An Ohio man has died in what his family describes as a tragic case of medical neglect, when, after complaining of constipation for up to a month, his autopsy revealed more than 20 pounds of hardened fecal matter in his gut. The man, identified in court documents filed in November 2025 as James Stewart, 41, lived with underlying intellectual and developmental disabilities in a staffed group home in Bazetta Township, Ohio, operated by Clear Skies Ahead. According to a wrongful-death lawsuit filed by his family, staff ignored his worsening complaints of constipation, abdominal pain, and behavioral changes in the days leading up to his death. Family attorneys say Stewart took medications known to slow bowel function, and the lawsuit alleges the home did not have effective systems in place to monitor his bowel movements. On November 15, 2024, Stewart was found unresponsive in his room. First responders noted his abdomen was “significantly distended” and rigid, with a light bruise on his abdomen. “Despondent, low energy, and complaining of pain” The complaint states, “James was typically a happy, friendly, and active individual, who brought joy to those around him. In the days and even weeks leading up to November 15, 2024, James was despondent, low energy, and complaining of pain.” The complaint added, “[Clear Skies staff] instructed James to ‘sit on the toilet,'” the same day Stewart died. “Even though he sat on the toilet for some time, James could not have a bowel movement,” the document says. The coroner determined that his colon was obstructed by stool so compacted it weighed over 20 pounds. This impaction created intense internal pressure, causing gas to force its way through microscopic tears in the intestines. Stewart’s death: “Entirely avoidable” Attorney Michael Mooney, who is representing Stewart’s family, called the death “entirely avoidable.” He told Ohio news outlet WFMJ that the impaction was so severe it caused what’s known as tension pneumoperitoneum, where trapped gas leaks from the bowel into the abdominal cavity, in this case, contributing to Stewart’s death. Medical experts say severe fecal impaction, while rare, can be deadly if untreated. When stool becomes fully compacted, it can compress other organs, tear intestinal walls, or lead to infection. In particularly extreme cases, surgical intervention or intensive manual disimpaction may be required. Stewart’s family is pushing for accountability from the group home. They say his complaints were obvious and should have triggered more urgent medical attention. The lawsuit alleges that a manager from Clear Skies Ahead and an employee from Fairhaven attended a telehealth psychiatric appointment with Stewart the day before he died, but failed to report his constipation symptoms to the medical provider. “They knew about it. They still weren’t paying attention,” Mooney said. As of now, Clear Skies Ahead and Fairhaven Industries — the company contracted to staff the home — have not publicly responded to the allegations.