FARMINGTON – A Massachusetts doctor testified Thursday at Dr. Larry Labul’s malpractice trial that Labul met the standards of care and exceeded them at times for 84-year-old Maxine Turner of Jay in February 2011.

Turner died on Feb. 11, 2011, less than three hours after being transferred to a skilled nursing facility in Farmington from Franklin Memorial Hospital.

Kelly Smith, a personal representative of her grandmother’s estate, filed a lawsuit against Labul and FMH, claiming negligence in the care of Turner. Smith, of Farmington, and her cousin, Megan Page of New Sharon, testified Wednesday.

Dr. Howard Sachs, a physician at the University of Massachusetts Medical Center in Worcester, Mass., testified Thursday on behalf of the defense in the fourth day of the civil trial in Franklin County Superior Court. The trial is expected to conclude Monday.

The court received the malpractice complaint in October 2014 but the case went through a prelitigation screening process prior to that. A panel that reviewed the case reached a split decision and the results were not admitted to trial.

Among the lawsuit’s complaints were that Labul treated Turner for chronic obstructive pulmonary disease instead of checking her for pneumonia and reconciling her medications. Turner had been falling asleep instantly and falling and hurting herself in late 2010 and early 2011.

According to the complaint, in January 2011, she hurt her ribs after she fell asleep and fell off a kitchen chair. When the pain did not lessen and it hurt to breathe, she went to the emergency room on Feb. 3. The family set up 24-hour care in Turner’s home as instructed. But when she didn’t get better she went to Dr. Larry Labul as a direct admit patient to FMH on Feb. 8, as recommended by her primary care physician.

Labul ran a number of tests and put her initially on steroids, antibiotics and other medicines and increased her oxygen in an effort to help her breathe better. He was initially treating her for pneumonia in case she had it which was appropriate care, Sachs said. Labul changed his assessment and plan after reviewing tests, Sachs said. Labul was trying to determine what was going on with Turner and the tests ruled out pneumonia, Sachs said.

Smith testified Wednesday that her mother died when she was young and she went to live with her grandmother. Turner raised her and was more like a mother, Smith said.

She testified she didn’t recall ever seeing her grandmother smoke but on cross examination by defense attorney Shana Solomon, Smith was shown a medical record that showed her grandmother had smoked for 39 years before she quit decades ago. Smith also learned from documents shown in court that Turner was diagnosed with chronic obstructive pulmonary disease years before she started helping her grandmother with her care.

A number of Turner’s medical records from doctor and hospital visits shown in the courtroom sometimes had COPD, which stands for chronic obstructive pulmonary disease, listed in her medical history and other times did not. In June of 2010, COPD was not on the list.

A witness for the defense said on Tuesday that the lung diseases Turner had were forms of COPD.

Smith testified that her grandmother was still able to do things for herself up until she went into the hospital in February, and even cooked a turkey dinner for the family in November 2010.

Turner made a decision while in the hospital in February 2011 that she would go to a skilled nursing facility to recover when it was known that was where she needed to go. That was important to Smith, who knew her grandmother did not want to go, Smith said.

Turner died suddenly a couple hours after being taken by Page to Orchard Park nursing home on Feb. 11. Page described her grandmother as gasping for breath and grabbing her arm. She had never seen Turner like that, she said. Page testified that she had been told at the hospital Turner did not qualify for an ambulance.

According to testimony, the following Monday, Smith met with the director of nursing at FMH and another hospital official. She wanted to know what the criteria for discharging her grandmother was and why she didn’t qualify for an ambulance. They didn’t have the answers, Smith said.

She testified she was told she would be involved in the medical review of what happened but was never called to participate. Smith said she was supposed to get some answers but it could take up to 45 days. When 45 days were up, she never heard from the hospital. She made some calls and left messages but those calls were never returned, Smith said.

She was eventually told the investigation was concluded and a copy would be put in the mail after the phone call. Instead she received a letter in June 2011 from an FMH vice president telling her they were sorry for her loss and that her grandmother had passed away after being transferred to nursing home, according to the letter shown in court. It also stated Turner was appropriately discharged and met the medical criteria to be transferred.

It also stated that they did “not find reasons for her sudden death that was related to the care she received at the hospital.” It said Smith could come in to see the director of care management to review her grandmother’s medical record and the criteria used to make the decision for the transfer.

Smith said she did not call because she had made several calls prior to the letter and they were never returned. She said she had taken other action.

NOTE: The article has been modified since it was first published to reflect that Feb. 11, 2011 was when Maxine Turner died. It was a reporter error. 

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