DEDHAM — As Lauren Wolf chewed her steak dinner, something went wrong: The 56-year-old woman, who had a severe mental disability, clutched at her throat and called for help before falling onto her face. But Annie Kwankam, the woman’s caretaker, thought she was “pretending” to choke, Kwankam told investigators. An hour later, Wolf was pronounced dead.
Kwankam, 57, pleaded not guilty to a manslaughter charge Thursday in Norfolk Superior Court that accuses her of ignoring her mentally ill client as she choked to death on a piece of steak in a Milton group home three years ago. Kwankam was ordered held on $20,000 bail.
The investigation took three years as prosecutors collected hundreds of pages of documents to charge that Kwankam had engaged in “wanton and reckless conduct,” a requirement of a manslaughter charge, said David Traub, spokesman for the Norfolk district attorney.
Kwankam, formerly of Brockton, was arrested in Alabama last month. She also faces a charge of permitting serious bodily injury to a disabled person by a caretaker.
“By her own admission, Ms. Kwankam, despite all of her training, did not make any efforts to resuscitate [Wolf] or perform any life-saving measures,” Assistant Norfolk District Attorney Brian Wilson said in court.
Defense lawyer Larry Tipton said his client had a long history of providing top-notch medical care without ever receiving a formal complaint of negligence. Kwankam was trained in CPR and first aid, and her professional certification was up to date.
In 2009, Kwankam had been a residential counselor at a Milton group home on Kahler Avenue, caring for six individuals with severe mental disabilities.
Wilson laid out a detailed timeline of the episode, quoting from Kwankam’s interview with investigators and records from the 911 call she placed to Milton police.
On the evening of Sept. 7, 2009, Kwankam was at the facility with two female residents. Another caretaker had taken the four male residents to a cookout.
Beef was on the dinner menu, and the facility’s policy required that caretakers cut food into one-half inch chunks. Though residents were typically able to feed themselves, staff members were instructed to keep watch in case of choking.
According to Kwankam’s testimony to investigators, Wolf had begun to eat, then said she felt she would vomit. She put her hands to her throat and ran toward the bathroom. On the way, she said in a whiny voice, “Annie, help, I’m going to fall,” Kwankam later recalled. Wolf fell face down in a bedroom.
Wilson said Kwankam told investigators she initially thought Wolf may have been choking, but believed the woman was pretending once Wolf fell to the ground. She had been known to “cry wolf” in the past, Kwankam said. She said she did not hear any guttural noises, nor did she see Wolf foaming at the mouth, typical signs of choking.
Several minutes later, when Kwankam returned to check on Wolf, the resident had “the look of death,” Kwankam said. She was clammy, had a weak pulse, and her chest rose and fell only slightly. The other caretaker returned, and Kwankam asked for assistance. They decided to call 911.
According to court documents, Kwankam told the dispatcher: “Sometimes I don’t know if she’s playing a game or not, so that’s why I’m asking for help.”
After a period of silence, while the dispatcher advised an officer on the situation, Kwankam said, “She’s not playing around, is she?”
Emergency services found Wolf unresponsive. She was pronounced dead at Milton Hospital at 6:55 p.m., more than an hour after she fell down.
Wilson said emergency responders who found the piece of meat lodged in Wolf’s throat said it was 1.5 inches in diameter.
But Tipton questioned whether the meat chunk was accurately measured. He pointed out that no autopsy was performed. He said Kwankam has no previous criminal record, is a military veteran, and had an associate’s degree in social service.
“This is a woman who has over 20 years of service . . . with no prior allegations of abuse, neglect, or malfeasance of any kind,” Tipton said.
Wilson acknowledged that Kwankam made no attempt to flee. She waited several months after the episode before moving to her birthplace, Birmingham, Ala.
Kwankam, who appeared in court in a plaid shirt and jeans, nodded vigorously when Tipton said she was committed to appearing in court to face the charges.
The manslaughter charge carries a maximum sentence of 20 years imprisonment.
The group home was operated by Vinfen, a private, non-profit human services company. Four men and one other woman lived in the home at the time of Wolf’s death, according to prosecutors.
In a statement Thursday, the company’s chief executive officer, Bruce Bird, said additional choking emergency training was conducted after Wolf’s death.
“In other incidents where staff was required to use those skills, including reports of choking, our workers have been able to effectively use their training to help the individuals involved,” Bird said.
Follow her on Twitter