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Day 3 Texas Nurse Trial


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2/11/2010
Alvin Wolff Jr.
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Day three in the trial of a former Winkler County Memorial Hospital
nurse included more revealing testimony from key figures in the case.

From Judge Rex warning the audience once again, to testimony from the
Sheriff, the hospital administrator and nurses inside the hospital, day
three of the trial saw heated direct and cross examinations of seven
witnesses with the prosecution and defense getting to the heart of the
issue.

The morning began with Winkler County Sheriff, Robert Roberts, on the
stand. Roberts admitted to defense attorney, John Cook, during
questioning, that nothing disparaging was in the original letter sent by
Anne Mitchell to the Texas Medical Board and that it was not
"non-governmental" in nature. The Sheriff did say he believes the
patient file numbers in the letter were confidential, although they do
not reveal any names, dates of birth or identities. Former Winkler Co.
Nurse, Cendy Antley, shared her thoughts on today's testimony.

"It really concerns me that there is this good old boy system going on
and that my county is suffering because of it", she said.

Next, Winkler Co. Memorial's Doctor Kenneth Winton took the stand and
admitted he's been reprimanded by the Texas Medical Board before. The
defense asked Winton whether the medical mistakes Dr. Arafiles made,
would be made in larger, professional hospital. Winton responded by
asking Attorney Cook, whether he was suggesting Winkler Co. Memorial is
not professionally staffed, to which Cook said, "I think the evidence
has made that much clear".

Ms. Antley believes the case, which has drawn national attention, could
get even bigger.

"One day this could become a book, this could become a movie because
their careers are ruined. That was Anne she kept coming. They didn't
like it. They wanted to shut her up and I think the civil trial will
bring to light a lot of that", she said.

Then, hospital administrator, Stan Wiley, faced a long line of questions
in cross-examination. He explained that the only reprimand handed to Dr.
Arafiles from the hospital was telling him “not to do it again”. This
includes improper surgeries, wounding a patient, sending a patient with
appendicitis home without care, and sticking a needle into a patient's bone.

"That is not a standard of care in any E.R. That is ridiculous, we don't
do that in America", said Antley.

Once the prosecution decided to rest, the defense called several former
hospital employees to the stand, including Doctor Naomi Warren, who said
she sent a letter of her own to the TMB regarding her concerns about
patient safety at the hospital. Dr. Pham, a colleague of Dr. Arafiles,
said he's had concerns about Arafiles' conduct. Winkler Co. Judge,
Bonnie Leck, testified that she thinks Anne should not have been fired.
Then former Winkler Co. Rural Health Clinic nurse, Debby Egger, took the
stand.

"Not for harassment. It was for patient safety", she explained to CBS 7
right after her testimony.
Finally, the defense called Lolly Lockhart to testify. Lockhart, a
former Texas Medical Board employee (PhD, RN) stressed that the board
weeds out possible false or harassing complaints from legitimate
complaints: meaning Doctor Arafiles probably had nothing to worry about.

"I've never seen any retaliation like this, ever in my almost 50 years
of nursing practice", said Lockhart.

Prosecuting Attorney, Scott Tidwell continued attempts to establish
harassment by Anne Mitchell directed toward Doctor Arafiles. A handful
of the prosecution's witnesses claim that Mitchell called Arafiles a
“witch doctor” and told them quote "we need to get this SOB out of here".

Just a day ahead of a likely finale to the trial, Ms. Lockhart says
she's holding her breath for nurses everywhere.

"If this case is not won by the nurse, it could virtually shut down all
reporting of all professional boards. Who would want to run the risk of
facing a criminal challenge just because they reported what they were
concerned about".

Doctor Rolando Arafiles, County Attorney Scott Tidwell and
administrator, Stan Wiley, all declined our interview requests.

The trial continues this morning and we’re told the jury may have their
ruling by the afternoon.

Thursday, February 11

The State and the Defense have put on their cases and rested.  This morning, Anne’s attorney has finished her defense.

The State had to prove five elements to prove Anne misused official information: 1) Anne was a public servant (all public employees are), 2) she had access to information because of her employment, 3) that information not public, 4) Anne used the information with the intent to harm another, 5) the information was used for a nongovernmental purpose.  The State’s evidence focused on the last two elements because the prosecutor told the jury that those were the two most in dispute.  The State’s main evidence consisted of several witnesses who testified about two to three occasions on which they heard Anne make statements such as “Dr. Arafiles will be gone in a year” “he is not a doctor”  “he is a witch doctor.”  There was also testimony of an ongoing conflict between Anne and Dr. Arafiles.  She had refused to sign off on his original credentialing because hospital bylaws required physicians to have unrestricted license.  The State also focused on the need to follow the chain of command.  In cross examination, Anne’s attorney was able to get in good information about substandard care by Dr. Arafiles on cases Anne reported to Texas Medical Board (TMB).  The Defense showed that most of the witnesses who testified about Anne’s motives had only been contacted within the past couple of weeks and not before Anne was indicted.
 
On Wednesday, Anne’s attorneys began her defense and called several witnesses to testify.  The first was a nurse practitioner who had worked at the Winkler County Rural Health Clinic and left because of her concerns that issues relating to the care provided by Dr. Arafiles had not been addressed.  She had also filed a complaint against Dr. Arafiles with the TMB at the same time as Anne and Vicki (all worked together).  The NP testified that she has subsequently filed a second complaint.  She testified that Anne was motivated only by her concern for patients.  The second witness was an LVN, who testified about her concerns regarding Dr. Arafiles’ work at the clinic.  She also left because of those concerns and the stress they were causing her.  The Defense called the Winkler County judge (not the trial judge) testified that she knew Anne and Anne had discussed her concerns about Dr. Arafiles. The judge said Anne’s motive was patient concern. Lolly Lockhart, RN, testified as an expert witness on a nurse’s duty.  Dr. Pham, Chief of Staff at Winkler County Memorial Hospital, testified about concerns about Dr. Arafiles’ care. He also testified that Anne was concerned about patient care and that Anne is a good nurse.

Thursday morning, the defense called a medical expert, who testified that he had reviewed the five cases cited in the complaint to TMB and found substandard care.  The Defense has rested.  Next, the charge will be read to the jury, the Prosecution and Defense will give their closing arguments, and the jury will begin deliberation. 

The case is no less perplexing as to why Anne was indicted.  All witnesses (even the State’s) have agreed nurses have a duty to report unsafe care.






Category: Medical Malpractice


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