1. See Zoe's swollen cheek. This is parotitis caused from dehydration. Dr. Hoban operated on her on 2/9/99 at his office. [Zoe took an ambulance taxi alone to Dr. Hoban/Nall's office. This is missing from IHS records available to Carol]. Zoe had had no oral hydration or food from 1/10/99 until 1/25/99, while admitted to the hospital: Blake Medical Center. [She was then put on thickened liquids - the diagnostic barium video swallow study is missing - 7-year retention required]! She had a sore throat prior to 1/25/99 in the hospital, yet this was ignored. Zoe had a nasal tube [KEO] inserted on 1/13/99 without ever having had a barium video swallow test until 1/25/99. No doctor or family watched the 1/12/99 speech therapist swallow test. Zoe's family was not informed as to any alternatives, but was frightened by use of the term "aspiration pneumonia". There is no signed consent form for 1/13/99 but there is one for 1/20/99. On 1/20 Zoe pulled out all the tubes and at this time Carol was enlisted to go against her mother's will. Zoe is shown by FMQAI as having left the hospital on 1/22/99 [sic]. A nasal tube is a physical restraint and is not to be used without trying less restrictive measures first, according to Medicare. It has as side-effects: parotitis and possible "aspiration." Having the nasal tube inserted increases the risks of aspiration! Careful eating was never mentioned as an alternative!!! The first video swallow test was made on 1/25/99 (two weeks after admission) at Zoe's daughter's insistence. (They were being harassed for a stomach tube operation [PEG], which Zoe did not want. Zoe and Carol were already harassed on the first morning in the hospital on 1/12/99 before any swallow evaluation having been performed. Zoe was not allowed to have any oral food or drink until after a swallow test. [Zoe arrived at the hospital at 12:48 PM noon on 1/11/99] in alert and hungry condition. No swallow test was given until the next day at noon]. Zoe received zero nourishment from admission until late afternoon on 1/13/99. ____________________________________________ 2. See the bandage on Zoe's eye. Zoe was allowed to fall in the nursing home. On 2/8/99, she fell because after physical therapy, she was wheeled back to room 226 and left in the wheel chair alone. She was tired and attempted to get in bed alone. She fell. No problems were found after checking her out. Zoe had strong bones. Zoe was, however, billed to Medicare as 2-person full assist, yet was left alone in a wheelchair in her room after therapy. A test to rule out DVT was canceled at 6:35 AM on 2/12/99 by Dr. Unaeze. He supervised her dying until 2/13/99 at 3:45 PM, yet did not sign her death certificate or bill Medicare as required. ____________________________________________ 3. You can't see the catheter, but it is there. This was forced on Zoe in the Emergency room of Blake Medical Center within the first half hour on 1/11/99. Zoe was alert and oriented and did not want to be catheterized. Her daughter was ordered away from her so it could be done. A catheter is a physical restraint. It was unnecessary! There is no doctor's order found in the court Medical records, which were certified as the only medical records ! Also, catheterizing is against the Florida state guidelines for stroke care! Zoe had an unnecessary catheter inserted against her wishes and never removed until after death one month later! Carol saw a nurse's aide abuse her mother on 2/5/99 [Tarina refused to give Zoe a requested bedpan, while calmly making up Zoe's bed]. Carol was talked into leaving Zoe at the facility to "wean her of the catheter." Carol was frightened of the urine getting on her mother's now excoriated rear-end and agreed. She was not informed of "home health"! ____________________________________________ 4. The facility, where Zoe was located cost Medicare about $500 per day. The facility is IHS of Bradenton, (Integrated Health Services of Bradenton) at 2302 59th St. W., Bradenton, FL 34209. Zoe was transferred there directly from Blake Medical Center (on paper "Blake Hospital" see http://www.spcpi.homestead.com/SuncoastFLecoRe port-6-02.pdf for illegal use of fictitious corporate names)! Date of transfer from Blake to IHS was 2/2/99 at noon. There was no medical necessity, although it appears to be retroactively created with different sets of medical records! Dr. Arrojo, who was to Carol's knowledge supposed to be the attending physician, wrote in his discharge summary that she was transferred on 2/1/99 (one day earlier - This required report was not written until almost 3 months after Zoe's death- against the laws of Florida and the United States). What is the matter with AHCA? Where are the citations? |