Shock Death Link Sunday Times newspaper of Western Australia January 21, 2001 By JIM KELLY SHOCK treatment may have contributed to the sudden death of a psychiatric patient at Graylands Hospital. Giovanni Mario Franco was a physically fit 30-year-old when he was admitted to Graylands in February 1998 to be treated for schizophrenia. But on March 10 he died suddenly in a locked ward under the constant watch of two nurses. Mr Franco had undergone electro convulsive therapy - known as - ECT or shock therapy - a day before he died. At an inquest into the death this week, Deputy State Coroner Evelyn Vickers was told it was possible the shock treatment caused his heart to stop beating. Mr Franco's sister Ima Franco and her husband Tony Goodlich claim they did not know shock therapy was being considered and would have tried to stop it happening if they been aware of the dangers. "In a medical hospital it is customary that family are consulted on risky procedured," she said. Forensic pathologist Dr Gerard Cadden told the inquest Mr Franco died from undetermined causes but the most likely explanation was cardiac dysrythmia - a catastrophic interference to a normal heartbeat. Asked if the fatal heart failure could have resulted from the shock therapy Dr Cadden replied: "Yes, it could have caused dysrythmia." He said the cause could never be conclusively determined, though, because dysrythmia left no medical traces. Mr Franco had no history of heart problems and an autopsy revealed his heart was normal. Graylands consultant psychiatrist Dr Joeseph Lee said he gained a second opinion and authorised shock treatment after medication failed to work. He said he told Mr Franco's father that ECT was being considered several days before ECT was administered. Dr Lee said ECT was a very safe treatment with a reported death rate of between two and four in 100,000. Independent consultant psychiatrist David Castle, who put the death ratio at one in 10,000, said Mr Franco received appropriate care and that shock therapy was the right choice of treatment. Mr Franco's family maintain Graylands did not do enough to keep them informed about his treatment, and produced information from the Internet which suggested the real figure for death following ECT was one in 200. Ima Franco said the family was distraught by periods when they were stopped from visiting Mr Franco, allegedly without explanation. "The first time (we were prevented from visiting him) he ended up paralysed for three months," she said. "The second time he ended up dead." ECT Routinely Used. ELECTRO Convulsive Therapy is routinely used in WA psychiatric institutions despite concerns about its safety. Treatment involves sending bursts of up to 460 volts into the patient's brain. Australian and New Zealand College of Psychiatrists spokesman Dr Paul Skerritt said ECT was a widely accepted treatment for depression and other conditions. "This is not a treatment from the dark ages," he said. "It does not do the brain any harm."