Midstate Medical Center v. Doe, No. CV-06-4005623S.
| Decision Date | 03 May 2006 |
| Docket Number | No. CV-06-4005623S. |
| Citation | 898 A.2d 282,49 Conn.Sup. 581 |
| Court | Connecticut Superior Court |
| Parties | MIDSTATE MEDICAL CENTER v. Jane DOE. |
O'Brien, Tanski & Young, LLP, Hartford, for the plaintiff.
Jane Doe, pro se, the defendant.
The plaintiff, Midstate Medical Center (Midstate) initiated the present action by way of an application for a temporary injunction and a permanent injunction dated March 14, 2006, and filed with the court on March 17, 2006. The defendant was served in-hand on March 14, 2006. The parties appeared as summoned on April 17, 2006, at which time the case was continued for a hearing specially assigned for April 19, 2006. The defendant filed a pro se appearance. The plaintiff, in an effort to protect the privacy and medical history relative to the defendant, had requested and received permission to refer to the defendant as Jane Doe.
The plaintiff alleged that it is an acute care facility hospital licensed for the practice of medicine in Meriden. It alleged that the defendant, Jane Doe, was admitted on or about January 3, 2006 as a patient for care relating to bilateral gangrene to her feet. The plaintiff further alleged that the patient care continued to a point where she was deemed stable for a transfer to a subacute care facility or to her home, but that the defendant refused to cooperate with the transfer, refused to abide by the plaintiff's rules and regulations, and refused to leave the plaintiff's facility. The plaintiff alleged that, as a result, it was forced to squander scarce medical resources for a patient whose needs could be adequately met at a subacute care facility or at her home with the assistance of visiting nurses. It alleged that as a result of the defendant's presence at the plaintiff's facility, other patients in need of acute medical care had to be refused treatment there or transferred elsewhere. The plaintiff also alleged that in January, February and March of 2006, the number of patients admitted to the plaintiff exceeded its authorized capacity. The defendant did not file a responsive pleading.
The plaintiff presented five witnesses in support of its claims.
Rosamond Everard, M.D., testified that she is a physician employed at the plaintiff's facility and had been involved in the care of the defendant since her admission on January 3, 2006. Everard testified that the defendant's admitting diagnosis was bilateral gangrene to both feet, complicated by a history of diabetes and nutritional issues. She testified that on or before February 18, 2006, the plaintiff's medical condition was stabilized and that she was medically able to be discharged to a subacute care facility (commonly referred to as a convalescent home or nursing home) or to her own home. She testified that, in fact, the plaintiff issued a discharge summary on March 8, 2006, indicating that the defendant was stable but would need limited nursing assistance which could be provided at a subacute care facility or at her own home.
Karen Darley testified that she is a licensed clinical social worker employed at the plaintiff's facility and that she has been providing care to the defendant. She testified that on various dates in January and February, 2006, she had been advised by the treating surgeon, Aurangzeb Ali, M.D., that the defendant was an appropriate candidate for discharge to a subacute care facility and that she initiated the process for discharge. She testified that she attempted to place the defendant at several acute care facilities, such as Gaylord Hospital, The Rehabilitation Hospital of Connecticut or The Hospital For Special Care, but that these facilities refused to accept the defendant since the defendant does not presently meet their criteria of requiring acute care. She testified that these acute care facilities will not admit a patient with the defendant's needs, as those needs can be adequately met at a subacute care facility or at her home. She further testified that the defendant had consented to such a transfer, had been accepted, but then changed her mind and now refuses to go to a subacute care facility, thus blocking any possible transfer. She testified that the defendant is very demanding, very difficult, uncooperative and refuses to abide by many of the plaintiff's rules. She testified that the defendant had, on various occasions, ordered in Chinese food, pizza, and brought in donuts from Dunkin Donuts, all contrary to medical advice, against the plaintiff's rules and inconsistent with her strict dietary needs. She further testified that the defendant underwent two psychiatric evaluations during her stay and was found to be competent.
Abey Bruce testified that she is a registered nurse and the director of cancer care and in-patient surgical services at the plaintiff. She reiterated Darley's testimony and described the defendant as difficult, disruptive and uncooperative.
Joseph Plunt testified that he is a security officer for the plaintiff and that on or about March 30, 2006, he discovered the defendant in the hospital kitchen walk-in cooler, sneaking and eating desserts. He testified that this area is off limits for nonemployees and that, as a result, he reported the incident and escorted the defendant back to her room.
Linda Berger Spivak testified that she is the plaintiff's vice-president for patient care. She reiterated the need for the defendant's bed and that the plaintiff was over its authorized capacity and that, as a result, it is being forced to send patients in need of acute care to other facilities, although they would normally have been served by the plaintiff. She further testified that the defendant had rescinded her medical authorization form, thus, preventing the plaintiff from releasing her medical records to any other facility in an effort to place her in another facility.
The defendant testified that she understands that her doctors believe that she no longer requires the care of an acute care hospital. She testified that in years past, she had been a patient at several different subacute care facilities (nursing homes) and would not go back now. She testified that she believes that such care is geared for older people, who are often mistreated. While she admitted that she herself was never a subject of the mistreatment which she observed with other patients, she adamantly refused to consider a transfer to such a facility. She testified that she would willingly be transferred to her home, but in that event, she would require the care of nurse's aides for four to six hours per day to help her with her daily living activities, as she had enjoyed prior to her hospital admission in January. She also testified that she has wounds on her sacrum and that a more skilled nurse would be required to assist her with the changing of those bandages two times per day. She testified that she lives alone and has no family, but that she has neighbors with whom she is close who have always served as a support system.
In response to the questions about whether a transfer to her home would be agreeable, Darley, the licensed clinical social worker, was further questioned regarding the feasibility of such a transfer. Darley testified that such a transfer would require coordination of several social and medical services, including the procurement and delivery of a special bed to the plaintiff's home, which would take just a few days, the coordination with the department of social services to provide aides, which could take two weeks, and the setting up of home care by way of New England Home Care, or a like agency, which would take a few days.
The defendant indicated her willingness to return to her home if these services could be put in place.
The court makes the following thirteen findings of fact. First, the plaintiff, Midstate Medical Center, is an acute care facility operating a hospital in Meriden. Second, the plaintiff has 124 hospital beds. Third, on January 3, 2006, the defendant, Jane Doe, was admitted to the hospital with a diagnosis of bilateral gangrene of her feet. Fourth, the patient's medical condition improved to a point where she was medically discharged on March 8, 2006. Fifth, that medical discharge permitted her to return home or to a subacute care facility. Sixth, her present medical condition necessitates nutritional and diabetic assistance, the changing of bandages two times per day, a special bed and the care of nurse's aides for four to six hours per day. Seventh, there presently exists no medical necessity for the defendant to reside at the plaintiff, and she is mentally competent. Eighth, the defendant's refusal to be transferred to a subacute care facility, i.e., a nursing home or convalescent home, is based on her personal belief that such care is more suited to old people and that it is distasteful to her. Ninth, the patient cannot be admitted to an acute care facility, such as The Hospital for Special Care, Gaylord Rehabilitation Hospital or The Rehabilitation Hospital of Connecticut, as she does not meet their strict medical criteria. Tenth, the defendant has rescinded all medical authorizations which would facilitate and permit the plaintiff to transfer her records, a necessary step toward transferring her to a subacute care facility. Eleventh, the defendant's continued presence at the plaintiff makes her bed unavailable to more seriously ill patients. Twelfth, as a result of the defendant's presence at the plaintiff, the plaintiff has had to turn away more seriously ill patients, resulting in a squandering of scarce medical resources. Thirteenth, and finally, there exists no legitimate, justifiable reason for the defendant to remain at the plaintiff, and the plaintiff has complied with all the proper procedures to discharge the patient to a subacute care facility or to her home.
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