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March 11, 2005     Cape Gazette
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March 11, 2005

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20 - CAPE GAZETTE, Friday, March 11 - March 14, 2005 Suit Continued from page 1 Attorney for Beebe Medical Center John Elzufon told the jury in his opening statement that mis- takes were made in Bailey's care that cannot be condoned or ex- cused. "You will award money," he said, to compensate Anthony "Tony" Bailey, Julie Bailey's three sons and her father for the loss of her life. "The Bailey fami- ly is clearly entitled to compensa- tion, and nothing will be done to contest that," he said. However, he said, "that doesn't mean, 'I don't care.'" Beebe Medical Center will refute the "al- legation that the men and women who have devoted their lives to caring for patients don't care about patients. The concept that Beebe Medical Center was dis- charging patients [to the convales- cent center] just to make money is just not true," he said. Elzufon also said while reports would show there were problems at the convalescent center, they al- so indicated that the facility's plans for correcting the problem were accepted by state inspectors. Elzufon also explained he would present his case after the plaintiffs did and he asked jurors toreserve judgment until they had heard the entire case. The trial, expected to last about four weeks, will hinge on whether care deficiencies in Bailey's case were serious enough that punitive damages are justified. File boxes filled with documents for both sides lined the courtroom's entire first bench, and defense attorneys said they have about 90 poster- sized documents and photographs ready to show the jury. In the first day of testimony, the jury heard a grieving husband's description of searching for his missing wife just after she was ad- mitted to the convalescent center and a paid nursing home expert's testimony that the tragedy was an accident waiting to happen. Bailey's husband, a Lewes resi- dent, first described the moment at Kupchick's restaurant, when he met Julie and instantly fell in love. They were married within six months. "It was a wonderful marriage," he said. She was also a terrific mother to three sons from an ear- lier marriage, a devoted nurse he said worked for Beebe for 20 years, and an avid gardener who loved to paint. Then he described a series of in- cidents that would lead to a diag- nosis of Alzheimer's disease. The first sign came when he discovered they were $10,000 in debt. 'rhat's too much money," he said. "It wasn't like Julie." She continued working at Beebe but began making mistakes that she couldn't explain. He de- scribed a trip when she was gone for hours while he was frantically calling state police, but when she finally showed up, she just laughed about it. By December 2002, Tony Bai- ley was taking her to adult day care at Gull House in Rehoboth Beach every day and caring for her at night. On Christmas Eve she became ill, and she was taken to Beebe Emergency Department, where she was treated for severe esophagitis. The following Satur- day, Dec. 28, Julie Bailey was moved to nearby Lewes Conva- lescent Center. "We were looking for some R and R for Julie and for me, too, to figure out what to do," Bailey said. He said he took some cloth- ing, including high-topped sneak- ers because she loved to walk, over to the center, where he filled out a long questionnaire. He was told the rest of the paperwork would be taken care of the follow- ing Monday. ,In the back of my mind, this was only going to be a temporary thing," he said. His wife had started her career at Lewes Convalescent Center, he said. "Julie trusted them." Satisfied at the time that his wife would be cared for, Bailey said he was completely exhaust- ed; physically and mentally, and he left for home, arriving there about 1 p.m. He immediately fell asleep on the couch, he said. At 5 p.m., he was awakened by a knock on the door. A Lewes po- lice officer told him that Julie had disappeared. He rushed to the hospital, where he was told that hospital staff had searched the fa- cility and she wasn't there. He began a search outside the facility, thinking she may have tried to walk home. "They only had her for two hours and they lost her. I just couldn't get it through my head that they lost her," Bailey testi- fied. "It was cold. I think it was 28 degrees," he said. "I had horri- ble visions of what might happen to her." He searched various routes she could have taken, finally reaching their home. "If she was trying to get there, I needed to be there," he said. By then, fire fighters, police and a helicopter were searching for Julie Bailey. Friends came by the house to ask where to search. Bailey testified convalescent center Administrator Owen Schwartz also went to his house during the search. Bailey testified that Schwartz said that was the first elopement in 22 or 23 years, a statement later contradicted by incident refiorts on file at the hos- pital that described at least five other elopements in a five-month period before Bailey was admitted to the facility. Finally, a hospital administrator called Bailey at home. "She told me they found her in the freezer," he said. "We're talking several hours," he said. "I was horrified." Bailey's voice broke when he described a later conversation with his wife's physician, Dr. Bhaskar Palekar. "He told me both hands and both feet are black," said Bailey, and could require amputation. Her temperature was 82 degrees. "He said coupled with dementia, it would be inhumane for me to al- low her to live." In the hours that followed, Bai- ley's condition improved. Color came back to her feet. Bailey said the high-topped sneakers saved them, but whirlpool treatments were ordered daily to try to im- prove circulation to her fingers. Bailey testified that despite orders that his wife was to receive med- ication before the painful treat- ments, he was there one day when the staff failed to provide painkillers before the treatment began. Despite her improvement, on Jan. 21, 2003, her doctor called to say Julie Bailey's heart had stoppsd beating. Expert testifies for family Bailey family attorneys also called Lance Youles, who testified as a paid expert on nursing home care. Youles said he had dxam- ined numerous documents related to the case, and as he spoke, Daniel stacked files on the wit- ness stand that soon rose nearly a foot high. Reading from enlarged docu- ments, Youles described the find- ings of state health department in- spectors who regulate nursing homes." Their reports indicated numerous deficiencies observed by the inspectors, such as leaving patients in one position for four to six hours at a time, which can re-' suit in pressure sores; failing to answer patient calls, considered a dignity issue; and failing to pro- vide adequate supervision for pa- tients who might wander or fall. Youles also testified that some of those deficiencies carried a rating that showed a patient had been harmed because of the problem cited. State officials repeatedly cited the facility for leaving medical carts, linen carts and other items in hallways. These were cited as a safety hazard because they pre- vent patients from using hallway handrails, and as a fire hazard be- cause they blocked evacuation routes. Youles said the reports also showed the deficiencies in kitchen management: food was too cold, the stove was encrusted with de- bris, and sanitation was unsatis- factory, among other problems. Youles testified one report in- eluded a criticism that went be- yond specific conditions in the fa- cility to criticize its board of di- rectors. The facility was cited because "the governing body failed to es- tablish policies to ensure safe op- eration of the facility," Youles said. That citation indicated in- spectors were sending a message to the board of directors, Youles said. He also said that while Beebe has produced five incident reports showing patients had eloped from the facility on five separate occasions, reference to only one of those situations could be found in state documentation. Also, although the incident oc- curred before Bailey was admitted to the convalescent center, it was documented only after an investi- gation of Bailey's case. "There's no evidence they found out about the other inci- dents," Youles said, although it was his testimony that such inci- dents would normally have been reported. Youles also testified that hospi- tals acquire nursing homes so they have a place to send patients that other nursing homes may not be willing to accept. Such patients may not require hospital care, but they may be too ill or may have problems that a specific nursing home is not equipped to handle. "If a hospital owns the facility, it will take whatever you send it," Youles said. The convalescent center was 30 years old when it was acquired in 1995, but Youles testified he saw no evidence that money had been invested to update the facility. "The primary purpose for this nursing home is a discharge outlet - a release valve, if you will, for the hospital," he said. "In my opinion, this incident was foreseeable. It was avoid- able. It was an accident waiting to happen. In my own opinion, it was reckless." That comment prompted a quick objection from Elzufon. The judge sustained it, and the ju- ry was directed to ignore that re- mark. On March 10, expert witness Dr. Kenneth Fischer and Julie Bailey's son, Shawn Connaway, testified for the plaintiff. Trial coverage resumes next week.