GENARO C. ARMAS
Family members charged with murder and neglect in the death of a 32-year-old Pennsylvania man with Down syndrome worried about losing his government assistance if he was placed in a personal care facility, authorities said.
Robert Gensiak weighed just 69 pounds and his body was covered with open sores and scabies when he died at a hospital in March.
"In the 26 years that I've been in the office ... this is the worst case of neglect that I've seen," Lackawanna County District Attorney Andy Jarbola said at a news conference Wednesday in Scranton. "This family -- the mother and two sisters -- basically let the man rot to death."
No other agencies were involved in his care, Jarbola said Thursday. County officials and an area advocacy group said the family never reached out for help to care for Robert Gensiak.
"Nobody had this guy on the radar screen, other than the family," Jarbola said in a phone interview. "It became really clear to us that the family didn't do anything to provide any type of ... additional care."
Susan Gensiak, 59, of Taylor in northeastern Pennsylvania, and her daughters, Joan, 35, and Rebekah, 24, were charged Wednesday with third-degree murder, involuntary manslaughter and neglect of care for a dependent person.
All three were sent to Lackawanna Prison, with bail set at $350,000 for Susan Gensiak and $250,000 for her daughters.
Court records did not list attorneys for the women, and a court clerk was unaware Thursday whether they had lawyers. A phone listing was unavailable.
The mother and sisters had little to say at their arraignments or outside court.
Robert Gensiak died March 20, the day after the weakened patient was transported to the hospital by ambulance. Authorities interviewed the family the day after his death, during which "family members expressed concern that if Robert was placed in a personal care facility they would lose the financial support they received for him each month," said an affidavit of probable cause.
Susan Gensiak asked whether she would still receive her son's Social Security benefit even though he had died, the affidavit said.
Autopsy photos showed Robert Gensiak's skin was yellow and laced with scabies -- a contagious skin infection caused by mites -- with open sores all over his body that were so extreme in spots that bone was visible.
His few remaining teeth were about to fall out, his head was covered in lice, and there was no food or significant fluid in his stomach, according to an autopsy.
"Robert's entire body was covered in a thick yellow scab-like rash" that "appeared to have cracked in various places, leaving open sores, which had been bleeding and oozing fluid," said an affidavit of probable cause.
The cause of death was sepsis due to the breakdown of his skin, with malnutrition contributing, according to Dr. Gary Ross, who performed the autopsy. Lackawanna County Coroner Tim Rowland ruled the manner of death as homicide due to neglect.
Robert Gensiak had not received medical attention since 2009, according to the affidavit. The family members indicated they were treating his condition with over-the-counter ointments and creams, and that they could not get medical treatment for him in part because of a lack of transportation, authorities said.
They called the doctor March 19 with his condition worsening, and the physician told them to call an ambulance to have Robert Gensiak seen at the hospital, according to the affidavit.
William Browning, director of Lackawanna County Human Services, said federal guidelines prevented him from formally disclosing information whether or not his department had specific cases. Generally, the department would have to rely on a report from the public, or a call for help from relatives, he said.
"With any case like this, it's unfortunate that it got to this level before even law enforcement heard about this," Browning said Thursday. "I wish there were better protections built in, but there aren't."
The Arc of Northeastern Pennsylvania, a Scranton-based organization that advocates for people with intellectual and developmental disabilities, was also not aware of the Gensiak case until charges were announced, said executive director Donald Broderick.
"We were as shocked and dismayed as everybody else," Broderick said. "Normally when you have a need and reach out, you get help. They just didn't reach out for help."
Emergency medical personnel who transported Gensiak to the hospital, along with five or six nurses at the hospital, contracted scabies from him because they were unaware at the time of his condition, Jarbola said.
The Times-Tribune of Scranton reported that all of those who contracted the disease were treated immediately and no longer have it.
Associated Press writer Michael Rubinkam contributed to this report.
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