CHATTAHOOCHEE, Fla., Aug. 8, 2012 -
Jim Saunders, The News Service of Florida
The mentally ill patient at Florida State Hospital thought she was in labor last December and needed help --- even going so far as to call 911 twice.
But as a state hearing officer listened to a parade of employees Tuesday, he heard sometimes-conflicting accounts about what happened in a women's unit at the Chattahoochee mental hospital that ultimately led to the patient getting rushed to Tallahassee, where she gave birth to a severely brain-damaged baby.
Hearing officer William Salmon will make a recommendation later this month about whether licensed-practical nurse Kathryn Cottle should have been fired for her handling of the patient. But Cottle's appeal of her firing is only part of the fallout from the Dec. 23 episode --- fallout that also includes a potential civil lawsuit against the state and an ongoing criminal investigation.
Cottle, a nurse at the sprawling Gadsden County hospital since 2009, and her attorney argued she did nothing improper in her care of the patient. She testified that, at one point, she called the hospital's emergency department to see if the patient could have an ultrasound, but was rebuffed.
"They acted like it was no big deal,'' Cottle testified.
But state Department of Children and Families attorney Kathi Lee Kilpatrick presented a different picture, contending that Cottle didn't believe the woman was in labor and did not respond adequately.
"This is a mental hospital,'' Kilpatrick said. "There's a different level of care here. It's not like working on a ward at TMH (Tallahassee Memorial Hospital)."
Cottle and another employee were fired because of the episode, and a third worker resigned. Cottle is challenging her dismissal with the state Public Employees Relations Commission, which will receive the recommendation from Salmon.
The patient, who is identified in the case by her initials, R.W., for privacy reasons, was taken by helicopter ambulance the night of Dec. 23 to Capital Regional Medical Center in Tallahassee. A DCF inspector general's report released in June said admission records indicated the child was "stillborn at 10:00 p.m., placed on life support" and later transported to another facility, Tallahassee Memorial Hospital.
Some sources said this week they believe the child might have died recently. But the News Service of Florida could not independently confirm that.
The exact medical complications suffered by the pregnant woman were not made clear during Tuesday's hearing. But testimony indicated, for example, that she had high blood pressure, which can lead to complications. Also, some questions focused on a condition known as a placental abruption, which can cause heavy bleeding.
Cottle's attorney, Sidney Matthew, has said in documents filed in the case that his client is not suspected of illegal actions. But DCF accuses of Cottle of handling the woman's care "improperly and untimely."
Kilpatrick, the DCF attorney, called several hospital employees as witnesses to try to bolster the agency's case during a seven-hour hearing. The testimony focused on a roughly 35- to 40-minute period Dec. 23 that started with the pregnant woman calling 911 and led to her going to the mental hospital's emergency department and, ultimately, being flown to Tallahassee.
For instance, registered nurse Debra Alwine was called to the women's unit during the middle of the time period and examined the pregnant woman. She said she did not see signs of trouble such as bleeding and could not feel contractions but "erred with caution" and directed that the woman go to the emergency department.
Alwine was critical of Cottle, describing her, in part, as argumentative with residents. But under sometimes-tense questioning from Matthew, Alwine acknowledged she was unaware that Cottle had called the emergency department earlier to ask about getting an ultrasound for the pregnant woman. Alwine said that would have been an appropriate step to take.
Another employee, Angelica Webb, testified that she didn't think Cottle believed the woman was in labor.
"I recall Kathy stating, 'If she's in labor and has that baby, I will tell her myself I am sorry,' '' Webb said.
But Matthew attacked Webb's testimony, saying she hadn't included such information in an incident report she wrote the day after the episode.
"You just made that up, didn't you?'' Matthew asked.
"No, I did not,'' Webb responded.