LARGO — His son safe in a hospital, Charlie Provenza thought he could take a moment to relax.
It had been a tense several hours with his adult son, Nicholas, who was in the midst of a psychotic break. Police had him hospitalized under the Baker Act, a law that allows for the involuntary commitment of those believed to be a threat to themselves or others.
Provenza headed to a taphouse in Tarpon Springs with his girlfriend and ordered margaritas. It was Cinco de Mayo 2017.
Then, he got the call. His son had escaped from Largo Medical Center.
The father, terrified, drove around Largo screaming his son's name. He didn't hear of his whereabouts again until about 18 hours later, with a knock on his front door. Nicholas Provenza, 25, had been shot and killed by a Tarpon Springs police officer, a state investigator told him. Charlie Provenza's worst nightmare had come true.
PREVIOUS COVERAGE: Man shot by Tarpon Springs police had troubled mental history, family says
Now, he and Nicholas Provenza's mother have filed a wrongful death lawsuit against Largo Medical Center. If their son had been adequately supervised at the hospital, the suit argues, he wouldn't have slipped out through an ambulance bay door and wandered freely while in a psychotic state for 18 hours before an officer, fearing for his life, shot and killed him.
"It's a no-brainer," Charlie Provenza, 59, told the Tampa Bay Times. "Your son is taken away in a police car in handcuffs. You think that level of security follows through to where he's medicated and stable" at the hospital.
HCA West Florida, the hospital's parent company, declined to comment on the lawsuit. A company spokeswoman said in a statement the hospital "extends our sympathy to the Provenza family, in the loss of their son Nicholas."
Nicholas Provenza had schizoaffective disorder: bipolar type, a mental illness with symptoms including paranoia, delusions and severe mood swings, according to the lawsuit. He's been taken into custody under the Baker Act more than two dozen times before.
The day before the shooting, it became clear that his medication had worn off prematurely. Both parents requested that police check on their son.
Charlie Provenza met Pinellas County sheriff's deputies at his son's Palm Harbor mobile home. A deputy determined "there was substantial likelihood that without care or treatment the person will cause serious bodily harm to self and others" and wrote he had made deadly threats toward his girlfriend, according to hospital complaint records provided by the Provenzas' attorney, Lance Block.
The son eventually ended up at the Indian Rocks Road campus of Largo Medical Center, which receives state funding for intake of Baker Act patients. A nurse noted Nicholas Provenza had homicidal ideations, records say, and was "mumbling in word salad and appeared to be responding to internal stimuli.".
But instead of taking him to a secure psychiatric unit, the 25-year-old was left in the hospital's emergency room, according to the lawsuit. A nurse who was keeping an eye on him left to attend to something else. Nicholas Provenza walked out, wearing only his hospital gown and boxers.
He surfaced the next day at a charity car show in downtown Tarpon Springs. Police officer Scott MacIsaac heard reports that a man was acting erratic and bothering customers at a nearby shop. The officer found Nicholas Provenza near E Tarpon Avenue and N Safford Avenue.
He reached into his pocket and pulled out what MacIsaac first thought was a knife (it was later determined to be a homemade shank.) Ignoring MacIsaac's requests to drop it, Nicholas Provenza lunged at the officer. MacIsaac shot him three times. The prosecutors who reviewed the case determined it to be a "justifiable homicide."
As the Provenza family struggled to figure out what went wrong, his grandmother filed a complaint with the Agency For Health Care Administration against Largo Medical Center.
"I feel the hospital was neglectful during the admission of my grandson, allowing him to escape when he was in a disturbed state," she wrote, according to a copy of the complaint Block provided.
The agency declined to release any documentation related to the complaint, citing medical confidentiality laws.
Investigators from the agency interviewed nurses, reviewed records and visited the hospital. A nurse told them Nicholas Provenza wasn't taken to a six-bed psychiatric safe unit because a younger patient was acting out. The nurse who was monitoring him in the emergency room had to leave her post to help another patient.
The investigation substantiated the complaint in 2017, records show. However, no discipline was handed down because the hospital had a plan to fix the problems. It included that psychiatric patients be taken straight to a safe area.
But his family members want to see broader changes come out of their loved one's death.
There should be a uniform state policy in place ensuring patients are secure at facilities that accept Baker Act patients, especially considering those facilities receive public money, Block said. And institutions that fail to do so should be held accountable.
"That's the purpose of the lawsuit," Block said. "It sends a message to this facility to take this type of situation seriously, and it sends a message to other facilities around the state that if you're going to … hold yourself out as an institution capable of providing Baker Act services, then the public has a right to take you at your word at it."
Charlie Provenza said the goal is ensuring that another family never has to endure what his did.
"It's not a broken arm," he said. "It's life or death."
Contact Kathryn Varn at email@example.com or (727) 893-8913. Follow @kathrynvarn.