MACHIAS, Maine — For the first time, a former nurse at Down East Community Hospital took the stand Thursday to defend his actions after a patient he discharged against medical advice was found dead outside the hospital in a snowstorm on Jan. 1, 2008.
Nurse John Zablotny testified Thursday he didn’t have all the information he needed to make a sound decision on whether to discharge patient Reid Emery against medical advice.
He also claims to have repeatedly asked doctors and other staff for assistance with Emery, he said during a hearing before Judge David Mitchell.
Zablotny’s nursing license had been suspended for two years, but the Law Court remanded the matter back to District Court after finding that Zablotny, now 49, had been improperly denied a hearing before the decision was made.
Zablotny said Thursday that when one of the doctors on staff at the Down East Community Hospital turned Emery’s case over to him, Zablotny went to Emery’s room to talk to the Eastport man. He found Emery, 61, to be calm and cooperative and saw no evidence Emery was having any difficulty moving.
Emery stated he wanted to leave the hospital “AMA,” which means “against medical advice.”
Zablotny asked him why and was told it was because of a “family tiff.”
Later testimony revealed the family discussed the fact that Emery wanted to be discharged but his wife wanted him to be transferred to Portland for a procedure.
Zablotny asked Emery where he would go. He walked to the window of his room, pointed and said he wanted to go to a residence near a red light visible from the room and meet some friends.
“I noticed that his gait was steady,” Zablotny said, adding he was evaluating the patient as they spoke. “There was no signs that he was having any difficulty moving any of his extremities.”
Zablotny asked asked Emery if he realized it was snowing and cold and the patient told him he did, he testified.
Emery told Zablotny there was no taxi available to take him to his friend’s house, according to testimony.
“I said, ‘I can look into a taxi for you,’ and he said, ‘no, one of the other nurses had already done that earlier,’” Zablotny testified.
He called for a taxi for Emery anyway and found none would be available for about two hours, he said.
After the conversation with Emery, Zablotny said he asked two different doctors at the hospital to examine the patient but they refused.
When asked one of the doctors again, he said the doctor told him, “‘You’ve told me this before and, bottom line, it’s OK for him to go,’” adding the doctor said medical professionals can’t treat patients like prisoners.
After filling out the paperwork, Zablotny was paged to the emergency room. He asked Emery to wait for him to return but, when he returned about 10 minutes later, Emery was gone, he said.
He could not immediately find Emery’s chart. But, when he finally found it in a lounge, he noticed another medical practitioner had written that Emery had “suicidal ideations.”
“All charts available and everything that I had reviewed [before finding Emery’s chart] nothing showed that there was anything to indicate [Emery] was incompetent to be discharged,” Zablotny said.
At that point, he called the Regional Communications Center, which alerts police to a situation at the hospital. He also called Emery’s wife, Margaret, even though Emery has expressly asked him not to notify relatives of his discharge.
“He actually told me not to contact [family] … but I violated that when I found the [chart],” he said.
When he notified Mrs. Emery of what happened, she became distraught, he said. Zablotny also called Machias police, met with Chief Grady Dwelley and participated in searches for Emery both inside and outside the hospital.
Zablotny testified that the physician is an integral part of the process of discharging a patient against medical advice. “He’s the physician and I answer to the physician,” Zablotny said on the stand.
During a break in the hearing Thursday, Zablotny’s lawyer, Joe Baldacci of Bangor, said Zablotny’s shift had begun only an hour and 15 minutes before he was told to take over Emery’s case.
“It’s clear all the information was not communicated to Mr. Zablotny,” Baldacci said.
Baldacci noted Zablotny has worked for Mount Desert Island Hospital in Bar Harbor since November 2008. Two doctors from MDI Hospital testified on Zablotny’s behalf Thursday before he took the stand.
“He has been there to help them save lives,” Baldacci said.
Assistant Attorney General Andrew Black declined to comment until after a verdict is rendered. This could be several months, he said, because both sides are being given four to six weeks to submit written closing arguments.
Baldacci said he believes the written closing arguments are appropriate in this case because it is a “fact intensive case.”