched closely because there was a possibility of him hurting himself,” she writes. “Also, they never had a psychiatrist examine him. I do not believe they should have released him until he had returned to normal.”

A day later, Paula Downing writes, her husband was somewhat better but upset he had failed his prior cognitive test. She tried to explain that it was temporary. He told her he was going to take the garbage out, and left the house.

When he hadn’t returned 15 minutes later, she began looking for him. She found him lying on the garage floor; he had shot himself with a handgun.

CHOMP spokeswoman Brenda Moore says the hospital doesn’t discuss specific patients, but described the hospital’s discharge procedure.

“When we discharge a patient, it comes after a careful review by those who provided the care. We give after-care instructions to the patient and their family members or caregivers,” she writes by email. “We also ask patients if they would like us to share information about the visit with their regular doctor or doctors for follow-up.”

Paula Downing says she’s in the process of hiring an attorney for the next step, filing a lawsuit. In a brief phone interview, she says she’s interested in one thing: “I just hope we can get the hospital to change their procedures.”

Downing’s career at SVMH spanned nearly 40 years, through the hospital’s biggest years of growth. He took over as CEO in 1985 and stepped down in 2011. When he left, Downing received a controversial $3.9 million supplemental package on top of his pension.