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In January, 63-year-old Paul Bertonazzi was driven to Johns Hopkins Hospital by Baltimore police because, officials said, he was experiencing a <a href="https://www.washingtonpost.com/local/public-safety/dc-mental-health-crisis-response/2021/05/17/2c761706-b746-11eb-96b9-e949d5397de9_story.html" target=_blank>mental health</a> episode and needed help.

Baltimore police took him to the emergency room. Within hours, according to officials,<b> </b>Bertonazzi’s body had gone limp, paralyzed from the neck down.

Now Maryland’s chief medical examiner has ruled Bertonazzi’s death a homicide — and determined he died as a result of “trauma to the body,” law enforcement officials said.

Bertonazzi suffered a cervical spinal cord injury after entering the psychiatric ward with two Johns Hopkins security guards and a charge nurse, according to a lawyer for the man’s family and police body-camera footage reviewed by The Washington Post.

The video footage, which the family obtained through a public records request and shared with The Post, shows hours of footage of Bertonazzi with police and then hospital staff, complaining several times of neck pain and stating he has a bad neck. Amy Orsi, the family’s attorney, told The Post that the man had a condition called spondylosis, which is arthritis of the spine.

But the body-cam footage, as well as surveillance video from inside the hospital, seems to cut off once the security guards and nurse entered the psychiatric ward with Bertonazzi.

The body-cam footage includes an interview with the charge nurse in the hours after Bertonazzi’s injury, in which the nurse told Baltimore police officers there was no violent interaction with the man.

The nurse told police Bertonazzi had been sitting handcuffed in a wheelchair. Staff wanted to remove his handcuffs, but he was not cooperating, the nurse said, so the security guards stood him up then placed him face down on a stretcher pad on the ground.

The nurse said on video that they removed the handcuffs, and then Bertonazzi told them he could not move his arms or legs.

Baltimore Police Department’s Special Investigation Response Team began investigating the incident that day, authorities said in a statement, and homicide detectives are working to determine the “manner in which the victim’s injury occurred.”

Orsi said her office is waiting to receive a copy of the autopsy report from the Office of the Chief Medical Examiner.

“We just don’t know at this point what happened, and that is what we’re trying to find out,” Orsi said. “Certainly we are looking to explore all legal remedies on behalf of the family.”

A Johns Hopkins spokesperson said in a statement that the hospital “cannot discuss any individual patient’s care due to patient privacy laws” but said they “are committed to providing the safest and highest quality of care for all patients.”

“We will cooperate fully with the authorities as they proceed with their investigation,” the statement said.

At 5:44 p.m. on Jan. 7, officers were called to a Burger King on Orleans Street — just a few blocks away from Hopkins — where Bertonazzi appeared to be experiencing a “behavioral crisis,” Baltimore police said. Officers said they found the man threatening to harm himself and others.

Medics tried to treat Bertonazzi, police said, but he was “combative” and refused care. Officers trained in crisis intervention detained the man, authorities said, and took him to the hospital after more than two hours of negotiating inside the Burger King, outside in the parking lot and inside police vehicles. Video shows him placed in a wagon and an officer sitting in the back with him at the hospital.

The body-cam footage of Bertonazzi’s time in police custody shows the man walking and moving his arms and legs. Once at the hospital, body-cam and surveillance footage shows the man in a hallway sitting in a wheelchair with his hands cuffed behind his back. Again, the man can be seen moving his upper body and legs.

But according to interviews captured on body-cam footage, hospital staff told police that they could not obtain surveillance footage from inside the psychiatric ward — where Bertonazzi became paralyzed — because the cameras in that part of the hospital only play live video and do not record due to medical privacy concerns.

After Bertonazzi told the charge nurse and security guards he could not move, hospital staff said they braced his neck, placed him on a backboard and paged the emergency room attending physician.

From there, Bertonazzi was intubated and spent five days in the hospital before he died of his injuries Jan. 12, authorities and the family’s lawyer said.

The hospital notified Baltimore police, the department said, who then informed the <a href="https://www.washingtonpost.com/dc-md-va/2023/03/07/maryland-police-deaths-investigation/" target=_blank>Maryland Attorney General Office’s Independent Investigations Division</a> (IID), which oversees all police-involved death cases in the state.

But after IID reviewed footage from the officers’ body-worn cameras, as well as surveillance video, they determined Bertonazzi did not sustain his fatal injuries while in police custody, the attorney general’s office said in a statement.

Bertonazzi’s body was transferred to the state medical examiner, which did not make a determination in the case until Wednesday — nearly 10 months after the man’s death.

“This was a complex case that required many ancillary studies and investigation,” a spokesperson for the <a href="https://www.washingtonpost.com/dc-md-va/2022/10/19/maryland-autopsy-medical-examiner-fowler/" target=_blank>medical examiner’s office</a> said in a statement. “It is not uncommon for complex cases to take many months before cause and manner of death is determined. Once the autopsy report proceeds through our standard finalization procedures, it would then be available for release, provided the State’s Attorney does not request it to be held for additional investigation.”

It’s up to police and prosecutors to determine whether to file criminal charges following a ruling of homicide from a medical examiner.

Orsi said that her office is exploring all possible causes of Bertonazzi’s spinal injury, including actions by Baltimore police and hospital staff.

An IID spokesperson said the office does not have investigative jurisdiction over deaths that occur when someone is in the custody of private security officers — and that the agency has no purview over the security guards employed by Johns Hopkins Hospital.

A spokesperson for Johns Hopkins declined to answer specific questions from The Post regarding the incident, including the employment terms of the security guards who interacted with Bertonazzi when he was injured.

Bertonazzi’s family learned of the medical examiner’s homicide determination this week, the same time as the public.

“His daughter is extremely distraught,” Orsi said. “This is certainly not what you expect when you have a family member come into the hospital.”

Indiana University, BA in journalism

Katie Mettler is a reporter covering policing, courts and justice. 

Katie Mettler

He became paralyzed at Johns Hopkins. His death was a homicide, police say.

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