HomeMy WebLinkAbout06-19-06
Joseph A. Ricci, Ii:sq
Pa. ID 49803
Lavery, Faherty, Young & Patterson, P.C.
225 Market Street
Suite 304
Harrisburg, PA 17101
(717) 233-6633
Counsel for Carlisle Regional Medical Center
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY PENNSYLVANIA
IN RE:
Ro bert D. Young
: DOCKET NUMBER:
....".
: EMERGENCY GUARDIANSHIP
EMERGENCY PETITION FOR TEMPORARY GUARDIANSHIP OF THE PERSON
AND NOW Comes, Carlisle Regional Medical Center by and through its counsel,
Lavery, Faherty, Young & Patterson, P.C., by Joseph A. Ricci, Esq., and requests that
this Honorable Court enter an order granting an emergency limited guardianship of
the person for Mr. Robert D. Young for the following reasons:
1. The alleged incapacitated person is Mr. Robert D. Young an adult male.
2. Mr. Young is currently a patient at the Carlisle Regional Medical Center, 45
Sprint Drive, Carlisle, Cumberland County, Pennsylvania, 17013.
3. Prior to his hospitalization, Mr. Young was being held on a warrant, for
failure to register as a sex offender, at the Cumberland County Prison located at 1101
Clairmont Road, Carlisle, Cumberland County, Pennsylvania, 17013.
4. The only known relatives of Mr. Young are his mother, Ms. Judy Britten and
an estranged father. Discussions with Ms. Britten have resulted in her stating a
willingness to assume guardianship of the person of her son, Robert D. Young. See
letter attached hereto as Exhibit "A."
5. The petitioner requests that this Honorable Court appoint Judy Britten as
temporary guardian of the person of Mr. Young.
6. Ms. Britten does not have any interest that is adverse to the interests of Mr.
Young, the alleged incapacitated person.
7. The emergency temporary guardianship of the person is necessary for the
following reasons:
a) Mr. Young is an adult individual who was found lurking in bushes
outside of a Carlisle home. The resident of the home reported this
incident to the Police who investigated and found Mr. Young lurking in
the bushes as reported. Upon his apprehension, it was learned that Mr.
Young had not registered as a sex offender, as is required by
Pennsylvania law; accordingly, he was arrested and transported to the
Cumberland County Prison.
b) Upon arrival at the Cumberland County Prison, Mr. Young was found
to be incoherent, rambling and disjointed in his thoughts.
c) Mr. Young was transported to the Carlisle Regional Medical Center for
Psychiatric evaluation.
d) Mr. Young indicated that he had been on a "hunger strike" for fear
that his food was being poisoned.
e) Mr. Young had not eaten for some time and also had failed to take
prescribed anti-psychotic medications.
f) Mr. Young was in need of nutritional supplementation because of his
failure to feed himself. Mr. Young was also in need of his psychiatric
medications because of his deteriorated mental state and paranoid
ideations.
g) At the time of his admission, Mr. Young was diagnosed with
Rhabdomyolisis, a condition of severe muscle breakdown attributed to
his malnutrition.
h) Mr. Young required medical care before his psychiatric issues could
be addressed; accordingly, he was admitted to the Carlisle Regional
Medical Center under the care of the Medical Center's Hospitalist
program in which he is being treated by Board Certified Internists.
i) Although Mr. Young has received intravenous nutritional support, he
requires the placement of a feeding tube to assure proper delivery of both
nutrition and medication. See Affidavit of Tina Collins, M.D., attached
hereto as Exhibit "B."
j) Mr. Young refuses to accept medication or nutrition by mouth.
k) Failure to obtain proper nutrition will result in Mr. Young's eventual
death by starvation. Failure to obtain appropriate medication will cause
the further and continual deterioration of Mr. Young's mental state.
1) With rare exception, Mr. Young refuses to engage in conversation with
the nursing and medical staff. When he has been conversant he has
indicated that he is aware of the fact that he is receiving intravenous
nutrition and his comments suggest that he desires the same. See
Affidavit of Tina Collins, M.D., attached hereto as Exhibit "B."
m) Mr. Young has been found by the Carlisle Regional Medical Center
staff psychiatrist, Dr. Kush, to be mentally incompetent and incapable of
making reasonable and meaningful decisions on his behalf.
n) Mr. Young has been declared to be in need of involuntary inpatient
psychiatric care pursuant to 50 P.S. 8304. See Order for Involuntary
Commitment attached hereto as Exhibit "C."
0) Mr. Young is scheduled to be admitted to the Mayview Psychiatric
Center, a center responsible for the psychiatric care of individuals
subject to incarceration.
p) Mr. Young cannot be admitted to the Mayview Psychiatric Center
without first having a feeding tube placed, since the Mayview Psychiatric
Center does not have the medical facilities to manage the intravenous
feedings he is currently required to receive.
q) Mr. Young cannot receive necessary and crucial psychiatric services
at the Carlisle Regional Medical Center since the Medical Center does not
have inpatient psychiatric facilities.
r) If Mr. Young were to receive a feeding tube as a result of a minimally
invasive surgical procedure performed under conscious sedation, he
would be able to be admitted to the Mayview Psychiatric Center and
receive the psychiatric care necessary to address his paranoia and
untreated psychosis.
s) Because placement of a feeding tube is a surgical procedure it requires
the patient's informed consent.
t) Mr. Young is incapable of providing his informed consent to undergo
the needed feeding tube placement.
u) Failure to undergo the placement of a feeding tube could significantly
impair the physical health of Mr. Young since it will be impossible to
properly evaluate and treat both his failure to oral consume nutrition as
well as medication.
v) Failure to undergo the placement of a feeding tube could result in the
further medical and psychiatric deterioration of Mr. Young.
w) Without the appointment of a guardian, the medical staff of the
Carlisle Regional Medical Center are unable to provide the reasonable
and necessary medical treatments to properly care for Mr. Young since
the patient is unable to provide the necessary consents for his continued
care.
11. A temporary guardianship will permit the appropriate decision making to
take place in the short term and potentially avoid the continued deterioration of Mr.
Young's physical and mental conditions.
12. It is hoped that once Mr. Young undergoes the proposed feeding tube
placement he will be able to be transferred to a an appropriate inpatient psychiatric
facility which will be able to alleviate his psychosis and address his failure to consume
food and medications.
13. If Mr. Young's medical and psychiatric conditions improve, as expected, the
need for a temporary guardian may cease to exist.
WHEREFORE it is respectfully requested that this Honorable Court issue an
order appointing Judy Britten, mother of the alleged incompetent person, temporary
guardian of the person of Robert D. Young for the purpose of providing medical
decision making authority.
Respectfully submitted,
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Dated: June 19,2006
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Joseph A.Ricci, Esq.
Pa. ID 49i03
Lavery, Faherty, Young & Patterson, P.C.
225 Market Street
Suite 304
Harrisburg, PA 17101
(717) 233-6633
Counsel for Carlisle Regional Medical Center
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AFFIDAVIT OF TINA COLLINS. M.D.
AND NOW this 19th day of June, 2006, I, Tina Collins, M.D., do hereby swear
and affirm:
1. I am a physician licensed to practice medicine in the Commonwealth of
Pennsylvania.
2. My medical practice is limited to the specialty of internal medicine.
3. I am the attending physician for Carlisle Regional Medical Center patient
Ro bert D. Young.
4. Mr. Young became a patient of the Carlisle Regional Medical Center on
June 1, 2006.
J. Mr. Young is a patient suffering from Rhabdomyolisis, a breakdo\vn of
muscle attributable to his failure to have consumed proper nutrition for several weeks
prior to his admission. Mr. Young is also severely mentally disabled, displays
psychotic behaviors and is generally non-communicative.
6. Mr. Young, prior to his admission was refusing to eat on the grounds
that he alleged all of his food was being poisoned.
7. Mr. Young, since his admission, has generally refused to consume any
food or medication by mouth.
8. Because, Mr. Young has refused to either eat or take his required
medications, it has been necessary to provide nutrition through an intravenous line.
9. Intravenous feedings are difficult to manage since they require careful
monitoring of the patient's blood chemistries since the nutrition is provided through
the blood stream and not through the normal route of the stomach.
10. Intravenous feedings require close and careful attention from a full time
attending medical doctor.
11. Intravenous feedings do not allow for the proper administration of
psychotropic medications necessary to treat Mr. Young's ongoing paranoia and
psychosis.
12. The need for intravenous fee dings prevents Mr. Young from being
transferred to a proper psychiatric facility which can address his ongoing paranoia
and psychosis. Treatment of these conditions is crucial if Mr. Young is to gain insight
into the need to consume proper nutrition.
13. Mr. Young requires the placement of a feeding tube to allow for safer,
easier, and less complicated nutritional support.
14. Placement of a feeding tube would permit the administration of
psychotropic medications.
15. Placement of a feeding tube would permit Mr. Young's transfer to a
proper inpatient psychiatric center.
16. Placement of a feeding tube would remove the need to maintain ongoing
IV access which would greatly minimize the risk of infection in an imunocompromised
patient.
17. Placement of a feeding tube is a minimally invasive procedure which can
be accomplished without the need for general anesthesia.
18. Placement of a feeding tube can be accomplished in a short procedures
center in less than 15 minutes with the use of only conscious sedation.
19. Failure to obtain placement of feeding tube will significantly compromise
the health of Mr. Young since he will not be able to obtain full time, inpatient
psychiatric care necessary to address his ongoing paranoia and psychosis; he will
require continued use of intravenous feedings which will expose him to a greater risk
of significant infection, and he will require frequent and repeated blood tests to
constantly monitor and balance the nutritional supplements included in the feeding
solutions.
20. Mr. Young has been declared mentally incompetent and placed under an
involuntary psychiatric commitment pursuant to 50 P.S. 9 304.
21. Mr. Young is not competent to provide his consent to the medical
procedures necessary for his continued health and well being.
22. Although Mr. Young is not competent to provide consent to medical care,
he did indicate that he wanted his "milkshake" when he noticed that his IV feeding
solution was removed for replacement.
23. It appears that Mr. Young IS aware of the fact that he is receIVIng
nutritional support and desires the same to continue.
Respectfully submitted,
Date:
Tina Collins, M.D.
Treatment
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