Byron tragedy - Mother of Tranyelle Harshman sues local ketamine provider

Two weeks after Tranyelle Harshman killed her four young children and herself at their Byron home, friends and family members gathered to commemorate their lives.

Nearly 300 attendees prayed, sang hymns, listened to memories of Harshman and her daughters Brailey, Olivia, Brooke and Jordan and tried to come to grips with an incomprehensible tragedy.

As Harshman’s mother, Rhonda Coplen, prepared to say goodbye to her daughter and granddaughters, she still had unanswered questions eating at her. But Coplen was convinced that the medication prescribed to Harshman was dangerous and may have, at least in part, caused Harshman’s unthinkable decision.

“It was a wrongful death,” Coplen said before the service.

Over six months later, she’s following through on that conviction. Acting on behalf of the family, Coplen filed a Monday lawsuit against the Cody clinic and provider who prescribed ketamine to Harshman. The suit in Wyoming’s U.S. District Court alleges that advanced practice registered nurse Krista Blough of Sage Psychiatry Services negligently “permitted or directed Ms. Harshman to self-administer ketamine at home without medical supervision or safeguards.”

According to the suit, Harshman fatally shot her four children and herself while in “an altered or dissociative mental state” induced by the ketamine. And the suit asserts that Blough’s negligence in prescribing and managing the drug “was a direct and proximate cause of the deaths of Ms. Harshman and her children.”

The filing also leaves the door open to suing whichever pharmacy filled Harshman’s prescriptions.

Coplen, who lives in Idaho, received permission from Harshman’s other family members and a Park County judge to represent the interests of her daughter and grandchildren in June. She’s being represented by the Colorado-based Olson Personal Injury Lawyers.

“I’m comfortable saying this did not have to happen,” attorney Sean Olson said in a Tuesday interview with the Tribune. “By bringing a lawsuit like this we are making sure we hold folks accountable for what happened. My hope is that we can prevent this from ever happening again.”

Sage Psychiatry Services did not respond to requests for comment.

A mother in pain

Coplen understands her thoughts and opinions may be controversial. She’s worried her answering questions may anger some and has the possibility of alienating her from friends and family she cares about deeply. Yet, Coplen was determined to answer questions honestly and offer pertinent information because, as she said, “People need to know the truth.”

“This is big enough that we can make positive change. And we can make people aware of things they need to be aware of,” Coplen said in an interview just days after the ceremony.

Over a series of conversations with the Tribune earlier this year, Coplen touched on the impacts of Harshman’s trauma, the stigma and expense of mental health and the need for systemic changes to support those in need.

Coplen said she and her daughter spoke often and without reservation.

“She’s the kind of kid who, honestly, if she had a pimple on her butt, she’d call and tell me,” Coplen said.

The more serious the subject, the more they discussed. There were extremely serious topics — physical health, mental despair, questionable treatments and even rape — often revisiting them for further exploration and support, Coplen said.

She insists the timeline leading to the Feb. 10 tragedy started years earlier.

The Tranyelle friends and family knew.

Harshman was born to Dennis and Rhonda Coplen on June 26, 1992, in Spokane, Washington. She was the third oldest of a baker’s dozen children. The family moved around before ending up in Wyoming, yet despite the constant upheaval, Harshman was a popular student. She graduated from Powell High School in the Class of 2010. 

She was intelligent and driven. 

One of her best friends, Stephanie McArthur, described Harshman as strong and resilient. She was, McArthur recalled, “a light on this earth.”

Friends remember Harshman being there for them, and as a loyal and fiercely protective mother. She was the “epitome of a mama bear for her children, her husband, her sister, her family, friends, co-workers alike,” McArthur said at February’s celebration of life service.

Harshman also faced immense challenges, McArthur noted, including mental health issues, post traumatic stress disorder, hormonal imbalances and other medical struggles.

Medical issues challenged Harshman for much of her life, her mother said.

Harshman underwent a hysterectomy after the birth of her youngest daughter in January 2023. After that, her emotional state seemed to plummet, Coplen said. Hysterectomies are associated with an increased risk of long-term mental health issues, especially depression and anxiety, according to an in-depth study by Mayo Clinic researchers. 

Harshman also had a miscarriage and gallbladder surgery. Physical issues contributed greatly to her depression, according to Coplen.

There was also a contentious divorce from her first husband and financial hardship.

And although she never reported the allegations to law enforcement, Harshman told family and friends that she’d been drugged and raped. The experience took a toll, Coplen said.

Family and friends worried about her emotional and psychological condition, but Harshman was a fighter.

“Despite these battles, she fought valiantly, striving to show up for her family,” McArthur said. “As a close friend, I will shout it from the mountain tops: She was doing everything she could to better herself and create the life that she had envisioned.

“Unfortunately,” McArthur said at February’s service, “the weight of it all became overwhelming, and in the darkness and in one breath, her body lost sight of the light.”

Seeking treatment

Mary Johnson, the CEO of the local mental health care nonprofit Oxbow Center, said the events Harshman faced over the years likely built up until there was a breaking point.

“Tragedies like this often leave us asking ‘why,’ and it is important to recognize that many complex and often unseen factors contribute to such events,” Johnson said in an interview with the Tribune earlier this year. “Mental health struggles, trauma and difficult life circumstances can build over time and result in devastating outcomes. It’s not always one single moment, but rather a combination of precipitating factors that can lead to such tragedies.”

Often, Johnson said, the social stigma surrounding mental health care keeps people in need from seeking treatment.

“Unfortunately, many people in crisis feel ashamed or reluctant to seek the help they need due to fear of judgement or misunderstanding,” she said. “It’s important for everyone to know that mental health struggles, including overwhelming emotional pain, are not a reflection of personal failure, but rather an issue that deserves support and intervention.”

Harshman sought treatment for her depression, but felt therapy was out of reach as hard financial times hit.

“Part of Tranyelle’s problem was getting a therapist and having somebody to be able to see for counseling,” Coplen said. “She could find a doctor to prescribe medications, but she didn’t have a therapist to talk and walk her through some of what she was experiencing.”

The Oxbow Center, which is the largest mental health care organization in the Big Horn Basin, and other facilities offer therapy on a sliding scale based on income. Still, expense, limited availability of qualified therapists, lack of knowledge of programs and a process that requires information many on the outs simply don’t have are among the often mentioned roadblocks to proper care, according to those who spoke to the Tribune.

Use of ketamine

Harshman wound up connecting with Sage Psychiatry Services in Cody, which reportedly prescribed her r-ketamine lozenges, which are sometimes used for treatment-resistant depression. An autopsy revealed ketamine in her system at the time of death, alongside clonazepam.

Clonazepam is believed to enhance the activity of certain neurotransmitters in the brain and is commonly used to treat panic disorder and anxiety. Warnings on the label report the drug can cause paranoid or suicidal ideation and impair memory, judgement and coordination. Combining it with other substances, particularly alcohol, can slow breathing and possibly lead to death.

According to Coplen, her daughter did drink. But it was the ketamine that worried the mother. She feels certain that ketamine troches or lozenges played into the tragic end.

The troches are small, lozenge-like tablets that dissolve slowly in the mouth and allow for quick absorption and rapid impact. 

Antidepressants can sometimes take weeks and months before the full benefit is realized. Ketamine can act in seconds or minutes, giving relief to those taking the medicine almost immediately in some cases, the Austin Ketamine Clinic reports.

However, the federal Food and Drug Administration has noted safety concerns that may be associated with ketamine products, including risks of sedation, dissociation, psychiatric events or worsening of psychiatric disorders, abuse and misuse. The FDA has not established safe or effective dosing of ketamine for any psychiatric indication.

During a July 2024 workshop hosted by the Reagan-Udall Foundation for the FDA, Dr. Gerard Sanacora of the Yale University Depression Research Program said ketamine has spurred a lot of excitement, “but I think it really speaks to the desperation of patients suffering from severe treatment resistant depression, and the desperation of the clinicians trying to treat them.”

While ketamine has been used safely for more than 50 years in surgical procedures, Sanacora said there is little known about the side effects and dangers of uses for severe depression and patients with suicidal ideation.

“There’s such excitement (and) enthusiasm about giving this treatment, and the hope and optimism that (ketamine is) offering patients and clinicians,” Sanacora said, “but we’re balancing that against very little data and the real risk of toxicity.”

At-home use

It’s essential to have regular medical consultations while using ketamine troches, according to instructions that come with the drug as well as recommendations from experts on pharmacology and ketamine. This ensures the effectiveness of the treatment and allows for any necessary adjustments. It is also suggested that a trusted person be present during administration. And there wasn’t a trusted advocate there for Harshman when she reportedly took her last dose.

In her pending suit against Sage Psychiatric Clinic, Coplen asserts that, “The applicable standard of care requires that ketamine be administered only in medically controlled settings with appropriate monitoring to mitigate risks of dissociation, psychosis, self-harm and harm to others.”

But she says that Blough “permitted or directed Ms. Harshman to self-administer ketamine at home without medical supervision or safeguards.”

At last year’s Reagan-Udall Foundation workshop on ketamine, Dr. Brittany O’Brien of the Baylor College of Medicine said home use is controversial, especially after the ketamine-related death of Hollywood actor Matthew Perry.

“I think it’s a really controversial, hot and problematic topic right now. It’s the safety issue, right?” O’Brien said. “Doing this unsupervised at home, you’re increasing the risk.”

“We have a lot of work to figure out, you know, how we’re going to be able to do this safely and effectively in the home — if that’s really where it’s best for the patient to be doing it,” she said.

According to Coplen, Harshman’s ketamine was prescribed on an “as needed basis.” There was no therapy linked to the drug, Coplen said, something that is required for treatment with FDA-approved versions of the drug.

“When (Harshman) took it, she hallucinated every single time,” Coplen added, and she said Harshman usually took the drug at night, after her children were in bed and asleep.

But on Monday, Feb. 10, Harshman’s children were home sick from school, and she took ketamine after they had all fallen asleep for a nap, Coplen said.

Based on Harshman’s other actions that day, including two phone calls to her mother, a call to check on a friend who’d received a series of bad news and making appointments for the kids later that month, Coplen believes something “unexplainable” must have happened.

Defense of ketamine

Oxbow Center CEO Johnson warned against “villianizing” ketamine treatments. When used as prescribed, it has helped people with severe trauma, including PTSD and treatment-resistant depression.

“I hate to almost villainize a specific substance, drug or medication without knowing ... how it was used and all of the details,” Johnson said, “because I don’t want people to think that if they’re prescribed something, that they shouldn’t use it, or they can’t use it in the way that it’s prescribed to them.”

Harshman’s husband, Cliff, told Cowboy State Daily earlier this year that Harshman tried various treatments for her PTSD and postpartum depression over a period of years. That included counseling, medication, supplements and a sleep aid that brought side effects. She eventually tried ketamine.

Cliff told Cowboy State Daily that he believes the drug can be “amazing” and said he wasn’t seeking to demonize a particular therapy.

“This works for a lot of different people,” he said of ketamine. “This was her last grasp at the rope, if you will, to hang on.”

Under federal court rules, Blough and Sage Psychiatry Service will generally have 21 days to file a response once they’re formally served with the suit.

(CJ Baker contributed reporting.)