Toxicologist weighs in on death of Pam Hupp’s mother

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pam-huppST. LOUIS COUNTY, MO (KPLR) - After Pam Hupp’s mother fell to her death from a third-floor balcony in 2013, the St. Louis County Medical Examiner found high levels of Ambien in the mom’s system.

Fox 2 News asked Dr. Michael Mullins about the drug screening. Mullins, a Washington University toxicologist, was not involved in the autopsy.

Our investigative team approached Mullins only with questions about how those levels might impact a patient. He did not know in advance about this case, the name of the victim, or her connection to Pam Hupp.

“You can overdose on it, but Ambien itself doesn’t cause enough respiratory depression to be fatal by itself,” Mullins said.
Hupp’s mom, Shirley Neumann, was found dead October 31, 2013. Neumann, 77, fell through aluminum bars from her third-floor balcony at a Fenton retirement community.

Hupp was the last person noted to see her mother alive. Now that Hupp’s charged with murdering a man with disabilities, the St. Louis County Police Department is reviewing Neumann’s death. At present, the case is closed and listed as an accident.

Blood tests revealed .84 micrograms of Ambien in Neumann’s system, more than eight times the amount of a prescribed dose.

“I can’t give you a definite number of pills for a 200-pound person, but up to 8 times the level…likely 8 (pills), but it could be 10 or 11 or 12,” Mullins said.

Ambien would not have rendered Neumann unconscious, Mullins said.

“The effects I would expect from that concentration of that amount of Ambien would be that person may be asleep or may be awake and in a dream-like state,” he said. The doctor added that he would not expect someone to lose much motor control.

“They may appear a little inebriated or be mistaken for somebody who may have had a few beers or a couple glasses of wine, but I don’t expect them to be falling down or unable to walk up the stairs or unable to function.” Hupp told Lincoln County sheriff’s deputies about her own experience with Ambien during a 2015 tape-recorded interview.

“I'm a lot better than I was. Part of it is the Ambien and that does some real wicked stuff to your memory. It truly… huge blocks… not even… you just don’t even remember… that stuff. I can get up and do something and my husband will go, you did… and I'm like, ‘No way.’ You can get up and walk around or whatever.” During that same interview, Hupp described another one of her relatives, who warned she was doing strange things on Ambien.

“I had no idea what it was doing until, you know, my son would complain or, you know, they’d go, ‘You need to get off that stuff because you're just doing stuff, you don’t know you're doing,’” Hupp said.

According to the report from the St. Louis County Police Department, Hupp's mom had just been to the doctor for "back pain and confusion." The report said Hupp took Neumann to St. Clare Hospital and later took her to spend the night at Hupp's O’Fallon, Missouri home, then finally returned Neumann to Lakeview the night before someone found her dead.

The St. Louis County Police Department is asking the public for information or tips as it reviews this case.

Pam Hupp returns to court November 30.

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