The family of a 50-year-old Air Force veteran who jumped to his death from a 10th-floor balcony at Tripler Army Medical Center Jan. 2 has sued the U.S. government, claiming carelessness and negligence on the part of the hospital.

The complaint, filed Thursday in U.S. District Court in Honolulu, said Robert Roth was treated at Tripler in 1999 for depression. He was successfully treated and the depression remained essentially controlled until December 2006, according to the lawsuit.

But at that time, the complaint states, Roth's depression was exacerbated, he had multiple meetings with his treating psychiatrist at Tripler, and he showed up at the Tripler emergency room on Dec. 16 and Dec. 26 for his worsening depression.

"On both occasions Robert verbalized a suicidal ideation and described a suicidal plan," the lawsuit said. "Despite these clear indications of Robert's worsening severe depression and his suicidal intent, Robert was not hospitalized and not otherwise prevented from carrying out his suicidal plan."

The suit seeks general and specific damages "in amounts that will be proven at trial."

Tripler released a statement yesterday saying: "We have received notice of a lawsuit filed by the family of Robert Roth. We have faith in the legal process, and believe cases such as this are appropriately tried in a courtroom. We have no other comments at this time except to emphasize that the facts of the case have been thoroughly investigated and the case will be vigorously defended."

The suit was filed on behalf of Roth's wife, Satsuki; his son, William; and Roth's mother, Joyce Ulmer.

Honolulu attorney Rick Fried, who is representing the family, said Roth was "crying for help," he had sought assistance on multiple occasions, and the hospital ignored him.

The retired master sergeant, who had a bipolar mood disorder and was on antidepressant medication, went to Tripler's emergency room on Dec. 16 seeking to be admitted and telling medical personnel he planned to jump off a Makapu'u cliff, according to an Army investigation.

He waited more than five hours and never saw a psychiatrist, only a physician training to be one, records show.

On his second visit, a day after Christmas, he waited about three hours and left angry — against the wishes of medical personnel — because he hadn't been seen yet by a physician, according to records and Fried.

He told medical personnel he planned to jump from the top floor of the hospital, according to Army records. He fled the emergency room after refusing to sign agreements that he was leaving against medical advice, investigators said.

A week later, and after seeing a Tripler psychiatrist, Roth jumped from the 10th-floor balcony not far from where he worked as a ward clerk.

"He tried — he asked for help, he begged for help. He certainly was entitled to treatment," said Roth's brother, Les, who lives in Phoenix. "If you walk into an emergency room and you have an arm hacked off and you are bleeding all over the place, you have a life-threatening situation. They don't make you wait, do they? ... Well, he had a life-threatening situation. He said, 'I need help, I'm going to kill myself.' He even told them how."

Les Roth said his brother had changed medications and was complaining of not feeling well.

When a psychiatrist saw Roth on Dec. 27, she noted that he showed "no suicidal tendency, no suicidal ideation, no suicidal plans, no suicidal intent," according to his records.

Les Roth said his brother could be dramatic, and he believes he may not have revealed the suicidal thoughts to the psychiatrist, a person to whom he had a loyalty.

"But he'd get home and get into a deeper funk, then he was willing to go and say, 'This is happening to me, I need help,' " Les Roth said. "They needed to see him immediately. Suicidal ideation is not to be taken lightly," he added.

Investigators were told Tripler's emergency room did not have any written standard operating procedure for handling patients with suicidal intentions.

Robert Roth, who served 20 years in the Air Force as a medic and paramedic in locations including the Philippines and Panama, retired from the service in 2002. His wife, Satsuki, and son William, in his mid-20s, live in Hawai'i, Les Roth said.

Reach William Cole at wcole@honoluluadvertiser.com.