Disabled woman would cry "help me" caregivers claim

Disabled Woman Would Cry 'Help Me,' Caregivers Claim By Jeff Johnson CNSNews.com Congressional Bureau Chief September 03, 2003

(Editor's note: This report contains quoted language and descriptions of alleged multiple instances of denied medical care that some readers may find offensive.)

(CNSNews.com) - A federal judge Tuesday refused to stop a Florida court from ordering the removal of a disabled woman's feeding tube at the request of her husband. However, the judge gave the woman's parents ten days to amend their lawsuit against the husband, the hospital caring for the woman and the hospice where she is being kept in anticipation of her death by starvation or dehydration. The lawsuit also named the husband's attorney as a "non-party co-conspirator" to the alleged violations.

Robert and Mary Schindler filed an emergency complaint Saturday with the U.S. District Court for the Middle District of Florida in Tampa in an effort to block their daughter's husband and legal guardian, Michael Schiavo, from moving forward with plans to remove his wife's feeding tube. Thirty-nine year old Terri Schindler Schiavo suffered a brain injury in 1990 under questionable circumstances. That injury, complicated by a lack of therapy for more than a decade, has required that she be given nutrition and hydration through a gastrostomy or "feeding tube."

Since receiving a $1.2 million medical malpractice award on behalf of his wife, Schiavo has provided only subsistence care for her and, based on affidavits included with the Schindlers' suit, allegedly forbidden medical professionals from providing his wife with any therapy or rehabilitation. He is currently allowing her to receive limited medical treatment for a severe infection under a court order.

Three medical professionals who had cared for Terri in the past filed affidavits accompanying the lawsuit, disputing Michael Schiavo's claims that his wife was in a "Persistent Vegetative State," which is the requirement under Florida law for a feeding tube to be removed. The medical experts also chronicled a long history of alleged denial of care and therapy by Schiavo.

Carolyn Johnson, a Certified Nursing Assistant (CNA), cared for Terri in a nursing home in the early 1990s. She described her shock at being ordered not to provide the same care for Terri as a patient in the same room with a similar brain injury was receiving.

"I learned, as part of my training, that there was a family dispute and that the husband, as guardian, wanted no rehabilitation for Terri," Johnson explained. "Once, I wanted to put a cloth in Terri's hand to keep her hand from closing in on itself, but I was not permitted to do this, as Michael Schiavo considered that to be a form of rehabilitation."

Another CNA, Heidi Law, cared for Terri at a convalescent center in the mid and late 1990s. Law described similar orders she received not to encourage Mrs. Schiavo's recovery.

"I know that Terri did not receive routine physical therapy or any other kind of therapy. I was personally aware of orders for rehabilitation that were not being carried out," Law alleged in her affidavit. "Even though they were ordered, Michael [Schiavo] would stop them. Michael [Schiavo] ordered that Terri receive no rehabilitation or range of motion therapy."

Law also alleged that her attempts to document Terri's potential for improvement were thwarted.

"I made extensive notes and listed all of Terri's behaviors, but there was never any apparent follow-up consistent with her responsiveness," Law said. "There were trash cans at the nurses stations that we were supposed to empty each shift, and I often saw the notes in them."

Law directly disputes Michael Schiavo's claim that Terri is in a Persistent Vegetative State, as well. In her affidavit, she detailed how she routinely provided Terri with a wet washcloth filled with ice chips to keep her mouth moistened and, on at least three occasions, fed Terri flavored gelatin.

"I personally saw her swallow the ice water and never saw her gag. [Another CAN] and I frequently put orange juice or apple juice in her washcloth to give her something nice to taste, which made her happy," Law recalled. "On three or four occasions I personally fed Terri small mouthfuls of Jell-O, which she was able to swallow and enjoyed immensely."

Carla Sauer Iyer was a Licensed Practical Nurse (LPN) at the same convalescent center in the mid 1990s, and also cared for Terri. She described Mr. Schiavo as being "focused on Terri's death.

"Michael [Schiavo] would say, 'When is she going to die? Has she died yet?' and 'When is that bitch going to die?'" Iyer charged. "Other statements which I recall him making include, 'Can't anything be done to accelerate her death, won't she ever die?' When she wouldn't die, Michael [Schiavo] would be furious."

Conversely, Iyer said that when she would have to call Schiavo to inform him of a downturn in Terri's condition, Schiavo would be elated.

"Michael would be visibly excited, thrilled even, hoping that she would die," Iyer recalled. "He would blurt out, 'I'm going to be rich,' and would talk about all the things he would buy when Terri died, which included a new car, a new boat and going to Europe, among other things."

Iyer also described incidents of Terri Schiavo talking, moving voluntarily and responding to external stimuli, descriptions that Iyer said were removed from Mrs. Schiavo's medical records. Both Law and Iyer reported Terri verbally communicating, also contradicting Michael Schiavo's claim that his wife was in a Persistent Vegetative State.

"During the time I cared for Terri, she formed words. I have heard her say 'mommy' from time to time, and 'momma,'" Law recalled. "She also said 'help me' a number of times."

Iyer described Terri as "alert and oriented," and said Michael Schiavo "systematically distorted" Terri's medical condition.

"Terri spoke on a regular basis while in my presence, saying such things as 'mommy' and 'help me,'" Iyer recalled. "'Help me' was, in fact, one of her most frequent utterances. I heard her say it hundreds of times."

The lawsuit filed by Terri's parents accuses Schiavo, both personally and in his official capacity as Terri's legal guardian, of violating the Americans with Disabilities Act for refusing to provide appropriate medical care and rehabilitation therapy, which are required by the law and for seeking to deprive her of nutrition and hydration, which is forbidden by the law.

George Felos, Michael Schiavo's attorney and a noted author and advocate in Florida's so-called "right to die" movement, is also named as a "non-party co-conspirator" in the lawsuit. The Schindlers allege that Schiavo, with Felos' help, sought to deprive Terri of her due process rights under the Fifth and 14th Amendments to the U.S. Constitution.

The suit charges that Terri was denied a guardian ad litem during most of the legal proceedings in which her husband sought to end her life and, the remainder of the time, suffered from "ineffective assistance of counsel, due process violations, and blatant conflict of interest with Terri's guardian, defendant Michael Schiavo," who is responsible for seeing that her legal interests are represented.

The only guardian ad litem and the only attorney to represent Terri prior to her parents' intervention in the case were removed when the attorney suggested that Michael Schiavo had a conflict of interest that prohibited him from serving as Terri's guardian.

The complaint also alleges that Schiavo and Felos conspired to deprive Terri of access to her priest in violation of the First Amendment and that the use of a 1999 Florida law in her case represented a Fifth Amendment due process violation of the constitutional prohibition on ex post facto legislation since Mrs. Schiavo had suffered her injury in 1990.

All of the cumulative rights violations are alleged under 42 USC 1983, which provides that, "Every person who, under color of any statute, ordinance, regulation, custom, or usage, of any State or Territory or the District of Columbia, subjects, or causes to be subjected, any citizen of the United States or other person within the jurisdiction thereof to the deprivation of any rights, privileges, or immunities secured by the Constitution and laws, shall be liable to the party injured in an action at law, suit in equity, or other proper proceeding for redress."

The hospice where Terri Schiavo is being kept and the hospital where her infection was supposed to have been treated are also accused of violating the Rehabilitation Act of 1973. That law requires that "handicapped" receive comparable medical care to that given able-bodied patients with similar conditions or injuries. Both facilities are subject to the Rehabilitation Act because they receive federal Medicare funding. The hospital is also charged with violating provisions of the Social Security law in 42 USC 1395dd, which requires the examination and appropriate treatment of emergency medical conditions and forbids the discharge of patients before their conditions are stabilized. The Schindlers believe their daughter was prematurely discharged from the hospital on more than one occasion in an attempt to hasten her death.

"The purpose of this lawsuit is to invalidate the lower court's decision," Felos told the Tampa Tribune Tuesday.

U.S. District Judge Richard Lazzara gave the Schindlers ten days to file an amended version of their lawsuit and offered Felos an additional ten days to respond. He would not, however, block a hearing scheduled for Sept. 11, during which Pinellas-Pasco Florida Circuit Judge George Greer is expected to set a date for Terri Schiavo's feeding tube to be removed.

Attorneys for both sides told reporters after the emergency hearing Tuesday that they do not expect Greer to set that date any earlier than the 20-day period set by the federal court for the Schindlers' amended complaint and Felos' response.

The following is from a website that fights the euthanasia movement:

Background

It is not clear what exactly caused Terri to collapse on February 25, 1990. What is clear is that the oxygen supply to her brain was cut off, leaving her permanently brain damaged. The most common theory is that, at the age of 26, Terri had a heart attack brought on by a low potassium level caused by an eating disorder. Another more recent theory suggests she may have suffered a serious neck injury.

Terri’s husband, Michael Schiavo, a respiratory therapist and nurse, recounted that he had awakened at 5 a.m. and saw Terri collapse to the floor. Her heart had stopped beating, and her brain was without oxygen for about five minutes. [St. Petersburg Times, 1/30/00]

Almost three years later, a jury awarded Terri approximately $700,000 for her on-going medical care in a malpractice suit filed by Michael against her doctor. The case rested on the fact that her gynecologist neglected to diagnose her low potassium level even after having her blood tested. The same jury also awarded $300,000 to Michael for loss of companionship. Ironically, during that trial Michael’s attorney, Glenn Woodworth, showed a video of Terri, and argued that, even though she was in a "vegetative state," "you can tell she has some sense of her predicament." He also pointed out to the jury that "[on the film] she knows her husband and looks into his eyes." [St. Petersburg Times, 11/12/92, 1/25/00]

But not long after the successful malpractice suit, Michael, Terri’s legal guardian, decided it was time to take her off life support and refuse antibiotics for infection. Since Terri was not on a ventilator or any other high-tech life support system, that meant withdrawing all her tube-provided food and fluids. The result: certain death by dehydration within one to two weeks. Terri’s parents, Robert and Mary Schindler, vehemently opposed Michael’s decision.

Michael & the Schindlers go to court

The battle over Terri’s care, or lack of it, ended up in the courtroom of Pinellas County Circuit Court Judge George Greer, who conducted a hearing in January 2000. Michael sought the court’s permission to stop Terri’s tube feeding, arguing that, prior to her brain damage, Terri had told him that she would not want to be kept on life support. Terri’s parents said that Michael never mentioned that Terri didn't want life support until after the malpractice settlement and that ,with further treatment, her condition could improve.Judge Greer appointed attorney Richard Pearse, Jr., to study the case and recommend a solution. Pearse’s report questioned Michael’s credibility, pointing out that he had stopped pursuing treatment for Terri only after the malpractice award. If Terri died, Pearse concluded, Michael would inherit the $700,000 and be legally free to marry a woman he‘d been engaged to for four years. If he divorced Terri, he would lose any claim to the $700,000. Michael’s attorney, George Felos, countered that Pearse was personally biased against the removal of feeding tubes and that the reason Michael had not filed for divorce was that he didn’t want the Schindlers to have the authority to keep Terri on life support. [St. Petersburg Times, 1/26/00]

On February 11, 2000, Judge Greer ruled that—in spite of the fact that Terri left no written evidence or advance directive indicating a wish to forego life support—Michael could order all food and fluids withheld from Terri starting on March 12. Greer later changed the target date until after the Schindlers had exhausted all appeals.

...

Question of abuse surfaces

During the hearing, one of the doctors testified that Terri had a "suspiciously rigid neck," and that the only other time he had seen this in a cardiac arrest patient was in a case of an attempted strangulation. This testimony prompted Pat Anderson, the Schindlers’ attorney, to reexamine Terri’s medical records. Among those records was a report on a total-body scan performed on Terri in 1991, 13 months after she collapsed. The scan showed that Terri had fractures of the first lumbar vertebra as well as several thoracic vertebrae, fractures of both sacroiliac joints and both knees and ankles, multiple rib fractures, and a compression fracture of her thigh. Doctors who reviewed the scan and the report concluded that she had a history of severe physical abuse. "Somebody worked her over real good," one physician said. Terri’s records also indicate that her progress in rehabilitation was hampered by "ossification" or "bone matter that forms around fractures," which indicates that the fractures were not fresh. [World Net Daily, 11/13/02; Tampa Tribune, 11/13/02; St. Petersburg Times, 11/13/02]

Judge Greer denied Anderson’s motion to allow discovery of this body-scan evidence during the hearing. His denial will be one of the issues before the Appellate Court. [www.terrisfight.org]

Michael’s attorney called Anderson’s motion "garbage," calling it "rife with unattributed hearsay, rank innuendo and libel." [World Net Daily, 11/14/02]

But during the January 2000 hearing, Terri’s friend and co-worker testified that she frequently saw bruises on Terri and that Terri had said they were from her husband "pinching her." The friend also said that Terri and Michael had had a violent argument on the day Terri collapsed and that she had tried to convince Terri not to stay home that night. Terri ignored her friend’s advice. [World Net Daily, 11/13/02]

What concerns Anderson and the Schindlers is the fact that, just prior to this latest hearing, Michael filed a petition requesting that the malpractice settlement money reserved for Terri’s care be used to pre-pay her cremation and burial costs. [World Net Daily, 11/1/02] Judge Greer granted the petition, a clear indication of his bias in this case. But, for the Schindlers, the request for a quick cremation coupled with the allegation of abuse "raises many doubts as to what really happened" the night Terri collapsed. [www.terrisfight.org]

And, as for the $700,000 awarded to Terri for her long-term care, it’s almost gone. That’s how Michael has paid for all the legal costs he’s incurred trying to end Terri’s life. [AP, 11/16/02; World Net Daily, 11/1/02; Ragged Edge Online, Issue 6, 2002]

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