Family members of the late Tranyelle Harshman contend it was the negligent prescription of ketamine that led the Byron woman to fatally shoot her four young daughters and then herself last winter. Acting on the family’s behalf, Harshman’s mother filed a suit against the Cody provider who wrote the prescription for the drug and the Casper-based pharmacy that filled it.

However, in recent responses to the litigation, Krista Blough of Sage Psychiatry Services and Compounding Specialists of Casper dispute that they were negligent or responsible for the five deaths.

“These deaths were the result of mental illness unrelated to any act of pharmacy negligence,” an attorney for Compounding Specialists wrote as one potential “affirmative defense” to the suit.

Meanwhile, an attorney for Blough and Sage submitted a defense suggesting that Harshman “may have suffered from pre-existing conditions or factors that led to her death and the death of her children.”

Those potential defenses were among several that Blough and Sage and Compounding Specialists listed in recent answers to the suit brought by Harshman’s mother, Rhonda Coplen, in Wyoming’s U.S. District Court. 

Harshman’s family and friends have said that her violent actions that day were starkly out of character.

At the time of the Feb. 10 shooting, Harshman was being treated with ketamine for post-traumatic stress disorder (PTSD), court filings say. (While Harshman had previously been treated for post-partum depression, Blough and Sage Psychiatry said that Harshman “did not meet the clinical criteria” for that diagnosis as of February.)

Ketamine has a dissociative effect and has shown promise as a treatment for PTSD, but the suit says it also has a “known risk of hallucinations and psychosis and detachment from reality.” The family’s complaint contends that the drug put Harshman in “an altered or dissociative mental state” at the time she fatally shot her children and self.

The suit is sharply critical of Blough’s decision to have Harshman take the ketamine at home, asserting that the drug’s risks are especially great “in unsupervised or outpatient settings.” Among other contentions, the family charges that Blough failed to properly monitor Harshman and that both she and Compounding Specialists failed to warn Harshman of the “extreme risks of home use.”

In their responses, however, Blough, the clinic and the pharmacy deny those allegations.

One of Blough and Sage’s defenses to the suit says that Harshman “was adequately informed of the risks, benefits and alternatives of the treatment and gave [her] consent based on that information.” Another says that Harshman “assumed the risk of the treatment.”

Blough and Sage also contend that the Harshman treatment was “common” and supported by a “respectable minority” of medical professionals.

As for Compounding Specialists, the company’s affirmative defenses include statements suggesting that the blame could lie with other parties and that some or all of the suit’s claims “are not made in good faith.”

An initial pretrial conference in the case is set for Dec. 11 before presiding U.S. District Judge Alan Johnson of Cheyenne.

Harshman was 32 at the time of her death. Her children — Jordan Harshman, Brooke Harshman, Olivia Blackmer and Brailey Blackmer — were 2, almost 3, 7 and 9 years old, respectively.