Bonnie Hardey

          5           MS. BARLOW:  We next call Bonnie Hardey.

 

          6           THE COURT:  Ms. Hardey, come forward.  Raise your

 

          7  right hand and face the clerk to be placed under oath.

 

          8                        BONITA HARDEY,

 

          9           being first duly sworn, was examined and

 

         10           testified as follows:

 

         11           THE COURT:  Have a seat up here, please.  State your

 

         12  name and spell your last name.

 

         13           THE WITNESS:  Bonita L. Hardey, H-a-r-d-e-y.

 

         14                      DIRECT EXAMINATION

 

         15  BY MS. BARLOW:

 

         16  Q.  Good afternoon.  What is your occupation?

 

         17  A.  I'm a registered nurse.

 

         18  Q.  What education and training did you receive for that

 

         19  occupation?

 

         20  A.  I went to college.  Before that I was a licensed --

 

         21  Q.  You'll have to speak up.

 

         22  A.  Before becoming a registered nurse I was a licensed

 

         23  practical nurse in the military.  Then I went to college and

 

         24  became a registered nurse.

 

         25  Q.  And what college did you attend?

 

          1  A.  Weber State.

 

          2  Q.  When did you become an LPN?

 

          3  A.  1980.

 

          4  Q.  When did you become an RN?

 

          5  A.  1993.

 

          6  Q.  What is your -- what was your professional experience as

 

          7  a nurse starting out?

 

          8  A.  First starting out I was in the military.  I flew

 

          9  medevac.  And then as a civilian, just working in the med

 

         10  surg floor, some nursing home experience.  Then, when I

 

         11  became a registered nurse, I became a director of nursing at

 

         12  a nursing home, worked some med surg and worked geropsych.  I

 

         13  took a lot of specialized geriatric courses when I became the

 

         14  director of nursing at a nursing home.

 

         15  Q.  Were you ever in a geropsych unit before the one at Davis

 

         16  Hospital?

 

         17  A.  The nursing home that I managed had an Alzheimer's

 

         18  geropsych type of unit, but it wasn't an inpatient unit.

 

         19  It's just that we had patients there that were on

 

         20  psychotropic medications.  But Davis was the first

 

         21  specialized geropsych unit I ever worked at.

 

         22  Q.  You indicated that you had some additional training in

 

         23  geriatric nursing care, is that correct?

 

         24  A.  That's correct.

 

         25  Q.  What training was that?

 

          1  A.  We would go to different seminars and take different

 

          2  classes on medications being used, treatments, specialized

 

          3  validation type of techniques and how to interact with the

 

          4  geropsych patient.

 

          5  Q.  Geropsych patients, what is their usual psychiatric

 

          6  complaint?

 

          7  A.  The majority that we got at Davis were usually ones that

 

          8  were in an agitated state or deep depression.  And we were

 

          9  referred from nursing homes that they were having

 

         10  difficulties controlling their behaviors.

 

         11  Q.  What kind of treatments were the people at the Davis

 

         12  geropsych unit receiving for their agitation or their

 

         13  depression, whatever their problem was?

 

         14           MR. BUGDEN:  Can we talk about each patient?

 

         15  Objection on relevance.

 

         16           THE COURT:  Sustained.

 

         17  Q.  (BY MS. BARLOW)  The patients that we're talking about,

 

         18  the five patients in December of '95 and January of '96, what

 

         19  kind of therapy or treatment was there at the geropsych unit

 

         20  for these people in late '95 and early '96?

 

         21  A.  Umm, they would come in and be treated -- evaluated by

 

         22  the psychiatrist that was on there before they came into the

 

         23  unit.  A social worker would also evaluate them before they

 

         24  even came to the unit to make sure that they were medically

 

         25  fit to sustain at least eight hours of therapy, meaning group

 

          1  sessions, interactions, small one on one groups with the

 

          2  nurse, occupational therapist, recreational therapist.

 

          3      And then their condition, such as agitation or

 

          4  depression, which I believe these five were agitation mostly,

 

          5  the doctor would come in and prescribe the medications and

 

          6  then we would go ahead and observe them, see if their

 

          7  behaviors got worse or better.

 

          8  Q.  Would you report any change in their behaviors?

 

          9  A.  Yes, we'd have to report -- we would try to -- when the

 

         10  next nurse came on shift we'd usually have an interaction

 

         11  with them; and then we would have documentation at the end of

 

         12  our shift, documenting what type of behavior we observed.

 

         13  Q.  In December of 1995 and January of '96, was this unit set

 

         14  up for any kind of medical -- physical medical emergencies?

 

         15  A.  Medical emergencies, as far as -- there were no O2

 

         16  adapters set up in the room in case a person started having

 

         17  breathing problems.  We didn't have rapid access to oxygen.

 

         18  We'd have to find an adapter, which meant we had to contact a

 

         19  respiratory therapist.  They'd bring the device in, plug it

 

         20  into the wall, and then we'd have to get an extension so that

 

         21  they could have that to be put in their mouth or their nose

 

         22  to help them.

 

         23      There was no crash cart on the unit itself in case they

 

         24  went into a cardiac arrest.

 

         25  Q.  And these were elderly patients?

 

          1  A.  Correct.

 

          2  Q.  When did you go to the geropsych unit at Davis Hospital?

 

          3  A.  I went there December of 1994.

 

          4  Q.  What shift did you work?

 

          5  A.  Day shift, which was seven to three; or the evening

 

          6  shift, three to eleven.

 

          7  Q.  How long did you stay at the geropsych unit?

 

          8  A.  I left October of '96.

 

          9  Q.  We've seen some indication in the records of

 

         10  interdisciplinary teams.  How were the teams set up, do you

 

         11  recall?

 

         12  A.  The term interdisciplinary team approach meant the

 

         13  doctor, the nurse, the occupational therapist, the social

 

         14  worker, the physical therapist.  They would interchange their

 

         15  ideas, what they observed.  Everybody would listen to

 

         16  everybody and then you would come out with a treatment plan

 

         17  that would best suit this individual patient's needs.

 

         18  Q.  You indicated that therapy groups took how long during

 

         19  the day?

 

         20  A.  Umm, different people would run -- they would run

 

         21  sometimes a half hour to an hour.  Then give them a break and

 

         22  let them relax.  Then we'd kind of divide it up where a nurse

 

         23  would do a group, a physical therapist would come in,

 

         24  sometimes speech therapy.  We tried to keep them running

 

         25  throughout the day, except during lunch periods where they

 

          1  could eat and take a nap if they needed to.

 

          2  Q.  Did Dr. Weitzel ever talk to you, during December of '95

 

          3  and January of '96, about patients missing groups?

 

          4  A.  Missing groups?

 

          5  Q.  Yes.  Not going to group for a variety of reasons?

 

          6  A.  No.

 

          7  Q.  During December of '95 and January of '96, did you ever

 

          8  see the defendant interact one on one with the patients that

 

          9  we're talking about in this case?

 

         10  A.  One on one, no.

 

         11  Q.  What time of day would Dr. Weitzel come in, if you can

 

         12  recall?

 

         13  A.  During that time frame he would come in usually around 11

 

         14  at night.

 

         15  Q.  Now, were the patients awake then?

 

         16  A.  No.  They were in their beds asleep.

 

         17  Q.  Did you see him write his reports about the patients'

 

         18  conditions?

 

         19  A.  Yes.  He'd sit at the desk and write the reports, the

 

         20  summary.

 

         21  Q.  And what did you see him do in order to prepare his

 

         22  report, as far as seeing the patient, that sort of thing?

 

         23  A.  If the doors were closed he would just open them a little

 

         24  bit and peak in and not even go into the room.  Then come

 

         25  back to the desk and ask the nurse what went on for the day

 

          1  and then he'd write the note.

 

          2  Q.  Did you ever see him in come in when you had patients in

 

          3  groups?

 

          4  A.  Yes.

 

          5  Q.  And what would he do if a patient was in a group as far

 

          6  as checking their condition?

 

          7  A.  Oh, on the occasion where I'd be having my group, he'd

 

          8  pop in and say I'm not interrupting and then leave.  That

 

          9  would be the course of the interaction.

 

         10  Q.  Do you recall Ellen Anderson?

 

         11  A.  Yes, I do.

 

         12  Q.  What was her condition when you first saw her?

 

         13  A.  Her condition when I saw her was not a very good

 

         14  condition.

 

         15  Q.  What day or what time was that, do you recall?

 

         16  A.  It was in the morning.

 

         17  Q.  I think you have 2C in front of you, which is Ellen

 

         18  Anderson's medical records.  Are they there?

 

         19           THE COURT:  I'll caution you, counsel, about not

 

         20  replowing ground.

 

         21           MS. BARLOW:  Yes, Your Honor.

 

         22           THE WITNESS:  I don't see that book.

 

         23           MS. BARLOW:  That's because I see it over here.

 

         24      (Pause in the proceedings.)

 

         25  Q.  (BY MS. BARLOW)  Just to refresh your recollection of

 

          1  when you saw her, if you would turn in 2C to page number 191.

 

          2  Do you recall when you first saw her?

 

          3  A.  It was in the morning.  According to this it was 7:30

 

          4  when I was coming on shift.  We had shift change at seven.

 

          5  It usually takes half an hour to get the report from the

 

          6  nurse that is leaving shift.

 

          7  Q.  Were you there when she passed away?

 

          8  A.  Yes, I was.

 

          9  Q.  What time was that?

 

         10  A.  Umm, 8:55.

 

         11  Q.  Did you see the defendant at all, in relationship to

 

         12  Ellen Anderson, prior to her passing?

 

         13  A.  Prior to her passing, I hadn't been on shift.  I mean,

 

         14  that was the first time --

 

         15           THE COURT:  Maybe ask when?  Do you mean within an

 

         16  hour, within a day?

 

         17  Q.  (BY MS. BARLOW)  From the time you came on at 7:00 until

 

         18  she passed at 8:55, did you see the defendant during that

 

         19  time period?

 

         20  A.  Yeah, he came in.

 

         21  Q.  When did he come in?

 

         22  A.  I want to think it was like afternoon.  Twoish.  I don't

 

         23  know.  He came on while I was there, though.

 

         24  Q.  Was it before she passed away?

 

         25  A.  No, no.

 

          1  Q.  Thank you.  Do you recall Judith Larsen?

 

          2  A.  Yes.

 

          3  Q.  What do you recall about Judith Larsen?

 

          4  A.  She was on the unit a really long time.

 

          5  Q.  Did you see any change in her condition during the time

 

          6  she was on the unit?

 

          7  A.  Yes.  She was throwing up during that time.  She

 

          8  deteriorated physically.

 

          9  Q.  I would like to -- if you would turn to 3B, which is

 

         10  Judith Larsen's medical records.

 

         11  A.  (Witness complied.)

 

         12  Q.  And turn to page 456.

 

         13  A.  (Witness complied.)

 

         14  Q.  There's an order written that appears to be by Dr.

 

         15  Weitzel on the 13th of December on that page.  Do you recall

 

         16  that order?

 

         17  A.  Do I recall the order that day?

 

         18  Q.  Well, what's the order for?

 

         19  A.  For MS, morphine, 15 milligrams, IM, Q four hours, PRN,

 

         20  severe pain or agitation.

 

         21  Q.  And then if you will turn over to page 458.

 

         22  A.  (Witness complied.)

 

         23  Q.  There's a note at the bottom of that page and what date

 

         24  is that?

 

         25  A.  That was on the 19th.

 

          1  Q.  And what is that note?

 

          2  A.  DC/MS, PRN.

 

          3  Q.  What does DC mean?

 

          4  A.  Discontinue.

 

          5  Q.  And did you note that discontinuation of morphine?

 

          6  A.  Yes.

 

          7  Q.  Do you recall a discussion with Dr. Weitzel regarding the

 

          8  order of morphine on the 13th and the discontinuation of the

 

          9  morphine on the 19th?

 

         10  A.  Yes, I do.

 

         11  Q.  Where did that discussion take place?

 

         12  A.  At the nurse's station.

 

         13  Q.  Was anyone else present?

 

         14  A.  Not that I'm aware of.  I don't know.

 

         15  Q.  What, if anything, did you say to Dr. Weitzel about this

 

         16  morphine order?

 

         17  A.  I was -- I asked him if we could have it discontinued

 

         18  because I had been reading in the geriatric books that she

 

         19  was on a lot of medications.  I was afraid that it would

 

         20  interfere or cause those drugs to increase in potency.

 

         21  Q.  What was his response?

 

         22  A.  He didn't talk directly.  He just kind of bent down and

 

         23  looked at me over his glasses.  And when he left he just

 

         24  pushed the chart in front of me and said there and then left.

 

         25  Q.  Do you know whether Mrs. Larsen ever got that morphine

 

          1  that was ordered on the 13th, PRN, any morphine from that

 

          2  order between the 13th and the 19th?

 

          3  A.  I don't know.  I would have to refer to the documents.

 

          4  Q.  Let's see if we can get to the right page.  If you would

 

          5  look at 510.

 

          6  A.  Yes, she did.

 

          7  Q.  When did she get it?

 

          8  A.  She didn't get it on the 13th, no.

 

          9  Q.  Did she get it any time between the 13th and the 19th?

 

         10  A.  No, she did not.  Well, yes, she did.

 

         11  Q.  Okay.  Where?

 

         12  A.  Up on the top there she got it on the 1st.

 

         13  Q.  But that's not between the 13th and the 19th?

 

         14  A.  Well, no.  No, she did not get it between those dates.

 

         15  Q.  Okay.  Then if you would turn to page 578.

 

         16  A.  (Witness complied.)

 

         17  Q.  We've heard testimony of some vomiting emesis, that sort

 

         18  of thing.  Were you present when that was occurring?

 

         19  A.  Yes, for one of the episodes.

 

         20  Q.  What did you write on 578 at 1400?  First, what day was

 

         21  that?

 

         22  A.  December 30th, 1995.

 

         23  Q.  What did you write at 1400?

 

         24  A.  Dr. Weitzel ordered MS, IM, to be given Q four hours

 

         25  around the clock.  Patient not PO intaking.  Oral care given

 

          1  and position changed.

 

          2  Q.  Did you question Dr. Weitzel about the order of morphine

 

          3  on the 30th of December?

 

          4  A.  Question him why he was reordering it?

 

          5  Q.  Well, did you question him at all about the morphine?

 

          6  A.  No, not directly.  That was -- I just reported her

 

          7  condition, the coffee ground, her irregular heart rate and

 

          8  that was the order he gave.

 

          9  Q.  If you would now turn to page 588.

 

         10  A.  (Witness complied.)

 

         11  Q.  This appears to be a continuance of 587, but the date has

 

         12  been punched out.  What date did you write on 587?

 

         13  A.  That was on January 2nd, 1996.

 

         14  Q.  And what did you write at 1830?

 

         15  A.  MS, IM, five milligrams given per doctor's orders.

 

         16  Patient remains unresponsive, staring.  Cool cloth positioned

 

         17  over eyes to prevent drying.  Patient remains with eyes open,

 

         18  staring.  Cool cloth removed.  Fingers cyanotic.  Heart rate

 

         19  irregular and strong.  No oral fluids taken.  Patient clamps

 

         20  teeth on swab, refusing to open mouth.  Patient repositioned,

 

         21  Q2 hours and oral care given.  Provided medications and

 

         22  comfort measures.  Patient remains with eyes open and

 

         23  staring, rigid extremities.  Continued to provide comfort

 

         24  measures.

 

         25  Q.  Did you talk to Dr. Weitzel about the morphine that was

 

          1  being administered to Judith Larsen at that time?

 

          2  A.  At this time to Dr. Weitzel, no.

 

          3  Q.  Did you talk to anyone -- well, did you talk to anyone

 

          4  about the morphine that was being given at this time?

 

          5  A.  With Judith, no.

 

          6  Q.  Did you ever, with the morphine that was given to Judith

 

          7  Larsen, question Dr. Weitzel about the appropriateness in

 

          8  your mind, from your nursing standpoint, of the morphine?

 

          9  A.  On the 19th I did when I asked him to discontinue it.

 

         10  Q.  And let's turn to 590.

 

         11  A.  (Witness complied.)

 

         12  Q.  What date did you write on that?

 

         13  A.  January 3rd, 1996.

 

         14  Q.  Okay.  And then at -- if you would read 1530 for us.

 

         15  A.  Free text, five milligrams MS, IM, given per scheduled

 

         16  dose by LPN.  Patient staring without blinking.  Patient

 

         17  repositioned.  Oral care given.  Patient repositioned.  Oral

 

         18  care given.  Uh, that's it.

 

         19  Q.  So that's the 1530.  You note that it was given by the

 

         20  LPN.  Was there anything unusual about noting it that way?

 

         21  A.  At the time when that dose was ordered, I didn't feel

 

         22  comfortable giving it.

 

         23  Q.  Why not?

 

         24           MR. BUGDEN:  I don't know that that's relevant.  All

 

         25  that matters is she decided not to give it.

 

          1           THE COURT:  Overruled.

 

          2  Q.  (BY MS. BARLOW)  Why not?

 

          3  A.  Because I felt her condition was -- I was focusing on the

 

          4  coffee grounds, the vomiting, bleeding and not a pain avenue.

 

          5  Q.  What did you write at 1740?

 

          6  A.  Patient repositioned.  Oral care given.  Patient with

 

          7  cyanotic extremities.  Mottling evidences on lower

 

          8  extremities and back.

 

          9  Q.  What were you -- what is your nursing assessment of what

 

         10  you're seeing in this patient at this time?

 

         11  A.  Circulation problems, blood flow problems, the turning

 

         12  blue.  Mottling means that her lower extremities weren't

 

         13  getting blood supply, from my nursing assessment.

 

         14  Q.  And from your nursing background what causes that kind of

 

         15  problem?

 

         16  A.  Heart problems.

 

         17  Q.  And then at 1800 you wrote what?

 

         18  A.  1800, patient with loud moaning.  Extremities twitching.

 

         19  Patient positioned and oral care given.

 

         20  Q.  And at 1830?

 

         21  A.  "Received order for MS, 15 milligrams, IM now and

 

         22  increase MS to ten milligrams every three hours due to

 

         23  patient's agitated state."

 

         24  Q.  Did you report an agitated state?

 

         25  A.  I reported that she was twitching and moaning.

 

          1  Q.  Did you give this ordered shot?

 

          2  A.  The shot here?

 

          3  Q.  Yes.

 

          4  A.  I'd have to look and see.

 

          5  Q.  Look at 507, it might help.  Well, maybe it won't.

 

          6      (Pause in the proceedings.)

 

          7  Q.  (BY MS. BARLOW)  Yes, turn to 507, but keep your finger

 

          8  back here.

 

          9  A.  1830, yes, it was given.

 

         10  Q.  And we're talking about here the 3rd.  You say it was

 

         11  given.  Are those your initials?

 

         12  A.  No, that's the LPN.

 

         13  Q.  Why did the LPN give it rather than you?

 

         14  A.  The LPN -- usually, if we had ten patients on the unit,

 

         15  they would give us two registered -- not registered, two

 

         16  nurses.  One might be an LPN and one might be an RN.  She's

 

         17  usually the medication person and then the RN is the

 

         18  assessment person.

 

         19  Q.  When you saw the condition that you're talking about

 

         20  here, or that you note here, did you have any concerns about

 

         21  morphine for this patient from a nursing standpoint?

 

         22  A.  From a nursing standpoint, knowing that morphine slows

 

         23  down circulation and respiration, yes, I was concerned from

 

         24  that angle.

 

         25  Q.  Did you happen to talk to Dr. Weitzel about this -- about

 

          1  your concerns at this time?

 

          2  A.  You know --

 

          3           MR. BUGDEN:  That can be answered yes or no.

 

          4           THE WITNESS:  Talked to him directly about the

 

          5  concerns of morphine, no.

 

          6  Q.  (BY MS. BARLOW)  Did you talk to anyone else about your

 

          7  concerns for morphine with Judith Larsen?

 

          8           MR. BUGDEN:  Asked and answered.

 

          9           THE COURT:  Sustained.

 

         10           MS. BARLOW:  On the 3rd of January I don't believe I

 

         11  asked, Your Honor.

 

         12           THE COURT:  All right.

 

         13  Q.  (BY MS. BARLOW)  On the 3rd of January did you talk to

 

         14  anyone else?

 

         15  A.  You mean other than the other nurse on the floor?

 

         16  Q.  Right.

 

         17  A.  No.

 

         18  Q.  If you would now turn to Mary Crane, which is 4B.

 

         19  A.  (Witness complied.)

 

         20  Q.  Do you recall Mary Crane?

 

         21  A.  Yes.

 

         22  Q.  And what do you recall of her?

 

         23  A.  Umm, she was the patient that I discovered a fistula on.

 

         24  Q.  What did you do when you discovered that fistula?

 

         25  A.  I contacted Dr. Dienhart.

 

          1  Q.  And why did you call Dr. Dienhart?

 

          2  A.  He was the medical doctor that did the medical evaluation

 

          3  on her when she was admitted.

 

          4  Q.  Did you tell Dr. Weitzel that you had called Dr.

 

          5  Dienhart?

 

          6  A.  Well, he found out I had.

 

          7  Q.  How do you know that he found out you had?

 

          8  A.  Because he had -- he had a discussion with me.  He was

 

          9  angry about it.

 

         10  Q.  Do you recall when that discussion happened?

 

         11  A.  Not the exact time or anything, but I was on the phone

 

         12  because I was calling about another patient, and he said by

 

         13  the way, I'm the primary physician and you don't call

 

         14  secondary doctors in.  I'll handle -- I just was trying to

 

         15  explain that it was a medical thing, but he raised his voice.

 

         16  That's the reason you can't suggest things.

 

         17           MR. BUGDEN:  Your Honor, this is not responsive.

 

         18           THE COURT:  Sustained.

 

         19  Q.  (BY MS. BARLOW)  That's okay.  They pay me to ask the

 

         20  questions.  So he told you that he was the primary.  What did

 

         21  you say in response?

 

         22  A.  I just said, umm, it was a medical need.

 

         23  Q.  What did he say to you?

 

         24  A.  I'm sorry.

 

         25           THE COURT:  Do you need a minute?

 

          1      (Pause in the proceedings.)

 

          2           THE WITNESS:  Okay.

 

          3  Q.  (BY MS. BARLOW)  Would you like a glass of water?

 

          4  A.  I'm okay.

 

          5  Q.  After he said that to you what did you say to him?

 

          6  A.  After he said what?

 

          7  Q.  You said that it was a medical emergency.  What, if

 

          8  anything, did he say to you in response to that statement?

 

          9  A.  He just said I'll provide all of her care.

 

         10  Q.  What did you say at that point?

 

         11  A.  Well, I wouldn't say anything after the way he talked.

 

         12  Q.  So you didn't say anything further to him?

 

         13  A.  (Witness shook her head.)

 

         14  Q.  Did you ever -- you had a nursing supervisor, a chain of

 

         15  command within the hospital?

 

         16  A.  Yes.

 

         17  Q.  Did you ever go up through the chain of command

 

         18  concerning discussions with Dr. Weitzel?

 

         19  A.  Yes, I did.

 

         20  Q.  To whom did you go?

 

         21  A.  My first contact was the nursing supervisor.  Then after

 

         22  that I went to Todd Chambers.

 

         23  Q.  And who was Todd Chambers?

 

         24  A.  He was the director over Horizon.

 

         25  Q.  Did anything change after you went up the chain of

 

          1  command with your concerns?

 

          2  A.  Umm, well, after Shannon Walker came on she was the new

 

          3  supervisor.  It was after the first of the year.

 

          4           MR. BUGDEN:  I don't believe that this is

 

          5  responsive.

 

          6           THE COURT:  Yes or no.

 

          7           THE WITNESS:  I'm sorry.

 

          8  Q.  (BY MS. BARLOW)  Did anything change?

 

          9  A.  Yes.

 

         10           MR. BUGDEN:  In this time frame?  Can we ask for

 

         11  that clarification.  Are we talking about December and

 

         12  January?

 

         13           THE WITNESS:  January.

 

         14  Q.  (BY MS. BARLOW)  January of '96?

 

         15  A.  Yes.

 

         16  Q.  You indicated a new nursing supervisor came on?

 

         17  A.  Yes.  Plus we carried no morphine on the unit.

 

         18           MR. BUGDEN:  I'll ask that she not volunteer this

 

         19  kind of information, that she only answer the question.  I

 

         20  ask that that be stricken.

 

         21           THE COURT:  It will be stricken.  The jury is to

 

         22  disregard that.  Go ahead.

 

         23  Q.  (BY MS. BARLOW)  So Shannon Walker, you say, came on

 

         24  board?

 

         25  A.  Yes.

 

          1  Q.  There were changes after that?

 

          2  A.  Yes, there were.

 

          3  Q.  Were there changes before that?

 

          4  A.  No.

 

          5  Q.  Okay.  If you would now turn to Lydia Smith.  That's 5B.

 

          6  A.  (Witness complied.)

 

          7  Q.  Do you recall Lydia Smith?

 

          8  A.  Yes, I do.

 

          9  Q.  What do you recall about her?

 

         10  A.  There wasn't anything striking that came out.  During

 

         11  that time she was the one patient who was admitted and

 

         12  deteriorated and then died.  That's what I recall.

 

         13  Q.  Do you recall Ennis Alldredge?

 

         14  A.  Yes, I do.

 

         15  Q.  What do you recall of Mr. Alldredge?

 

         16  A.  Umm, he was feisty.  He was a good man.

 

         17  Q.  Do you have number 6B in front of you there?

 

         18  A.  Uh-huh.

 

         19  Q.  If you would turn to page 61 in that.

 

         20  A.  (Witness complied.)

 

         21  Q.  Were you on duty during your shift on the 10th of

 

         22  January, which is the day that he came in?

 

         23  A.  Yes, I was.

 

         24  Q.  Do you recall seeing any interaction between Dr. Weitzel

 

         25  and Ennis Alldredge on the day that Ennis Alldredge came in

 

          1  on the 10th of January?

 

          2  A.  The 10th?  Umm, when he came in -- I don't know on that

 

          3  date, I don't recall.

 

          4  Q.  If you will turn back to page 11 now.

 

          5  A.  Page 11?

 

          6  Q.  Yes.

 

          7  A.  (Witness complied.)

 

          8  Q.  There's an order up at the top.  If you would read what

 

          9  date that was.

 

         10  A.  1/10.

 

         11  Q.  Of '96?

 

         12  A.  '96.

 

         13  Q.  And if you would read the first order there.

 

         14  A.  Haldol, ten milligrams, IM now.

 

         15  Q.  Just above that.

 

         16  A.  Ativan, one milligram, and Haldol, 10 milligrams, IM now.

 

         17  Q.  Do you recall what led up to this order being made by the

 

         18  defendant?

 

         19  A.  Well, Ennis was kind of agitated and when Dr. Weitzel

 

         20  went in the room he kind of kicked out at him.

 

         21  Q.  Who kicked out at whom?

 

         22  A.  Ennis did.

 

         23  Q.  Kicked out at Dr. Weitzel?

 

         24  A.  Yes.

 

         25  Q.  Okay.  And then what did Dr. Weitzel do?

 

          1  A.  He was annoyed that he'd made contact with him.

 

          2  Q.  So what did Dr. Weitzel do?

 

          3  A.  Well, he came out and ordered to have the Haldol and the

 

          4  Ativan given to him.

 

          5  Q.  Now turn to page 77.

 

          6  A.  (Witness complied.)

 

          7  Q.  What date was that?

 

          8  A.  1/14/96.

 

          9  Q.  Were you there when Ennis Alldredge passed away?

 

         10  A.  Yes.

 

         11  Q.  At 7:35 you wrote a note.  Would you start reading that,

 

         12  please.

 

         13  A.  "Patient with deep labored respirations.  Patient turned.

 

         14  Moaning.  Turning procedures.  Patient has thick mucus

 

         15  drainage from mouth.  Oral care given.  Lungs with rales

 

         16  throughout.  Cyanotic extremities.  Family members at

 

         17  bedside."

 

         18  Q.  Is there anything about his condition at that time that

 

         19  as a nurse gave you concern?

 

         20  A.  He was definitely deteriorating.  And the cyanotic means

 

         21  he was turning blue.  His extremities were turning blue.  His

 

         22  condition was deteriorating.

 

         23  Q.  And at 8:00 what did you write?

 

         24  A.  Umm, patient given 10 milligrams morphine on due to

 

         25  continued moaning.

 

          1  Q.  And the rest of that note?

 

          2  A.  Patient respirations labored.  Patient is with eyes open,

 

          3  staring.  Family remains at bedside.

 

          4  Q.  Now, let's look back.  We're talking about the 14th.

 

          5  That 0800, do you recall if it was a PRN order or if it was a

 

          6  routine order?

 

          7  A.  I don't know.  I'd have to look.

 

          8  Q.  If you would turn to page 47, I think we can answer that

 

          9  question.

 

         10  A.  (Witness complied.)

 

         11  Q.  Which is the medical record.

 

         12  A.  Okay.  At 8:00, yes.

 

         13  Q.  Who gave that shot?

 

         14  A.  I did.  That was his scheduled med.

 

         15  Q.  Now, that was at 8:00.  Did you have occasion to contact

 

         16  Dr. Weitzel about this patient's condition at that time?

 

         17  A.  Yes.  I called him.

 

         18  Q.  And if you would turn to page 14, was there any order

 

         19  given in response to your telephone call?

 

         20  A.  Yes.  He ordered ten more milligrams of morphine.

 

         21  Q.  At what time?

 

         22  A.  At 9:20.

 

         23  Q.  Did you question or talk to Dr. Weitzel about that

 

         24  morphine order?

 

         25  A.  Question him about it, no.

 

          1  Q.  Did you talk to him about it?

 

          2  A.  Talk to him about it, no.

 

          3  Q.  Did you say anything directly to him about --

 

          4           MR. BUGDEN:  I think that this has been covered at

 

          5  this point.  Asked and answered.

 

          6           THE COURT:  I think she indicated she didn't say or

 

          7  do anything, Ms. Barlow.

 

          8           MS. BARLOW:  Okay.

 

          9  Q.  (BY MS. BARLOW)  Did you administer that morphine dose?

 

         10  A.  No.

 

         11  Q.  Did you tell Dr. Weitzel that you were going to or not

 

         12  going to administer that dose?

 

         13  A.  No, I didn't.

 

         14  Q.  And why did you not?

 

         15  A.  Because I was afraid he'd yell at me again.

 

         16  Q.  Now, that was at what time?

 

         17  A.  At 9:20.

 

         18  Q.  What did you write back on 78 at 9:20?

 

         19  A.  Which page again?

 

         20  Q.  Page 78.

 

         21  A.  Patient to be given now order of ten milligrams morphine

 

         22  IM, and Ativan .5.  Patient with decreased functions.  Apnea,

 

         23  60 seconds, meaning he wasn't breathing.  Heart rate tachy

 

         24  and thready.  Medication held, not given.  Peripheral pulses

 

         25  weren't felt.  Cyanotic extremities.  Family at bedside.

 

          1  Aware of declining condition.  Wife awoken from sleep to be

 

          2  with patient.

 

          3  Q.  And were you present when Mr. Alldredge passed away?

 

          4  A.  Yes, I was.

 

          5  Q.  What time was that?

 

          6  A.  Umm, at 9:36.

 

          7           MS. BARLOW:  I think that's all I have of this

 

          8  witness.

 

          9           THE COURT:  Cross-examine, Mr. Bugden.

 

         10                      CROSS-EXAMINATION

 

         11  BY MR. BUGDEN:

 

         12  Q.  Ms. Hardey, I'm Walter Bugden.  I'm going to ask you a

 

         13  few questions.  I'm one of the lawyers that represents Dr.

 

         14  Weitzel.

 

         15      With regard to Mr. Alldredge, you told us that on January

 

         16  14th, by 8:00 p.m., his condition was declining.  He was

 

         17  close to death, is that about right?

 

         18  A.  He was declining, his condition.

 

         19  Q.  Are you aware that on the preceding day the family had

 

         20  decided on no further medical interventions and that on the

 

         21  preceding day they had decided to step back, no medical

 

         22  interventions and let Mr. Alldredge die, were you aware of

 

         23  that?

 

         24  A.  That he is going to hospice care, you mean?

 

         25  Q.  No.

 

          1           THE COURT:  Just listen to the question.

 

          2  Q.  (BY MR. BUGDEN)  I don't think that's what I asked.  Were

 

          3  you aware that on January 13th, and we were just talking

 

          4  about January 14th, 1996.  Are we oriented now?

 

          5  A.  Uh-huh.

 

          6  Q.  I'm asking you on the day before, on January 13th, are

 

          7  you aware that Mrs. Alldredge, speaking in behalf of the

 

          8  Alldredge family, had decided to step away, no more medical

 

          9  intervention, and let Mr. Alldredge pass away with comfort

 

         10  care?  Are you aware of that, yes or no?

 

         11  A.  I don't know the exact date, you know.  I was aware that

 

         12  he was a DNR.

 

         13  Q.  You were aware that he was a DNR?

 

         14  A.  Yes.

 

         15  Q.  Were you aware that the family had asked for only comfort

 

         16  measures, were you aware of that?

 

         17  A.  Yes.

 

         18  Q.  All right.  People passing away, even for a veteran nurse

 

         19  like yourself, it's an emotional experience, is that about

 

         20  right?

 

         21  A.  When there's six, yeah.

 

         22  Q.  Pardon me?

 

         23  A.  When there's that many people dying in such a short time.

 

         24  Q.  I don't believe that's what I asked you.  I would ask

 

         25  that it be stricken.

 

          1           THE COURT:  Mr. Bugden, I'll take care of that.

 

          2  It's not responsive.  Listen to the question and respond to

 

          3  it.  Go ahead.

 

          4  Q.  (BY MR. BUGDEN)  I'm just asking you, ma'am, -- never

 

          5  mind.  I won't ask that question.  I will ask you to listen

 

          6  to my questions and answer the questions.  Can we agree to do

 

          7  that, ma'am?

 

          8  A.  Uh-huh.

 

          9  Q.  Thank you very much.  You had a conversation with Dr.

 

         10  Weitzel one day when you had a little bit of spare time on

 

         11  the unit and you were looking at the geriatric handbook, is

 

         12  that right?

 

         13  A.  Pharmacology books.

 

         14  Q.  Okay.  You were looking at some pharmacology books.  And

 

         15  you had a conversation with Dr. Weitzel about some of the

 

         16  dosing he'd been doing, is that right?

 

         17  A.  Yes.

 

         18  Q.  And with all due respect, in terms of the hierarchy in

 

         19  the medical arena, you were the nurse, he was the doctor, is

 

         20  that right?

 

         21  A.  We were an interdisciplinary team.

 

         22  Q.  An interdisciplinary team, but a nurse doesn't prescribe

 

         23  medication, does she?

 

         24  A.  Correct, we don't.

 

         25  Q.  What you do is you follow the doctor's orders and you

 

          1  administer the medicine, is that right?

 

          2  A.  Correct.

 

          3  Q.  You don't have a license to prescribe, do you, Nurse

 

          4  Hardey?

 

          5  A.  No, I do not.

 

          6  Q.  You didn't go to medical school?

 

          7  A.  No, I did not.

 

          8           MR. BUGDEN:  That's all I have.

 

          9           MS. BARLOW:  No redirect.

 

         10           THE COURT:  You may step down.  May this witness be

 

         11  excused?

 

         12           MS. BARLOW:  Yes, Your Honor.

 

         13           MR. BUGDEN:  Yes.

 

         14           THE COURT:  You may be excused.  Thank you for

 

         15  testifying.

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