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Nursing Home Sued for Violating Woman's End-of-Life Directive

  • Date: 2013/05/15
  • Compassion & Choices
  • Synopsis : Suit seeks unspecified financial damages for negligence, emotional distress, breach of fiduciary duty, elder abuse, violation of rights, and injunctive relief.

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Hospital, Nursing Home Sued for Violating 91-year-old Dying Woman's End-of-Life Directive - Daughter Had to Decide to Remove Mother's Ventilator to End Her Suffering.

A Lakeland woman is suing a Lakeland hospital and nursing home, claiming her frail, 91-year-old mother's wishes were violated when aggressive, traumatic Cardio Pulmonary Resuscitation (CPR) was imposed upon her despite a Do Not Resuscitate order.

The 91-year-old woman, Marjorie Mangiaruca, was not allowed to die naturally, a desire she had made clear to her daughter, Sharon Hallada (pronounced "Holiday"), when Marjorie learned that she was in the early stages of Alzheimer's disease many years ago. Instead, following the aggressive, traumatic resuscitation, Sharon was put in the painfully stressful situation of directing that her mother's ventilator be removed so she was allowed to die and stop her suffering.

Kathryn Tucker, director of legal affairs for Compassion & Choices, the nation's leading end-of-life choices advocacy group, and Florida trial lawyer Jeffrey Badgley filed the civil suit in the circuit court of the 10th judicial circuit in Polk County on behalf of Sharon Hallada, and her deceased mother, Marjorie Mangiaruca, against the Lakeland Regional Medical Center hospital and Oakbridge Healthcare Center nursing home.

The suit seeks unspecified financial damages from the hospital and nursing home for negligence, emotional distress, breach of fiduciary duty, elder abuse, violation of rights, and injunctive relief to ensure that training of staff prevents such violations of patient rights in the future.

"My husband and I had taken care of my mother in our home since she got Alzheimer's disease 10 years ago. But before she reached the advanced stage, she made me promise to honor her wishes not to receive life-prolonging treatment," said Hallada, who held medical power of attorney for her mother and told the hospital about her wishes. "The one thing I promised my Mom is that she would die peacefully. Yet the hospital and nursing home ignored my mother's and my wishes, making her and our family suffer unnecessarily."

"My life is not the same because this painful memory haunts me every day," added Hallada, who is a retired life insurance underwriter. "The only reason I am suing is to ensure no other family has to suffer the devastating emotional trauma that we have endured."

The complaint alleges that the hospital failed to transfer the Do Not Resuscitate Order signed by a hospital doctor, Jose Reinoso, M.D., and Sharon to the nursing home and the nursing home failed to ascertain if this very elderly ill patient had any end-of-life care directives.

As a result, on Oct. 10, 2011, when Sharon's mother went into cardiac arrest at the nursing home, she was subjected to violent, painful medical interventions by nursing home staff, EMTs who transferred her back to the hospital and by hospital staff. They included having her lip split open, having a hole cut in her throat, receiving paralyzing drugs, having tubes inserted into her throat and her stomach, and having air forced into her lungs.

Two days later on Oct. 12, 2011, the emotionally traumatized Sharon was forced to make a decision she shouldn't have had to make: she told the hospital staff to remove the ventilator from her mother, and allow her to die. The hospital transferred Sharon's mother out of the intensive care unit and into a palliative care unit, where Sharon held a bedside vigil for the five days before her mother finally died on Oct. 17, 2011.

"This is a tragic situation," said Tucker, who was lead counsel in two landmark U.S. Supreme Court cases, asserting that mentally competent terminally ill patients have a constitutional right to choose aid in dying. "These combined failures led to unnecessary suffering by Sharon's mother, forcing Sharon to make the decision to remove the ventilator from her mother."

Ironically, Lakeland Regional Medical Center brags on its website that the "unique strengths of our physicians, our healthcare providers, our hospital...is driving us to new standards of care," but that was a far cry from Sharon and Marjorie's experience.

"Healthcare providers must be held accountable for these highly preventable violations of patient rights," said Badgley, who has an "AV" rating by the Martindale-Hubble peer review system, the highest rating from judges and lawyers in the community. "We are bringing this case to send healthcare providers a message that they must ensure that patients' end-of-life wishes are both ascertained and respected. Failing to honor those wishes is a serious affront to personal autonomy."

Contrary to TV lore, CPR "restarts" a heart only 5 percent of the time, or less "and only for a while in elderly patients, those with advanced cancer, dementia (such as Alzheimer's disease), and living in nursing homes, according to family and palliative medicine physician Dr. Jennifer Black.

"To add insult to injury, I had to pay for the medical care the hospital provided to my mother following her resuscitation against her wishes," concluded Hallada. "And the hospital never apologized to me."

With over 30 local groups and 40,000 members and supporters throughout the United States, Compassion & Choices leads the movement for end-of-life choice. We support, educate and advocate. Learn more at: www.compassionandchoices.org Jeffrey Badgley's law firm, the Badgley Law Group, is recognized in the Bar Register of Preeminent Law Firms, the definitive guide to the most distinguished law firms in America. Learn more at: www.badgleylaworlando.com

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