A former nursing director and the final defendant in a landmark case involving inappropriately medicating patients at a Lake Isabella skilled nursing facility was sentenced to three years in prison Wednesday.
Three patients died and others suffered adverse reactions at the Kern Valley Healthcare District facility after Gwen Hughes ordered they be given psychotropic drugs not for therapeutic purposes but for convenience's sake, state Deputy Attorney General Steve Muni said. The case is believed to be the first of its kind in the country in which doctors and nurses have been held criminally liable for the improper administration of psychotropic medications.
Muni said Hughes, 59, ordered the medications to control anyone she found disruptive. These medications led to swift declines in the health of the patients who received them.
The drugged residents suffered serious side effects ranging from severe lethargy that inhibited eating and drinking to weight loss, drooling and incoherence. At least 22 residents at the facility were over-medicated, according to the Attorney General's office.
Hughes, in a wheelchair and using a breathing apparatus, made no comment during sentencing in Department 2 of Kern County Superior Court. Her attorney, Dana Kinnison, said he sympathized with the victims' families, but he argued for a lesser sentence because Hughes did not intend malice and the medications were given with the approval of others at the facility.
Judge Michael G. Bush, however, said Hughes violated the trust of family members who placed their loved ones in her care. He said the 3-year sentence was appropriate.
"These folks that are placed there need to be safe," he said.
Dealing with grandmother's death
Tammy Peters, granddaughter of victim Fanny May Brinkley, cried tears of joy following the sentencing. Brinkley died Dec. 23, 2006 after receiving Depakote, a drug used to treat seizures and that can cause drowsiness, weakness and depression.
After not eating for six days, she was rushed to the emergency room, where she died.
Peters said putting her grandmother in a nursing home was not an easy decision, but the family thought it was for the best. They thought she'd be given the care and respect she deserved.
"I will never trust a nursing home to care for a loved one again," Peters said.
Bonnie Feiler, another of Brinkley's granddaughters, said prison time for Hughes is a step in the right direction. She said her grandmother meant a lot to her, and had lived with her family when Feiler was a child.
Brinkley bought Feiler her first Bible, and the two walked everywhere together, Feiler said. After seeing scary movies Feiler would ask to sleep in her grandmother's bed, but her grandmother gave her some advice to calm her nerves.
"It's not the dead you need to be afraid of, it's the living," Feiler said her grandmother told her.
Tish Orr, a nurse who had worked at Kern Valley Healthcare District off and on for 25 years, said the skilled nursing facility completely changed when Hughes was hired. Staff were bullied into giving the medications Hughes ordered, and Orr said she was often at odds with Hughes because Orr, as a charge nurse, wouldn't force other nurses to give the psychotropic drugs.
Orr said she suffered a nervous breakdown shortly after Hughes was dismissed from the facility, and she's never returned to nursing.
"I agreed with the sentence, except I didn't think it was harsh enough," Orr said.
Natalie Davis, another former nurse who worked at the facility, said the patients who were overmedicated were so out of it that they couldn't even say what their names were. Davis quit instead of having to continue to work under Hughes.
The criminal complaint filed by the California Attorney General's office said the two other patients who died were Eddie Dolenc and Joseph Shepter.
Dolenc was given unnecessary anti-psychotic medication that caused him to become extremely sedated and unable to eat or drink, the complaint said. He died one month after being admitted to the facility, likely from dehydration or pneumonia.
The complaint said Shepter went to the emergency room on Jan. l4, 2007, for dehydration and died five hours later. He had been given three anti-psychotic drugs.
An investigation conducted by the state Department of Public Health began in January 2007 in connection with complaints about the Healthcare District, and it was discovered residents had suffered adverse reactions as a result of "chemical restraints and unnecessary medications," according to a news release from the Attorney General's office.
Nurses at the Kern Valley facility said the drugging of patients began when Hughes was hired in mid-2006, according to the criminal complaint filed by the California Attorney General's office. She held meetings in which she and the staff discussed residents' behavior and Hughes told the pharmacist what drugs to prescribe, the nurses told investigators.
Hughes threatened to fire nurses or have their licenses revoked if they refused to give the medications, the complaint said.
Hughes was dismissed from Kern Valley Healthcare District in January 2007, when the attorney general's investigation began. She pleaded no contest Oct. 11 to one count of causing harm or death to an elderly or dependent adult, and in return nine other felony charges were dismissed.
In addition, Hughes agreed to surrender her nursing license. She is the final defendant in the case, and the one to receive the most substantial punishment.
Pamela Ott, former administrator of the facility, was sentenced to probation and 300 hours of community service in late August. Ott, instead of conducting her own investigation into the reports of overmedication, relied on Hughes' reports and took no action, Muni has said.
Dr. Hoshang Pormir, who signed off on Hughes' orders after the drugs were administered, was sentenced in July to three years' felony probation. In addition, the Medical Board of California issued disciplinary actions and a two-year probationary period against him that, among other things, prohibits him from engaging in the solo practice of medicine and from practicing in skilled nursing facilities, convalescent homes and assisted living facilities.
Pharmacist Debbi Gayle Hayes accepted a plea deal in 2009 and received three years' probation.
With the criminal portion of the case over, civil proceedings will likely soon resume against Kern Valley Healthcare District. Attorney Daniel Rodriguez, representing two families of patients who he said were overmedicated, has filed a lawsuit against the facility for elder abuse and civil rights violations.