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HomeMy WebLinkAbout03-16-06 2 4It 1 APPEARANCES: 4It 4It 10 11 12 13 2 MARIELLE F. HAZEN, CELA Law Office of Marielle F. Hazen 2000 Linglestown Road Suite 303 Harrisburg, PA 17110 3 4 5 6 7 8 9 14 15 I N D E X 16 witness MICHAEL DEMICHELE, M.D. 17 Examination by: Ms. Hazen Paqe 3 18 19 20 21 22 23 24 Exhibits 25 (None) APEX Reporting Service . 1 2 3 having been 4 follows: 5 3 PRO C E E DIN G S MICHAEL DEMICHELE, M.D., sworn, was examined and testified as MS. HAZEN: This is the deposition of 6 7 8 9 Dr. Demichele. Am I saying that correctly? myself. THE WITNESS: Correct. MS. HAZEN: Present are Dr. Demichele and This is regarding Lillian Huntz. 10 EXAMINATION 11 BY MS. HAZEN: 12 . 13 14 15 16 17 18 19 20 21 . Q I have several questions for you. If you don't understand a question, please let me know so I can rephrase it, and if you don't understand it or if you don't hear a question, please let me know so that I can restate. Would you please state your name and professional address? A Michael Demichele, M.D., 108 Lowther Street, Lemoyne, PA. Q Would you describe your education, 22 training, and background with particular emphasis on 23 your experience in evaluating individuals with 24 25 incapacities. A Okay. I went to Hahnemann Medical School APEX Reporting Service . 7 8 9 10 11 12 . 13 14 15 16 17 . 4 1 from '87 to '91. I graduated medical school, went to 2 Hartford, Connecticut, the University of Connecticut, 3 did an Internal Medicine residency program. 4 I have been boarded in Internal Medicine 5 and got reboarded approximately two years ago, which is 6 necessary for everyone in Internal Medicine. So I am board certified current in Internal Medicine. I see anywhere from 1500 to 2000 patients a year, a busy practice. I see and examine at least 25 to 30 patients a day, see a lot of geriatric patients, and I probably have done on an estimate five to six of these competency type of exams before. Q A Q A When did you first examine Lillian Huntz? She was seen in 6/05. What were the circumstances? She at that point had a -- I have to ask 18 you a question. 19 20 How much of her medical history should I Enough to give her -- disclose? 21 Q Anything relevant to the competency issue. 22 A She at that point had a fungating breast 23 mass that she really I don't even think knew or 24 25 understood what it was, had a blood clot on her lung, and a pleural effusion which had been treated, and APEX Reporting Service . . 15 16 17 18 19 20 21 22 23 . 24 25 5 1 2 psychiatrically at that time I deemed her to have dementia. I didn't think she could understand her fate 3 or what she wanted or didn't want. 4 I had to speak to several family members 5 at that time and told them that she most likely had a 6 breast tumor. 7 The family did not want aggressive 8 treatment, and said that she had made her wishes clear 9 to all of them beforehand that she did not want to have 10 anything aggressively done. 11 I discharged her on June 17th, 2005. 12 At that point her diagnosis was blood clot in her lung, 13 14 called a pulmonary embolus, probable fungating breast cancer, and a pleural effusion most likely secondary to cancer. The next time I was contacted was by the family to see if I could help participate since I met her before, and because they didn't have a physician to go to with determining her competency and mental abilities. So we had our next visit on 1/16/06 In which I did the mental status examination focusing on her abilities to concentrate, make decisions, and have memory. Q At this point what is her diagnosis? APEX Reporting Service . . . 9 10 6 1 A The diagnosis is probable breast cancer, 2 history of pulmonary embolus, and dementia. 3 4 5 6 7 Q A Q A Q The breast cancer, is that being treated? No. What is the prognosis for it? Poor. The dementia, could you describe her 8 impairment? A She did very poorly with orientation to person, place, time of the year. She did extremely 11 poor with short- and long-term memory testing. She 12 could not name simple objects. She could not read very 13 14 15 well, nor follow directions. When I asked her to write sentences, she could not do this correctly. She could not write or 16 follow and write shapes that we asked that most people 17 should be able to do. 18 The biggest deficit was In her whereabouts 19 within the time, year, date, where she was. 20 She also, on further questioning, not 21 involved in this exam, did not have insight into her 22 disease or its manifestations. 23 24 25 Q In your opinion, is Lillian Huntz' ability to receive and evaluate information and communicate decisions impaired to such a significant extent that APEX Reporting Service . 6 7 8 9 10 11 12 . 13 14 15 16 17 18 19 20 21 22 23 . 7 1 she lS totally unable to manage her financial 2 resources? 3 A Correct, she lS unable. 4 Q Is she totally unable to meet her 5 essential requirements for physical health and safety? A Q Correct. With the dementia, is that a progressive condition? A Q A Q Yes. So you don't expect any improvement? No. What is your recommendation for meeting essential requirements for physical health and safety for Lillian Huntz? A My requirements? The family has been, from all of the meetings I have had, which were several by phone in June, and then when they brought her to the appointment, it seems like the family has been mainly the ones who have been taking care of her. Q Do you think she needs 24-hour supervision? A Q Yes. With regard to her financial resources, do 24 25 you believe someone else needs to handle those? A Yes. APEX Reporting Service . . . 8 1 Q Given your testimony, I assume you don't 2 think she has the capacity to sign the Power of 3 Attorney. 4 5 A Q At this point, no. So do you know of any less restrictive 6 alternative to guardianship that would meet her needs? 7 8 A Q No. In your opinion, would the physical or 9 mental condition of Lillian Huntz be harmed by her 10 presence In court at the hearing on this matter? 11 12 13 A Can you restate that? you are asking. I am not sure what A She needs to be present under Pennsylvania 14 statutes at the hearing in this matter unless there is 15 medical testimony that her physical or mental condition 16 would be harmed by participating in the court 17 proceeding. 18 19 A I am not really sure if she would be able to sit there and to go through it. She was very 20 cooperative the last time I have seen her about asking 21 the questions. I thought she thought some of the 22 questions may have been silly or beneath her, but maybe 23 she was just too embarrassed to answer or didn't know. 24 I don't know how she would be or react in 25 a court room. APEX Reporting Service . 5 6 7 8 9 10 11 12 . 13 14 . 9 1 2 3 Q Is there anything else you think the Court should hear in this matter? A I think that she has a terminal disease, 4 probably breast cancer. She has had blood clots on her lungs. I think it's quite adamant, if it was due to her family, that she's even gone as far as she did because I don't think -- wasn't sure she was even going to survive this long, but she did. I don't think, to the best of my knowledge, she should be making decisions. Q At this point she is living at home with a caregiver and the family is participating in that. They are concerned about the adequacy of that situation, and would like to see her in a care setting, 15 which is what has precipitated this guardianship 16 petition so that they will be able to make that 17 decision for her. 18 19 A Q Okay. You would think that is consistent with 20 her best interests? 21 A I would. 22 MS. HAZEN: I have no other questions. 23 I thank you for your time, and the family thanks you 24 25 for your time. (The deposition was concluded at 11:54 a.m.) APEX Reporting Service . . . 1 2 3 10 C E R T I F I CAT E I, Sharon L. Dougherty, a Notary Public for the 4 Commonwealth of Pennsylvania, do hereby certify: 5 That the witness named in the deposition, prior 6 to being examined, was by me first duly sworn or 7 affirmed; 8 That said deposition was taken before me at the 9 time and place herein set forth, and was taken down by 10 me in stenotype and thereafter transcribed under my 11 direction and supervision; 12 13 That said deposition lS a true record of the testimony given by the witness and of all objections 14 made at the time of the examination. 15 I further certify that I am neither counsel for 16 nor related to any party to said action, nor in any way 17 interested in the outcome thereof. 18 19 20 21 22 23 24 25 APEX Reporting Service