for those who asked

CLINICAL RECORD — WASHINGTON REGIONAL MEDICAL CENTER

At approximately 5:31 AM on April 2, 2025, Alexander Pierce Sprandel was transported to Washington Regional Medical Center Emergency Department by EMS. He had been playing video games with friends when they observed him cutting himself and called police. EMS responded and transported him to the hospital. The treating physician, Dr. Green, documented superficial lacerations to Alexander's left forearm. Alexander was fully conscious, GCS 15, not intoxicated, with all toxicology screens negative.

Heather Sprandel was present at the hospital. Alexander was diagnosed with Depression (F32.A) and Suicidal Ideation (R45.851). The physician discussed the potential need for inpatient psychiatric care. The patient and Heather specifically indicated they did not want inpatient psychiatric treatment. Alexander was discharged with urgent referrals — marked "as soon as possible" — to Springwoods Behavioral Health and Vantage Behavioral Health.

Heather was a participant in the decision to refuse inpatient care and accept outpatient referrals instead.

Two days later, Alexander returned to the Emergency Department. He presented seeking inpatient psychiatric treatment — he came back on his own and asked to be admitted. He reported having felt more and more suicidal over the past several months. All toxicology screens again negative.

Heather was again present at the bedside. The attending physician, Dr. Marks, discussed inpatient treatment options with both Alexander and Heather. Heather again declined inpatient admission on Alexander's behalf. Alexander — who had come back to the hospital asking to be admitted — was again discharged home.

The attending physician's addendum states:

"Patient no longer wishes to seek inpatient care. He states he no longer feels thoughts of self-harm. His mother is at the bedside and I have an extensive conversation that we have already arranged inpatient treatment options, but the patient does not wish to do this. We have an extensive conversation, the mother states she is willing to accept responsibility and understands that he is not a no risk patient in terms of mental health, the patient states that he will return to the emergency department should he have further suicidal ideation. I do not believe he is high risk given his social support."

The physician's low-risk determination — the clinical basis for sending Alexander home — rested specifically on the existence of a supportive social network. The suicide risk stratification form confirms this: the listed protective factor is "Supportive social network or family, identifies for living."

That protective factor was false. It did not exist in the form the physician believed it did.

Heather was present at the bedside during both visits. At the April 4 visit, the physician's assessment of Alexander as low-risk rested on the existence of a supportive social network. Alexander's father — a person who had been actively and repeatedly attempting to reach him — had been blocked from his phone, prevented from approaching his residence by trespass orders initiated by Heather, subjected to three criminal citations arising from those attempts, and was at that moment in active litigation with Heather in Washington County District Court. Alexander's paternal grandmother, aunts, and uncles had received no communication from him for approximately eight months.

None of this was in the clinical record.

Heather did not tell the physician that Alexander's father was blocked. She did not tell the physician that the paternal family had been cut off. She did not correct the physician's assumption that a support network existed. She stood at her son's bedside, acknowledged that he was not a no-risk patient, accepted the discharge rather than the admission, and allowed the physician's protective factor finding to stand on the basis of a social network she had spent eight months destroying.

Alexander was sent home into an environment of engineered isolation on the basis of a protective factor that did not exist, and Heather was the only person in that room who knew it.

Alexander never appeared at Springwoods Behavioral Health. Springwoods has confirmed in writing that their only record is the referral call from Washington Regional Medical Center. No patient visit by Alexander Pierce Sprandel ever occurred. The same is true of Vantage Behavioral Health. No psychiatric follow-up of any kind occurred in the eleven months between April 2025 and Alexander's death on February 28, 2026. No psychiatric medications were ever prescribed.

The most charitable explanation — that Heather genuinely believed she could manage Alexander's recovery at home — does not survive the April 4 visit. He came back two days later asking to be admitted. She said no again.

An inpatient psychiatric admission removes the patient from the parent's sphere of control. A competent intake clinician would interview Alexander without Heather present. Standard clinical protocol would include questions about his living situation, his relationships, his support network, his access to lethal means. Alexander would have been the sole source of his own history in that intake interview.

What Alexander would have described — his father blocked and legally restrained from the property, his paternal grandmother and family silenced, the household managed by his mother, financial support conditioned on compliance with estrangement — would have been documented in a permanent clinical record by clinicians with legal and ethical obligations to act on what they found.

The physician's protective factor finding — supportive social network — would have collapsed in that intake interview. Standard clinical protocol for suicidal patients includes means restriction counseling — specific questions about firearms in the home and specific recommendations about their removal or securing. The firearm in the safe deposit box, accessible only to Alexander, would have been identified as a specific risk. A recommendation about it would have been documented in the clinical record.

None of that record was created because Heather declined admission twice and the referrals were never followed through.

The most complete explanation for why Heather continued the isolation after the hospital visits is that the isolation was not a side effect of the conflict — it was the mechanism of control she required. Alexander isolated from his paternal family was Alexander whose account of his home environment could be managed. Alexander admitted to inpatient care was Alexander whose account of his home environment would be documented permanently, without her present, by people with legal obligations she could not override.

She kept him out of inpatient care and away from his paternal family for the same reason: both represented environments she could not control, and both would have produced records she could not afford to exist.

Fifteen days after the April 4 discharge, Alexander's father contacted Heather asking to speak with Alexander. Her response was: "He does not want to talk to you. I have told you this and he has as well. Give him the space he has asked for."

The physician had just identified a supportive social network as the clinical basis for sending Alexander home. Heather blocked access to that network within fifteen days of the discharge and continued blocking it for the remaining ten months of Alexander's life.

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