HomeMy WebLinkAbout06-12-06 petitioners exhibits
RE: Contance Meredith
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Dr. Richard Dyer, 6n 106
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IN THE COURT OF COMMON PLEAS, CUMBERLAND COUNTY,
PENNSYLVANIA
ORPHAN'S COURT DIVISION
IN RE: CONSTANCE M. MEREDITH,
ORIGINAL
An Alleged Incapacitated Person
No. 06-0294
On the Petition of WILLIAM MEREDITH:
Deposition of: RICHARD K. DYER, M.D.
.
Taken by
Petitioner
Before
Sarah C. Thomas, RMR
Reporter-Notary Public
Beginning
June 7, 2006; 2:00 p.m.
Place
Danville State Hospital
Second Floor Conference Room
200 State Hospital Drive
Danville, Pennsylvania
COUNSEL PRESENT:
MARIELLE F. HAZEN, ESQUIRE
2000 Linglestown Road
Suite 202
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Harrisburg, Pennsylvania 17110
For - Petitioner
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RE: Contance Meredith
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Dr. Richard Dyer, 617/06
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INDEX TO WITNESSES
FOR - PETITIONER
DIRECT CROSS REDIRECT RECROSS
Richard Dyer, M.D. 3
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RE: Contance Meredith
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Dr. Richard Dyer, 617/06
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STIPULATION
2 It is hereby stipulated by and between counsel for
3 the respective parties that signing, sealing, certification
4 and filing are hereby waived; and that all objections except
5 as to the form of the question are reserved to the time of
6 trial.
7
8
*
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10 RICHARD DYER, M.D., called as a witness, having
11 been duly sworn or affirmed, testified as follows:
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MS. HAZEN: This is Wednesday, June 7th, at 2:00
13 o'clock p.m. This is the deposition of Dr. Richard Dyer.
14 Present are Dr. Dyer, the court reporterl and myself.
15 DIRECT EXAMINATION
16 BY MS. HAZEN:
17
Q.
Could you please state your name and professional
18 address.
19
A.
My name is Richard K. Dyer I D-Y-E-R1 M.D. and I am
20 currently employed at Danville State Hospital, 200 State
21 Hospital Drive, Danville, Pennsylvania, 17821.
22
Q.
Please outline your educational background,
23 including the schools that you have attended and the
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24
professional degrees that you have attained.
25 A. I attended college at the University of Nebraska at
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RE: Contance Meredith
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Dr. Richard Dyer~ 6nl06
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Omaha from 1973 to 1975. I attended medical school at the
2 University of Nebraska College of Medicine from 1975 to 1978.
3 In September of 1978, I received my M.D. degree from that
4 University. I then completed a four-year residency in
5 psychiatry at the University of Nebraska Medical Center from
6 1978 to 1982, and have been in the practice of psychiatry
7 since that time.
8 I am Board certified by the American Board of
9 psychiatry and Neurology.
10
Q.
Do you hold any Pennsylvania professional licenses?
11
A.
Yes. I hold a license to practice medicine in the
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State of Pennsylvania with my specialty in psychiatry.
13
Q.
When was that license issued?
14
A.
1989, I believe.
15
Q.
Have you ever testified as a witness in a court
16 proceeding before?
17
A.
Yes, I have.
18
Q.
How recently?
19
A.
If you include commitment hearings, yesterday.
20
Q.
Okay. This is a deposition regarding Constance
21 Meredith. What is her date of birth?
22 A. Her date of birth is 5/23/32.
23 Q. Have you examined her?
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24
A.
Yes. I was her attending psychiatrist from May 1st
25 through June 1st of this year, covering on the floor where
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Dr. Richard Dyer, 6n 106
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she is currently hospitalized.
2
3
Q.
Where is she currently hospitalized?
A.
She is currently hospitalized on unit 310 of
4 Danville State Hospital.
5
6
7
8
9
10
Q.
What is that unit?
A.
Urn, that's a female longer-term psychiatric unit.
Q.
Prior to May 1st, who was her attending?
A.
Urn, Dr. Wieslawa Kaczanowska.
Q.
I guess you can't provide any help on that.
A.
I don't have it written down anywhere. It's a
11 Polish name. I can't tell you how it's spelled.
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13
14
15 Hospital?
16
Q.
When was she admitted into Danville?
A.
She was admitted on September 7th of 2005.
Q.
Prior to that was she at the Harrisburg State
A.
Yes, I believe she was, and admitted here as a
17 transfer with the closure of Harrisburg State Hospital.
18
19 Hospital?
20
21
Q.
When was she admitted to the Harrisburg State
A.
I have to refer to the records for that.
Urn, it looks like nine months prior to her transfer
22 here, but I don't have that date in front of me. I don't
.
23 have it easily available from here.
24
Q.
So you were her attending for just a one-month
25 period?
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RE: Contance Meredith
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Dr. Richard Dyer, 617/06
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A.
Just a one-month period, that's correct.
2
Q.
But you received her history in the form of a
3 medical record from Danville and from the Harrisburg State
4 Hospital?
5
A.
Right.
6
Q.
When was your most recent examination of her?
7
A.
Actually, I talked with her, um, June 2nd. I
8 stopped by to see her and just touch base prior to this
9 hearing.
10
Q.
What is her diagnosis?
11
A.
Her diagnosis at this time is schizophrenia,
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paranoid type and organic brain syndrome.
13
Q.
With the paranoid schizophrenia, could you describe
14 how that's exhibiting in Mrs. Meredith?
15
A.
She continues to express a wide variety of
16 delusional beliefs. She believes that her esophagus is
17 missing and that's why she is not able to eat. She says that
18 her intestines are also missing, that she is being poisoned,
19 so she refuses to eat the food. She believes that the
20 doctors are coming to operate on her, because of some of
21 these things. She also expresses some paranoid beliefs about
22 her husband.
23 These are things that have been going on for many
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years and have not responded particularly well to
to
25 treatment. She was lying on the floor waiting to be
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embalmed, she was standing in the middle of the hallway on
2 the unit waiting for a taxi, those sorts of things.
3
Q.
With the organic brain syndrome, could you describe
4 that?
5
A.
She is demented. By that I mean that she has
6 memory problems, doesn't know where she is, doesn't remember
7 items in her past, is easily confused.
8 As an example, when I met her on June 2nd at 2:30
9 in the afternoon, she was standing motionless in the hallway.
10 I asked her what she was doing and she said she was waiting
11 for breakfast, not recalling at all that she had breakfast
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and lunch previously that day. And she continued to stand
13 there and was standing in the hall still when I left after
14 talking with her, maintaining that she was waiting for
15 breakfast.
16 Those are the kinds of things that interfere with
17 her ability to make rational decisions. She is not in touch
18 with reality and where she is, when it is, and what is going
19 on.
20
Q.
What is her current treatment plan?
21
A.
Urn, she currently is being treated with
22 antipsychotic medication and a medication for dementia.
23 Current medications are Risperdal. That's R-I-S-P-E-R-D-A-L.
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24
She receives a total of five milligrams a day. She is also
25 on Prolixin, P-R-O-L-I-X-I-N, and she receives five
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RE: Contance Meredith
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milligrams a day. She is on At ivan , one milligram, and --
2 she receives one milligram a day. She is also on Aricept,
3 A-R-I-C-E-P-T, five milligrams a day.
4 Prolixin and Risperdal are antipsychotic
5 medications that are used in treating schizophrenia. Aricept
6 is a medication used in dementia. She was started on Aricept
7 at Harrisburg State Hospital, but they noticed no real
8 response to it and neither have we. We haven't seen any
9 improvement in her cognitive functioning as a result.
10
Q.
And the Ativan?
11
A.
The Ativan is for agitation. Because of her
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confusion and misinterpretation, she frequently gets agitated
13 and the Ativan helps maintain a little more calm stability
14 for her.
15
Q.
Is she currently a patient here at Danville State
16 Hospital?
17
A.
Yes, she is.
18
Q.
Do you anticipate her continuing to need that level
19 of care?
20
A.
Um, that was the discussion I had with her husband.
21 He attended a treatment team meeting and the treatment team
22 has felt for a couple months that Connie no longer requires
23 the level of care of a locked inpatient secure psychiatric
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unit and that she could be cared for in a nursing home with
25 an Alzheimer's unit or a locked wander guard system to care
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RE: Contance Meredith
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for demented patients.
2
The husband has resisted this. His wife has been
3 mentally ill for the majority of their marriage and she has
4 been in and out of hospitals many times. He believed that
5 this was just another hospitalization and that she would get
6 better and be able to return home, and he wasn't willing for
7 quite a while to accept that that probably was not the case
8 and that she wouldn't be able to return home and function.
9 So that's a long way of saying that the decision of
10 the treatment team dealing with her is that Connie could be
11 cared for in a less restricted setting than a locked, secured
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state hospital.
13
Q.
But she would need 24-hour care?
14
A.
She would need 24-hour care. She would need
15 24-hour supervision for her safety.
16
Q.
And it would need to be a secured unit?
17
A.
Yes.
18
Q.
In your opinion, what is the likelihood that her
19 condition will improve?
20
A.
Realistically, I don't believe that there is any
21 possibility it will improve.
22
Q.
So it's your expectation that she will need 24-hour
23 care for the remainder of her life?
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24
A.
Yes. I do believe that. The records from
25 Harrisburg State Hospital indicate that she suffered some
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RE: Contance Meredith
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cognitive deterioration there and this has been just a
2 continuation. She is 74 years old, has a life-long history
3 of mental illness, and is showing some cognitive decline, so
4 that tends to be a progressive process. And I don't see
5 any -- any indicators that that will turn around at all.
6
Q.
So you expect, rather than improvement, that we are
7 going to see continued decline?
8
A.
I believe so, yes.
9
Q.
In your opinion, is her ability to receive and
10 evaluate information and to communicate decisions in any way
11 impaired to such a significant extent that she is totally
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unable to manage her financial resources?
13
A.
Yes. I believe that her ability to receive and
14 evaluate information and communicate a decision is totally
15 impaired. She -- she misinterprets information that's given
16 her, if she understands it at all. She frequently does not
17 understand it and is generally unable to communicate her
18 decisions, so I think she's completely impaired.
19
Q.
Is her ability to make decisions to safeguard her
20 physical well-being also totally significantly impaired?
21
A.
Again, she is out of touch with reality, believing
22 that she is waiting to be embalmed, believing that parts of
23 her body are missing. I don't believe she is capable of
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making rational decisions regarding her self care.
25 Q. We talked about what your recommendations are for
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RE: Contance Meredith
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meeting her requirements for physical health and safety.
2 With regard to managing her financial resources, do you
3 believe someone else needs to do that for her?
4
A.
Absolutely.
5
Q.
So you believe a guardianship is appropriate?
6
A.
Yes, I do.
7
Q.
Do you know of any less restrictive alternatives?
8
A.
I don't know all of the legal options available,
9 but she needs someone to speak for her and look out for her
10 well-being, whether that's a durable power of attorney or a
11 guardian, or whatever the legal definitions might be. She is
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incapable of managing her own life, financial, physical, in
13 any way.
14
Q.
The primary less restrictive alternative would be a
15 durable power of attorney. She would need to have capacity
16 to understand that document and to execute it.
17
A.
She does not have that capacity.
18
Q.
So that would not be an alternative?
19
A.
That would not be. As I said, I am the
20 psychiatrist. You are the attorney. So
21
Q.
We each have a role here.
22 In your opinion, would her physical or mental
23 condition be harmed by presence at the hearing on this
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matter?
25
A.
Yes. I believe it would. I don't believe that --
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RE: Contancc Meredith
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that Connie is capable of understanding the purpose of the
2 hearing. I think that that would be very threatening for
3 her. She would not be able to participate meaningfully. I
4 think it would present a real risk for her emotionally to be
5 present at the hearing.
6
Q.
Do you believe she would become agitated?
7
A.
I do. I believe she would become very agitated and
8 misunderstand the intent of the hearing.
9
Q.
So her mental condition, you feel, would be harmed
10 by attending?
11
A.
I do. I strongly do.
.
12
Q.
Is there any other information you believe is
13 relevant to this proceeding that the Court should hear?
14
A.
Urn, after meeting with her husband, and discussing
15 the matter with him, and spending time with Connie, I believe
16 her husband is a well-intentioned man who has only his wife's
17 best interests at heart and I think that appointing a
18 guardian, whether it's him or someone else, at this time is
19 the most appropriate, safest way to manage this woman's
20 current condition.
21
Q.
Very good. I thank you for your time. The family
22 thanks you for your time.
23 (Whereupon, the deposition concluded at 2:15 p.m.)
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RE: Contance Meredith
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COUNTY OF UNION
2 COMMONWEALTH OF PENNSYLVANIA:
3
4 I, Sarah C. Thomas, the undersigned Notary Public,
5 do hereby certify that personally appeared before me, RICHARD
6 K. DYER, M.D., the witness, being by me first duly sworn to
7 testify the truth, the whole truth and nothing but the truth,
8 in answer to the oral questions propounded to him by the
9 attorneys for the respective parties, testified as set forth
10 in the foregoing deposition.
11 I further certify that before taking of said
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deposition, the above witness was duly sworn, that the
13 questions and answers were taken down stenographically by the
14 said Sarah C. Thomas, Court Reporter" Selinsgrove,
15 Pennsylvania, approved and agreed to, and afterwards reduced
16 to typewriting under the direction of the said Reporter.
17 In testimony whereof, I have hereunto subscribed my
18 hand this 7th day of June, 2006.
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sal~~hC~MR .
Reporter-Notary P~b11C
My Commission Exp1res
. u_.L~V-V-O=R~.'---'
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