MANVEL — The death of a 15-year-old Daystar patient has been ruled a homicide, opening the residential treatment facility to additional scrutiny that could mean criminal charges and a civil lawsuit.

Latasha Bush died Feb. 27, three days after she was held on the ground by three staff members at Daystar Residential Treatment Center in Manvel. A Harris County medical examiner ruled her death a homicide caused by complications of asphyxia.

Initial reports indicate Bush had a history of bipolar disorder and seizures. She became combative with Daystar employees, was held in a “basket hold” for five minutes and went unresponsive, according to reports.

Daystar is a private live-in treatment facility that cares for patients with the most severe mental or physical problems. Some have behavioral problems, some have been abused and for all, Daystar is the last stop before permanent hospitalization.

Bush was sent to Daystar by Children’s Protective Services and had been there less than two weeks when she died.

Her death was the third known restraint-related death at the facility now known as Daystar. In 1993, a 16-year-old girl died after being restrained. In 2001, another 16-year-old girl died under similar circumstances. Both deaths were ruled accidental, caused by heart failure.

All three deaths are being investigated by the Brazoria County district attorney’s office and Residential Childcare Licensing, the state agency charged with investigating abuse in childcare facilities.

Cal Salls, executive director of Daystar, declined to comment on the case, instead referring inquiries to his attorney, Don Carsey of Austin. Carsey did not return calls seeking comment Wednesday.

Bush’s mother, Leslie Brown, wants to know why her daughter died. So far, Daystar officials have not given her details.

“I already know how, but why?” Brown said. “She’s a child. She’s 15 years old, and these are adults.”

A “basket hold,” the restraint used on Bush, involves crossing patients’ arms across their bodies, taking them to the ground and holding them there. In the case of Bush, three attendants were used to place her in a basket hold, records show.

Mark Collmer, a Houston attorney representing Bush’s mother, said Bush was held down so tightly it cut off her airway. Collmer plans to file a lawsuit this week alleging gross negligence.

“One of the goals is to get them to tell us truthfully what it is they did to her,” Collmer said. “Whether or not we’ll get that out of them, I do not know.”

The three girls’ deaths show a pattern that Collmer hopes to examine more closely.

“Have they taken the appropriate steps to only exercise that particular restraint when it is absolutely necessary and other avenues have failed?” Collmer asked.

Estella Olguin, a spokeswoman for CPS and Residential Childcare Licensing, said CPS was still placing kids at Daystar. While the autopsy finding is troubling, it is too soon to shut the facility down, Olguin said. However, the three staff members involved in Bush’s death are on leave pending the outcome of the investigation.

Licensed to handle up to 156 kids, Daystar is one of two facilities in the state that accepts Level 6 patients. Level 6 care requires one-on-one supervision of children deemed severely aggressive, children who show signs they are a “severe or critical risk of harming themselves or others,” Olguin said.

Because facilities like Daystar are so hard to come by, state officials want to collect all the information before taking any action.

“We just really want to make sure we look at everything,” Olguin said. “We don’t want to shut down a place that could care for kids with such severe needs.”

Brown hopes a lawsuit will push the state to take action against Daystar.

“I want them to do what they have to do to get this place either closed down or get it in order so no more children die in that place,” Brown said. “That is my main goal.”

Brown, who lives in Beaufort, S.C., said she talked to her daughter often but did not know she had been moved to Daystar until a CPS caseworker called to tell her to go to a Houston hospital immediately.

“The next time I talked to her was in a hospital bed,” Brown said.

Brown said she was shocked and hurt to hear her daughter’s death was the third restraint-related death at a Daystar facility.

“I figured somebody should have been doing something about it before now,” Brown said. “I’m still having a hard time dealing with that.”

State officials will review records to determine how the restraint was administered and whether proper procedures were followed, Olguin said. Also, they will review Bush’s medical history and meet with Yenne.

Since Bush’s death, Daystar has implemented additional training for staff members, Olguin said. Physical restraints are still used but should be used only after verbal commands have failed, she said.

District Attorney Jeri Yenne said within a few months she could take information about Bush’s death to a grand jury for possible criminal charges. First, she wants to gather as much information as possible about all three girls’ deaths. That includes CPS files, medical records, psychological evaluations and more.

“We want to make sure that we have all these children’s records to see if there is a common factor,” Yenne said. “We are going to review each and every case on its merits. ... The information is voluminous as to each case.”

Facilities like Daystar operate “under the radar” because they are psychiatric facilities involving children, Collmer said.

“If there’s a problem at one of these facilities it doesn’t seem to be as well publicized unless someone is killed,” Collmer said.

This is not the first time Daystar has been investigated. In an unrelated matter, a pharmacist who previously worked at Daystar is under indictment for fraudulent Medicaid billing, but that case did not involve mistreatment of patients, Yenne said.