The Arlene Berry Death Coverup!

Introduction

There is a public interest in knowing how Arlene Berry came to her death and how her health care providers are implicated.

Arlene Berry was murdered May 24th of 2000 on the order of Dr.Edward Henry Jordan to cover-up medical stupidity. He treated her over the telephone, unseen, while sitting at home watching TV. He ordered a brain damaging neuroleptic drug following administration of a 30 mg opiate narcotic in the face of undiagnosed and untreated medical conditions, resulting in catastrophic decline.

The facts of this case have been taken from the deceased's medical record from the Kirkland and District Hospital. A very small part of the information contained herein comes from observations made by the family of the deceased. Virtually all of the information presented, with the exception of a few personal observations made by myself and based on the extensive research done, is now a matter of public record.

The allegations of negligence and homicide from which an inference can be made are mine alone and are indeed supported by the FACTS of the case, and by evidence based supporting data.

This paper represents a rare "exposed" case of wanton and reckless disregard for human life on the part of several nurses, and medical homicide (or liability murder) on the part of several doctors, with an attempted cover-up on the part of all concerned. In the very minimum, all of the doctors and nurses involved herein could potentially find themselves facing charges of criminal negligence causing death, or murder, conspiracy notwithstanding. The implications of the findings herein are so profound that, according to a hospital insider, Health Canada has issued a "gag-order" in an effort to save face (with so many doctors and nurses involved in this unnecessary death), a blatant attempt not only to prevent the media from becoming involved, but also as a means to deny justice. In my opinion the health authorities have also insinuated themselves into a conspiracy, or party accessory (after the fact) to a medical homicide. These political and ministerial thugs, attached to the public purse, including the sinister College of Physicians and Surgeons of Ontario and their corporate counterparts seem to think that they and the physicians they seek to shield are all above the law.

Published under a wide variety of titles internationally, the Arlene Berry case stands as a testament to what can only be construed as widespread corruption in Ontario's healthcare system.

In Memory of Arlene Berry

The FACTS

Arlene Berry developed "flu-like" symptoms suggestive of gastrointestinal illness within two weeks following radiation therapy, at the end of April of 2000. She died about about 10 days later, on the 24th of May of 2000. Total time lapse 24 days; mean 3 weeks plus, or just under 4 weeks.

In December of 1999, Arlene Berry was sent to Timmins & District Hospitalin Timmins, Ontario, where she was diagnosed, according to her physician, with "carcinoma of the left main bronchus with residual cancer of the aorta due to a complete collapse of the left lung".

Her family MD, Dr. Edward. H Jordan had been treating her 'assumptively' for what he termed a "suspected bronchitis". It took another doctor to read her X-ray chart, and to order more appropriate testing before anything was done.

On or about January 12th of 2000, Arlene Berry was admitted to the Timmins & DistrictHospitalin Timmins, Ontario, where she had a left lung pneumonectomyon January 13th of 2000, under the care of Dr. Claudio de la Rocha, a Cardiovascular and Thoracic Surgeon who immigrated to Canada from Mexico.

Following surgery, Arlene Berry was discharged home 5 dayslater. On or about March 16thof 2000, Arlene Berry returned to Timmins where she underwent follow-upstudy and testing at the same hospital, consisting of a CT scan, and a mediastinoscopy with mediastinotomy, as part of her post-operative evaluation.

What the family had found to be peculiar however, was a dramatic voice change following the mediastinal procedures, suggesting a "partial vocal fold paralysis" thought to have been procedure related. Although she began to regain her voice in the weeks that followed, the voice remained somewhat "whispery" for the memainder of her days.

Following that testing, Arlene confided "I don't have AIDS, or brain tumors, or anything like that, but I might have a "cyst", or "infection".

A cystis a suitcase for the infectious material inside. Some of them parasites with simulation of stroke related damage in cultured human nerve cells has been reported. Trapped blood (ie. from an old hemorrhage or occipital bleed) can also lead to the growth of cysts. Patients can be asymptomatic even if the cyst is quite large.

Arlene was diagnosed by de la Rocha as having "adenocarcinoma". Dr. de la Rocha performed a left lung pneumonectomy on January 13th of 2000; a follow-up was done April 16th of 2000 - detecting a "cyst" with an associated infection.

She was then referred to the Northeastern Ontario Regional Cancer Centre situated at the Laurentian Site, Sudbury, Ontario for consideration of radiation therapy, under the care of Dr. Hugh Prichard, a radiation oncologist. By the end of April 2000, Arlene Berry had completed her post-operative course of radiationtherapy. In light of this treatment, her condition was seen to be stable. She had been scheduled for X-ray follow-up in Sudbury on Tuesday May 30th at 2:30 PM.

Following radiation, Arlene Berry remained quite well, until about one week prior to her admission to the Kirkland and District Hospital on o May 23rd of 2000, with the exception of "a suspected UTI", which was never confirmed.

According to her Rx List, Arlene Berry had also been given Amoxicillinfor infection. Amoxicillan belongs to a class of penicillin-like drugs, side effects of which include severe nausea and vomiting, including abdominal pain.

According to the hospital record Arlene Berry was admitted to the Kirkland and District Hospital on May 23rd of 2000 by Dr. Spiller for "IV fluid and Gravol", evidenced at A-6. From that record it seems clear that either Dr. Spiller lied, or that he was totally oblivious to the administration of Morphine Sulfate evidenced at A-12. According to the same record she was admitted for "vomiting". Vomiting is not a diagnosis, but rather a symptomof many causes.

According to record she was given more than IV and Gravol. If not Dr. Spiller, who ordered the 30 mg MS Contin on his watch?

For the two-week period prior to her hospital admission, her headaches, were accompanied by stomach pain, loss of appetite, nauseaand vomiting, weakness, fatigue, and feeling unusually cold. In the last week of her life, she developed headaches which at times had become increasingly severe.

A-5 of the record documents the presenting complaint as "headaches, accompanied by severe stomach pain", and "abdominal pain ongoing for 2 weeks", for which she was prescribed "antibiotics".

Abdominal or 'stomach pain concurrent with nausea and vomiting points to the abdomen'as the source of the problem which should have been a 'red flag' suggesting the possibility of "intestinal obstruction". Abdominal pain can also be the result of "intestinal ischemia". The hallmark of intestinal ischemia is "abdominal pain". The features of abdominal migraine is an abrupt onset of severe abdominal pain followed by an abrupt discontinuation of symptoms. Abdominal migraine is one of the variants of migraine headache, ie. (headache lethargic migraine). A strong family history of migraine headachesis a common finding.

OP-53 documents a history of bloody bowel movements when voiding evidenced by "bloody BM's x 4 days" (bloody, black, or tarry stools). Bloody stools may signify bleeding stomach, diverticular bleeding, or intestinal infection. The same record documents "pale-looking and lethargic". Pale skin suggests decreased blood supply to the skin. Lethargy and drowsiness are often associated with moderate to severe dehydration, including congestive heart failure. Lethargy may also be caused by the toxic effects of waste products on brain function.

According to the record at OP-53 she was "Here 1 week ago for UTI. Last period on 6th of May". Onset of menstrual periodis closely related to onset of migraine headaches, including illness.

Case reports cited primarily in women having period in which a blood-soaked tamponmay provide an excellent breeding ground for the bacteria and is a significant cause of urinary tract infections.

The RN who saw her noted that she had been "taking morphine" for pain management, and also that she had recently "stopped" taking the morphine, noting her recent medical history that for "2 weeks" she had the "flu". The same record also documents a question mark (?) with respect to possible morphine allergies, seen at A-5.

OP-53 documents a history of Tylenol and Aspirin, including a documented "daughter states takes a lot", suggests a history of drugs that can break the gastric barrier, and damage the gastric mucosa, ie., NSAID's (non-steroidal anti-inflammatory drugs). Aspirin is the drug classically associated with Reye syndrome.

According to the patient's Rx list, Arlene Berry had been given sodium phosphate(used to treat constipation) while under the care of her oncologist, and sodium dosucate prescribed by her family MD, and to the best of my knowledge kept taking them following her discharge home, until her prescription ran out. She had found the prescribed laxitives to be ineffective and so turned to over the counter laxitive and tap water enemas for what appeared be drug opiate induced dysmotility. Enema is contraindicated in patients with fulminant disease, because of the danger of precipitating toxic megacolon or perforation of the colon.

(failure to educate pt)

The emergency department record at A-6, what I take to be Dr. Spiller's physical examination, documents a "soft, non-tender"abdomen, and "no masses".

The record at A-17 documents a "0" use of acc muscles; and a "0" use of abd muscles.

What appears to be a referral at A-6 of the medical record, a chart-copy from the admitting physician (Dr. Spiller), directed to the attention of the family physician Dr. Jordan, documents what I take to be a provisional diagnosis of "vomiting", while the record at N-11 documents "vomiting, lung CA". According to the same record she returned to the ED (emergency department) on May 23rd of 2000 "with the very same complaints". Rapid evolution of illness and patient return within 24-48 hours suggests a severe illness.

According to Dr. Jordan, "she had presented to the ED several days before with vomiting and it was thought that she had a UTI", to rule out delay in seeking treatment. According to the hospital record at A-8 "she was given antibiotics and sent home".

On examination, the physician who saw her documented positive bowel sounds with no rebound tenderness. evidenced at A-6.

At the time of her admission to the hospital, Arlene Berry's blood pressure was documented at 115/70bpm, with a pulse of 79 and regular. with signs of "mild diffuse weakness" and difficulty ambulating, evidenced at A-6. The same record documents a respiratory rate of 18, on admission. The normal adult respiration rate is 12 to 18 breaths per minute. At the time of this assessment, Arlene Berry was found to be "alert and oriented", with "NO Focal deficits".

According to the outpatient record at OP-54, the patient's recent head CT scan showed "NO METASTASIS", and her mediastinoscopy, a surgical procedure to examine the mediastinum inside of the upper chest between and in front of the lungs, were found to be "NEGATIVE". From that record it seems clear that NO clinically detectable metastasis were found.

The Health Management Record at A-21 of the record documents the patient's sensory cognitive perceptual pattern as "sedated". Increased sedation is also a serious side effect of many pharma agents, including electrolyte derangements which can mimic sedative intoxication.

The record at A-23 documents a "slurred"speech as evidenced by a checkmark in the upper left corner. Speech may be unintelligible, "slurred" or whispery with GBS, as the various muscles required to form speech are weakened.

The record at OP-54 dated May 22nd of 2000 documents a "haggard appearance", including "large blood trace leukocytes", what I take to mean leukocyte estrace, marked by an unusually high number of white blood cells (WBC's). When put on a fast, or a restricted diet, causing a steady reduction, in the course of three or four weeks the patients will begin to show a haggard appearance.

The Outpatient Record from the hospital dated May 22nd of 2000, seen at OP-54 documents a recent history of hematuria (blood in urine) for "three days". The healthcare provider who saw her made a diagnosis of UTI. The same record documents a prescription for Cipro, for treatment of urinary-tract infection. The belated test result however, what I assume to have been a urology test, or a bacterial culture test, evidenced at OP-55 of the record, later returned a finding of "NO Growth". A negative urine test can also suggest the presence of unusual bacteria or viruses causing symptoms of UTI.

The record at OP-54 documents "SEPTRA DS GIVEN BEFORE & CIPRO GIVEN AFTER". The same healthcare provider (whose signature is illegible) also made a notation with respect to the "flu", which was then directed to the attention of the patient's "family MD", namely, Dr. Jordan.

Cipro is a broad-spectrum antibiotic indicated in the treatment of a variety of infections, including the flu. Bactrim/Septra is also the antibiotic most frequently associated with drug-induced aseptic meningitis. Certain combinations of medications, such as penicillin and sulfa-based antibiotics can cause the body's immune system to react by over-stimulation.

N-9 of the nurses' notes documents a precaution for a "resistant bacteria" ,as evidenced by a check mark in the upper right hand corner of that document, under the subheading for "INFECTION CONTROL PRECAUTIONS". The same precaution is also noted in the upper right hand corner of the record at A-21. There are no further details.

Arlene Berry was still neurologically responsive when I saw her following her admission. She was able to reach and use for herself the kidney basin at her bedside table, as she occasioned to vomitmore of the same flu-like "yellowish liquid" that she had done so many times on the days before, and in fact used it for herself in our presence, at which time a cool cloth was provided by the nurses, as evidenced by the record at N-6.

The same record documents upwards of "100cc yellowish fluid", what is frank 'bile', or "bilious vomit". The time of that assessment was documented at 1915 hours on May 23, 2000, following Arlene Berry's admission to the Kirkland and District Hospital. The same record documents that the patient had stated she was "very tired", whereupon she was then assisted to bed, as evidenced at N-6.

Vomiting is a symptom of many causes. The clinical difference between bilious and non-bilious vomiting (ie, vomiting yellow or green) is critical in distinguishing life threatening abnormalities.

The word "bilious"comes from the word cholera. The word cholera is Latin for bilious disease and has come to indicate a severe intestinal infection. People with bowel obstructions may repeatedly vomit yellow, or green colored bile and a history of frequent bilious vomiting in the presence of abdominal pain should have been a 'red flag' suggesting intestinal obstruction, which should have been treated emergently.

Arlene Berry also complained of being "cold" and so the nurses provided her with extra blankets, evidenced at N-6. Her very last words were that she was "feeling a little better", also evidenced by that record.

Feeling unusually "cold" with chilly feelings is a common finding in many subjects with Guillain-Barré Syndrome.

A-26 documents a body temperature >37.0 . According to the record the documented temperature is slightly above 37ºC at approximately 37.8 suggesting a low-grade fever. Pathogenic bacteria grow best at human body temperatures in the 37ºC range.

N-5 of the Nurses' Notes documents "Sudden large queery bloody emesis,reddish brown liquid" at 0255 hours, on May 24th of 2000. Submit, when everything in the intestine slows down, everything in it backs up.

N-3 documents an "Suctioned orally thick brownish secretions"at 0320 hours (in the small hours of the morning), suggestive of a more significant backup of intestinal material, i.e., vomiting of fecal matter due to obstruction of the bowel, evidenced by family present as "a large chocolate coloured (gross appearance), odorless, pasty material, looking pretty much like feces".

If you are unable to open your bowels due to an obstruction somewhere, then your feces cannot exit your body via the normal route and you can get nauseated and start to vomit fecal matter. This condition requires urgent medical attention and probably surgery.

The same record documents "suctioned down ET tube several times for small amount of brownish mucous" (a reddish brown liquid, suggestive of old blood or admixture of blood and gastric content) at 0330 hours, while A-17 documents "being suctioned for moderate amounts of coffee-ground emesis by RN" at 0330 hours on May 24th. Suctioning infers that the patient's airway has become obstructed with secretions or debris. Bulbar weakness and difficulty handling secretions and maintaining an airway may be observed in the GBS patient.

The record at A-5 documents a blood pressure of 115/75 at 17:05 hours on May 23rd that by 18:45 hours had dropped to 100/50 bpm.

Marked blood pressure lability with alterations between hypertension and hypotension following paresis suggests an atypical course of GBS.

The record at A-20 documents a Glucose of 13.2 Hmmol/L): >236 mg/dl. (the normal range is 4.1 - 7.8). High blood sugar usually comes on slowly. To convert mmol/l of glucose to mg/dl, multiply by 18. (13.2 x 18 = 237.6).

Glucose levels above 11.1 mmol/l (200 mg/dl) at 2 hours confirms a diagnosis of diabetes. Symptoms of severe high blood sugar include drowsiness and difficulty waking up.

A-19 of the record documents an elevated WBC Count of 22.4 H. WBC = Leukocytes. The presence of an elevated WBC count is called Leukocytosis. White cell count is actually 22,400. A normal WBC is 5,000 to 10,000. Normal Adult Range: 3.8-10.8 thous/mcl Optimal Adult Reading: 7.3

WBC leukocytes are the body's primary defense against bacterial infection and also reflect the degree of physiologic stress. WBC's are also elevated with dehydration, and hyperviscosity secondary to dehydration.

If the total WBC is high due to a rise in neutrophils and eosinophils, then an allergic, or parasitic process is most likely. An increase in the WBC count (leukocytosis) is also a typical response to noxious stimuli.

The record at A-19 documents a Neutrophil count of 92.0 H with an absolute neuts of 20.0 H.

Neutrophils, are also known as "segs","PMNs"or "polys"(polymorphonuclears). CSF in bacterial meningitis is typically dominated by the presence of PMNs. PMN’s generally predominate in bacterial infections. "The presence of polymorphonuclear granulocytes does not rule out the diagnosis of Guillain-Barré syndrome". Eur J Neurol 10(5): 479-86.

Neutrophilia (or neutrophil leukocytosis) is a condition where a person has a high number of neutrophil granulocytesin their blood. Neutrophilia may be due to a number of acute and chronic causes such as infection, inflammation, emotional stimuli, drugs, metabolic hormonal, and endocrine disturbances, including hematologic abnormalities.

Wegener's granulomatosis, granulomatous cerebral amebiasis, vasculitis, and heart attack are high on the order of Neutrophilia.

Leukocytosis, especially neutrophilia, indicates systemic infection and is rare in the absence of bacterial "superinfection", also called "superbugs" are bacteria, viruses or mixed infection which are resistant to antibiotics.

The record at A-19 documents a Lymphocyte count of 2.0 L(low) suggestive of lymphocytopenia in which lymphocytes (T-cells) are reduced with nutritional deficiency, infection, and ascites due to "fluid build-up in the abdomen", and/or an exhausted immune system. If bacterialinfection is present in ascites this may suggest spontaneousbacterial peritonitisin which abdominal pain is a prominent finding. If peritonitis is not treated promptly and effectively multisystem organ failure occurs rapidly.

A-19 documents a Red Blood Cell (RBC) Count of 4.30(3.80 - 5.80 is normal), but the HCT (Hematocrit) is very low, with a reduction suggestive of anemia. Anemia is also a prominent cause of dyspnea when the hemoglobin concentration falls below 8-10 g/dl.

The same record seen at A-19 documents an HCT count of only 0.361 L (low): HCT is the measurement of the percentage of red blood cells (RBC's) in whole blood. The hematocrit (HCT) is another way of measuring the amount of hemoglobin (Hb), and in this case it is very low. Thus anemia is present when HCT is <>1.0 x 109/L.

The monocytes are a type of phagocyte which mature into "macrophages"; they are important germ eating cells. The majority of patients with Guillain-Barré syndrome will have 10 or fewer monocytes.

Patients with a low monocyte count have a higher risk of getting sick from an infection, particularly those caused by bacteria. In cancer, or leukemia, the monocytes become elevated. In this case the monocyte count is well below the normal range.

A-20 documents an O2SAT (oxygen saturation)- arterial oxygen saturation (SaO2) of 98.9 H, with with a NORMAL reference and an evident run time of 1720 hours, notably several hours after the patient's alleged time of death, following her transfer out to Sudbury on May 24th of 2000.

The same record documents an Arterial Ph of 7.437. Hydrogen ion concentration expressed as pH "Power of Hydrogen". A Normal pH is 7.35 - 7.45. The pH is a parameter expressing the acidity of a solution. Neutral pH is 7. For example, the pH of blood is normally 7.4 and that of muscle is 7.0. pH under 7 is acid; pH over 7 is basic or alkaline.

Compensation has occurred when pH has returned to normal range. Compensation is not always total. It may be partial in which case the pH will remain slightly decreased or slightly increased. The time of that assessment is documented at 0400 hours.

A-18 of the medical record documents an "inferior ischemia", a sign of reduced oxygen supply to vital organs due to reduced or poor blood flow to the heart. An "inferior ischemia" is the hallmark of "impaired organ perfusion", as it implies that, unless corrected, there may not be enough oxygen in the blood to sustain vital organs.

The same record at A-18 documents "Sinus Tachycardia". Sinus tachycardia occurs when the sinus rhythm is faster than 100 beats per minute. The rhythm is similar to normal sinus rhythm with the exception that the RR interval is shorter, less than 0.6 seconds. P waves are present and regular and each P-wave is followed by a QRS complex in a ratio of 1:1. At very rapid rates, the P-waves might become superimposed on the preceding T waves such that the P waves are obscured by T waves.

Sinus tachycardia, (>90/min), is seen in over 35% of patients with Guillain-Barré Syndrome, and over 30% suffer from hypertension (Parry, 1993).

A-20 documents a Sodium level of 144 (137 - 145) mmo1/L.

Hyperglycemia can lower the serum sodium concentration by 1.6 mEq/L for each 100 mg/dl, also giving rise to a false test.

A-20 also documents a serum potassium level of 3.4 L at 0400 hours on May 24th of 2000. Low potassium is defined as a potassium level below 3.5 mEq/L.

A-20 of the hospital record documents a CK (Creatine Kinase) level of only 40 units per liter (U/L) at 0400 hours.

EVIDENCE OF SUBSTANDARD CARE

N-10 of the Nurses' Notes document the patient's level of care as "routine", which showed little or NO concern for patient safety. Further, NO close patient monitoring or toxicological screening was done, marked by a complete absence of nursing care plan, as evidenced at A-21 of the medical record. In fact, NO inherent bloodwork was done in a timely manner. NO protocals were ever followed or implemented, in this case.

According to the medical record at N-6 Arlene Berry was admitted at 18:45 hours and had spent 75 minutes in the ER, as evidenced at A-3. In all that time, the ED physician, Dr. Spiller, did very little. NO simple blood tests were done or even ordered at that time. It is also clear that no course of action was charted, marked by a clinically evident inability on the part of the ED physician to adequately make a proper evaluation or even make a provisional diagnosis. In fact, Dr. Spiller had no idea what to look for and chose to play the "wait-and-see" game in the face of life threatening indicators. Not only did the patient's family physician fail to attend, NO diagnosis or differential diagnosis was made following the patient's admission at that time, or at all. NO protocols were followed. There is absolutely nothing on record to suggest that any Supportive Care & Symptom Control Regimens were ever implemented.

A-3 of the record, what I take to be the physician's diagnostic chart is a total blank. Again, from that record it seems clear that nothing was entered because nothing was done. The same record was filed out-of-sequence. The emergency record at A-4 was also filed out-of-sequence. Interestingly both of these records were dated using a rubber stamp that is consistent with backdating.

The record at A-12, what I take to be physician orders documents a concomitant or concurrent administration of Senokot (laxative), MS Contin (narcotic analgesic), Statex (morphine family), and Gravol (an anticholingeric agent), including IV solution and additives, the most dangerous of which is the MS Contin, a brand name for "Morphine Sulfate".

Coadministration of narcotic analgesics such as MS Contin with laxitives, ie. Senokot may have additive central nervous system (CNS) and gastrointestinal (GI) system effects which can increase the risk of severe constipation or paralytic ileus, including CNS depression.

"Contin", is a pharmaceutical industry buzzword for "time-release"or"continuous"release. Additionally, Arlene Berry had been given Statex(a narcotic: opioid agonist analgesicused to relieve pain) which also belongs to a class of the morphine family.

"MS" (morphine sulphate) is often confused with 'Magnesium Sulphate'. Magnesium Sulfate is used to treat severe constipation. Overuse of laxitives, or in combination with bisphosphonates or Magnesium Sulfate, or an overdose of magnesium sulphate used to treat severe constipation can lead to hypermagnesemic pseudo-coma, which mimics a central brainstem herniation syndrome.

According to the record at A-13, Arlene Berry was given 30 mg (po bid) morphine by nurse McCrank at 2000 hours on May 23rd, the eve of her death in the face of an undiagnosed and undifferentiated condition(s) associated with "abdominal pain". Nurses do not dispense medications to patients without a doctor's order.

A judicious dose of morphine on standing order to patients with non-traumatic abdominal pain is usually in the range of 05. mg/kg

The record at N-6 also documents telephone orders received by the hospital from Dr. Jordan at 2030 hours for Stemetil 10mg by IV, 4 times daily for "control of nausea", given by the RN, as further evidenced by the physician's orders seen at A-11. Stemetil suppresses activity in the trigger zones of the vomiting center by "paralyzing the gastrointestinal tract" which governs the vomiting reflex, which can also exacerbate dismotility.

A typical single dose of Stemetil for a small woman with low body weight is 5mg.

The antiemetic action of Stemetil (prochlorperazine) may "mask the signs and symptoms of drug overdosage from other drugs and may obscure the diagnosis and treatment of other conditions".

Morphine and prochlorperazine have a profound impact on bowel motility, often resulting in fecal impaction.

The co-administration of a narcotic analgesic and a neuroleptic agent will result in neuroleptanalgesia with drug-induced reduction of oxygen intake, resulting in respiratory depression. Respiratory depression represents the principal negative variable introduced with "conscious sedation" and left unrecognized and untreated, is the cause of panic, including most serious complications.

Neurolept-analgesia, also called "conscious sedation" refers to the use of major tranquilisers, ie stemetil/prochlorperazine in conjunction with narcotics such as morphine. Neurolept-analgesia is defined as a state of CNS depression.

Notably, my wife had also been given penicillin based medicines and sulfonamides such as Bactrim (Septra DS) and CIPRO (cyproflaxin) on the days before her admission; penicillin and sulfa-based antibiotics can cause the body's immune system to react by overstimulation.

Septra DS is an antibacterial agent with a wide spectrum of adversities (difficulty breathing; closing of the throat; swelling of the lips; and unusual bleeding).

Signs and symptoms of overdosage reported with sulfonamides include anorexia, colic, nausea, vomiting, dizziness, headache, fatigue, drowsiness, decreased appetite. Hematuria may also be noted.

Cross-reactions between penicillins and sulfa-drugs including sulfonamides are common triggers of drug-induced GBS serum sickness and fixed drug eruptions.

Stemetil is widely distributed into body tissues and fluids. Stemetil undergoes metabolism in the gastric mucosa and on first pass through the liver where it enters the enterohepatic circulation and is excreted chiefly in the feces.

Stemetil can also lead to changes in the blood-brain barrier (BBB), allowing an infectious agent to gain entry to the brain and produce lethal central nervous system (CNS = brain and spinal cord) infection. The scientific literature describe two bacterial factors specific to the meningitis pathogen that thwart the normal protective role of the blood-brain barrier, leading to serious infection.

Further, sugar solution in IV creates gaps in the blood-brain barrier allowing chemicals to enter. Infected material can block the blood vessels to the brain, and Stemetil can help shuttle it directly into the brain and CNS. Once across the blood-brain barrier, the infection enters neural cells, with resultant disruption in cell functioning, perivascular congestion, hemorrhage, and inflammatory response diffusely affecting gray matter disproportionately to white matter.

Blood borne infection in the blood lyse easily. It seems logical to assume that Stemetil would be contraindicated to serious infection for this reason.

Increased sedation is a serious side effect of this type of agent. Oversedation > results in obtundation characterized primarily by reduced alertness and hypersomnia. Hypersomnia is defined as a state of sleep in excess of 25% of the expected normal. Further, phenothiazines have even been reported to trigger diabetes in patients with no previous history of diabetes.

Stemetil poisoning is marked by oversedation, respiratory depression and hypotension. Stemetil (prochlorperazine) intoxication or poisoning can also cause deep physiologic depression that resembles and can mimic brain death

It is also clear that Dr. Jordan sought to eliminate the symptom "nausea", without his attendance, as evidenced by the phone order"for control of nausea" and without any appropriate blood testing, or addressing any possible underlying causes.

Further, Dr. Jordan neglected to consider the etiology of the nausea and vomiting as a condition requiring prompt medical intervention. Instead, he elected to give the patient a brain damaging neuroleptic antipsychotic-antiemetic drug without any review of her medical record, and without the benefit of toxicological screening or close monitoring, evidenced at A-21. Clearly, the etiology of the nausea and vomiting had never been determined, as evidenced at A-3.

The record at 0020 hours seen at N-6 documents the discovery by duty nurses of the patient's "head against the left side bed rail with her feet under the right side rail". Sensory loss in GBS, if present, takes the form of proprioception (loss of sence of one's own perception of the relative position of neighbouring parts of the body to each other), which is occasionally impaired spontaneously, especially with extreme fatigue.

The ED physician, Dr. Mark Spiller was up to assess the patient's condition. Upon examination her eyes were documented as being "sluggish". She was simply repositioned by the nurses, as evidenced by the record at N-6. Her"pupils were dilated at approx. 5 mm" with "very little reaction to light", and far from getting better she was becoming progressively worse, as evidenced by a sense of urgency seen on the record to the attendance of the patient with increased activity evidenced at N-6 between 0030 and 0055 hours, also noted at N-5. Clearly, from that record and apart from running around the room looking busy and repositioning the patient, nothing was done. It seems clear that the ED physician failed to properly assess the patient's condition, which fell far below an acceptable standard of care. Further, to add insult to injury, NO blood-work had yet been done.

While the clinical feature of 'fixed dilated pupils' is a valuable clinical sign it does not necessarily mean that the patient has severe brain injury.

I assume that Dr. Jordan would have been alerted by phone. He claims to have called in at 0100 hours but nevertheless opted not to change his orders, as evidenced by the "no change in orders" seen at N-5. From that record it is clear that Dr. Jordan elected to alienate and treat the patient over the telephone, unseen, in the face of life threatening indicators, all of them ignored and without ever having reviewed the patient record.

Further, between 0200 hours and 0220 hours the patient's blood pressure had risen slightly from 150/72to 162/80, a sign of mounting hypertension such as caused or worsened in response to treatment. The record at A-26documents the time of that assessment as 0220 hours, while N-5 documents the time of the same assessment at 0230 hours, a 10 minute difference. The same record documents a HR (heart rate) in the 160's, what is termed "sinus tachycardia".

A-26 documents a blood pressure of 162/80 with an SaO2 of 80% at 0220 hours, followed by a lethal drop in blood pressure to 78/70 by 0235 hours, in which blood pressure rises or falls significantly, a hallmark feature of orthostatic hypotension. Orthostatic hypotension is also a hallmark feature of diabetic autonomic neuropathy.

CAVEAT: Systolic blood pressure <80 mm HG is a hallmark of haemodynamic instability. The term "hemodynamic instability" is most commonly associated with an abnormal or unstable blood pressure, especially hypotension, or trauma due to clinical insult.

EVIDENCE OF ALTERED RECORDS

There are numerous material deficiencies in the related medical record of Arlene Berry which manifest a complete lack of internal consistency, ranging from out of sequence records, from the physician's Discharge note seen at A-1 and A-2, which is mared by error, inconsistency, omission, and contradiction, to the nurses Triage, to obviously rewritten, altered, and falsified medical records, tailored to obfuscate the truth, seen between N-1and N-3 of the nurses notes, with A-16 and A-17 presenting similarly, including as follows:

A-26 of the record documents a BP (blood pressure) of 78/70 at 0235 hours, while N-5 documents a BP of 98/70 at the very same time, suggestive of copious error.

A-24 documents a heart rate of 174 bpm at 0330 that is consistent with "trauma", while the Ventilation Record documents a heart rate of only 126 at the very same time, a significant difference.

A-4 of the record, what I take to be a Trauma Legend, barely visible in the physician’s notes situated in the lower right hand side of that record, there is an "obliterated" area suggesting a white-out, or perhaps an erasure. From that record it seems clear that relevant information was deliberately withheld, or removed to conceal an event.

TRAUMA is defined as any insult to the body, clinical or otherwise.

The record at A-6 documents a "history of metastatic lung cancer", while the outpatient record at OP-54 clearly documents "no metastasis"and "mediastinoscopy negative".

N-4 and N-5 present with less than half a page of documentation consistent with deliberate omission, such as having rewritten that record for the express purpose of withholding incriminating information.

A-16 documents a blood pressure of 163/117 at 0330 hourswhile N-3 documents a blood pressure of 136/85 at the very same time. The same record documents a blood pressure of 121/81 at 0400 hours, while N-2 documents a blood pressure of 112/57 at the very same time. More copious error.

N-4 of the record documents that Dr. Jordan was called in at 0225 hours. A-1 of the record documents "I was called in later that night because the patient had become obtunded", while the record at N-2 documents "attempts to pull away to painful stimuli" as late as 0400 hours on May 24th, being one hour and thirty-five minutes later, according to the record.

Was it the doctor's belief that Arlene Berry ceased to be a human being after becoming unresponsive following undiagnosed, untreated and/or inappropriately treated conditions? So much so that he decided to write her off?

To be continued...

View the medical record of Arlene Berry