Care Questioned in Windber Hospital Death

By Walter F. Roche Jr.

State Health inspectors have determined there were multiple violatons of state and federal mandates in the care provided to a patient who died at a tiny rural Pennsylvania hospital in mid-April.
In a 33-page report recently made public, the state health reviewers found the deficiencies went from the bottom to the very top of the 47-bed Chan-Soon Shiong Medical Center in Windber Somerset County.
The reviewers found the vomiting patient died on April 19 because of a lack of equipment - a functioning sunction machine- and lack of qualified personnel - a respiratory therapist clocked out 15 minutes before the patient went into crisis.
The hospital is owned by a non-profit controlled by Patrick Soon Shiong, a California billionaire and medical researcher. He is listed as the head of a web of non-profits including those controling the Somerset County hospital.
The report concludes that the hospital's board failed to annually review the person responsible for managing the hospital, a requirement. In fact the official's performance was never reviewed.
Hospital officials did not respond to questions about the death and the report. Most of the report centers on the care provided to an unnamed patient who had undergone surgery at the facility.
A review of the patient's record showed an unexplained weight gain starting on April 10 and ending on the date of death, April 19. The patient's weight jumped from 171.8 on April 10 to 192.4 on April 12 and 190 pounds on the day of death.
"No action was taken to address the weight gain," the report states. In addition the patient was suffering from growing edema, spreading from his feet to groin.
The surveyors said that when the patient went into crisis on April 19, a Code Blue was called when a call for a more thorough Rapid Response Team was called for under hospital policies.
In its plan of correction the hospital, formerly known as the Windber Medical Center, realligned staff and re-educated the staff on proper procedures.
The surveyors also found the suction machine first used on the patient was not properly functioning and the lid of a cannister was not secure. A second sunctioning machine couldn't be located even on the crash cart.
Employees questioned said they were unaware suctioning equipment was required on crash carts. The hospital's plan of correction promises they will now be installed.
A review of the patient's record showed that on 34 occasions hospital employees failed to administer physician ordered anti-hypertensive medications to the patient.
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Cadden, Chin Trials Off Till 2023

By Walter F. Roche Jr.

The trials of two former pharmacists charged with 11 counts of second degree murder are apparently months away as the judge on the case has set an April 14 date for another preliminary hearing.
Livingston County Circuit Judge Michael P. Hatty set status hearings for April 14 of next year for Glenn Chin and Barry Cadden. Hatty also denied a motion by Cadden's attorney to bar the use of evidence previously collected by federal investigators in their probe of the two men.
In both the federal and Michigan cases, Cadden and Chin have been charged for their roles in the 2012 fungal meningitis outbreak which ultimately killed over 100 patients across the country including 11 in Livingston County.
In separate federal trials the two were acquitted of second degree murder racketeering charges but were found guilty of racketeering, conspiracy and related fraud charges. Cadden was sentenced to 14.5 years on the federal charges while Chin got a 10.5 year federal sentence.
Hatty previously ruled that the two defendants must be tried separately. He also denied motions to force prosecutors from the Michigan Attorney General's office to file a so-called bill of particulars, giving more detailed evidence on each of the charges.
In a statement issued today Michigan Attorney General Dana Nessel said," “Eleven Michiganders tragically died as a result of a lack of concern for patient safety.”
“My department looks forward in taking the next steps to seek justice for the victims and their families,”she added.
Cadden was president and part owner of the New England Compounding Center, the company that produced thousands of vials of methylprednisolone acetate loaded with a deadly fungus. The steroids were injected into the spines and joints of unsuspecting patients. In addition to the 100 deaths more than 700 were sickened, many seriously.
Chin was a supervising pharmacist at NECC overseeing the clean room where the deadly drugs were produced.
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Conigliaro House Goes for $4 million

By Walter F. Roche Jr.

With a court ordered lien lifted, one of the defendants in the criminal case stemming from the 2012 fungal meningitis outbreak has sold a suburban Boston home for $4 million.
Records at the Norfolk County Registry of Deeds show Douglas Congliaro and his wife, Carla, sold their 8,934 foot Dedham home for $4 million on Sept. 30.
Conigliaro recently asked a federal court judge to lift a lien that had been placed on the property after he and his wife were charged with making structured withdrawals from bank accounts to evade reporting requirements.
U.S. District Judge Richard G. Stearns granted the motion and lifted the $250,000 lien.
Conigliaro was one of 14 charged in late 2014 following a two year probe of the deadly 2012 fungal meningitis outbreak.
Douglas and Carla Conigliaro pleaded guilty to reduced charges and were sentenced to probation, which they have already served. They were not charged for involvement in the deadly outbreak that resulted in the deaths of more than 100 patients across the country.
The Dedham home was purchased in 2001 for a little over $1 million and had been on the market since Spring with an asking price of more than $4 million. The 8,934 home has seven bedrooms, eight baths, a Christopher Peacock kitchen, an outdoor swimming pool and includes acess to the Charles River.
Conigliaro is listed on the deeds as residing in Winter Park, Florida in a lake front home he purchased for $1.2 million in 2005. The Conigliaros also own a $4.2 million Beacon Hill condo.
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Yara Drops Out of USN Project

By Walter F. Roche Jr.

Yara North America, the third participant in a massive industrial project in Midway, TN. has abruptly pulled out of the sometimes controversial project headed up by US Nitrogen LLC.
The withdrawal was made official in a brief letter sent this week to Tennessee environmental officials by Henri Groenen, a Yara vice president. In the letter Groenen said the company was surrendering the two permits the company currently holds, but never really utilized.
The third company on the Midway site, Praxair, remains and both Praxair and US Nitrogen are currently operating. Praxair produces liquefied carbon dioxide, while US Nitrogen manufactures ammonium nitrate.
Yara planned to produce calcium nitrate at the facility and while it obtained state permits never erected a manufacturing facility and submitted annual reports to TDEC stating that operations had yet to begin.
In his letter Groenen thanked TDEC officials for their assistance and cooperation. He offered no explicit explanation for the withdrawal.
"Unfortunately we were not able to greenlight the final investment decision for this project after so many years of diligent work by many people," Groenen wrote in the letter to TDEC's Amanda Davis and other agency officials. Contact:wfrochejr999@gmail.com

Judge Denies NECC Defendants' Motions

A Michigan judge today denied a motion for more detailed information from prosecutors sought by the two former pharmacists facing multiple second degree murder charges.
Livingston County Circuit Judge Michael P. Hatty denied the motion for bills of particulars following arguments by lawyers for Barry Cadden, Glenn Chin and prosecutors from the Michigan Attorney General's office.
Chin and Cadden's lawyers argued that without more detail about the charges they would be unable to provide a full defense.
Prosecutors responded by pointing out that extensive details have already emerged during lengthy appeals in the case going all the way to the state Supreme Court. Both Cadden and Chin had appeals denied by the state Supreme Court and the Michigan Court of Appeals.
Hatty delayed ruling on a second defense motion regarding evidence extracted from computers by federal officials investigating the 2012 fungal meningitis outbreak.
The outbreak was caused by contaminated drugs produced by the New England Compounding Center, the company where Chin and Cadden were employed.
Hatty said he needed additional information before ruling.
Hatty will meet with the three attorneys on Nov. 17 to work out a schedule for future motion hearings. Donna Borton

Cadden: Details "Vague and Insufficient"

By Walter F. Roche Jr.

One of the defendants facing 11 counts of second degree murder says prosecutors have only provided "vague and insufficent" details of the charges against him and he wants a Michigan judge to order them to provide details in a "bill of particulars."
The 12-page motion filed for Barry J. Cadden has been countered by a Michigan prosecutor's contention that Cadden already has extensive details on the murder charges and the motion should be denied.
The filings come in advance of a Thursday hearing before Livingston Circuit Court Judge Michael P. Hatty on Cadden's motion and a similar one filed in behalf of Glenn A. Chin, a co-defendant in the case stemming from the 2012 fungal meningitis outbreak.
Cadden and Chin were charged on Dec. 21, 2018 by the Michigan Attorney General's office after a lengthy investigation into the deaths of 11 Livingston County residents. They were all injected with a spinal steroid laced with fungus and produced at the company where Cadden and Chin were employed.
Calling the charges against him unprecedented, Cadden's motion states that despite state and federal investigations, no one has been able to determine how the methylprednisolone acetate produced at the long defunct New England Compounding Center became contaminated with a deadly fungus.
Stating that without a bill of particulars, the motion states Cadden is left to speculate on just what he is specificaly accused of doing that caused the deaths. The motion concedes that if he is convicted of the charges, Cadden is likely to spend his life in jail.
"The state has failed to elucidate the factual basis for it charges," the brief authored by Gregory Gleesom and Thomas Cranmer states.
"The least the state could do is provide Mr. Cadden with fair notice of what he allegedly did wrong," the motion states adding that the state has failed to prove malice or causation, two essential elements for a second degree murder charge.
In its response Michigan prosecutors said Cadden's claims are disingenuous and the details he seeks have already been made public in a series of appeals filed in state courts. All appeals were denied.
The filing asserts that under state law Cadden is not entitled to a bill of particulars and the court should not use its powers of discretion to order one.
Assistant Attorney General Erika L. Hamilton wrote that the since charges were not in so-called short form, a bill of particulars is not mandated. Instead, the brief states, the charges already detail who was injected with the contaminated steroids and when and where that occurred.
Citing testimony in a preliminary examination and subsequent testimony in appeals courts, the motion states Cadden is being disingenuous in claiming he does not know the nature of the charges against him.
Hamilton cites testimony from former NECC employees about the insanitary conditions at NECC and the roles played by both Cadden and Chin.
"A bill of particulars would be superfluous," the filing concludes.
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USN Files River Report

By Walter F. Roche Jr.

US Nitrogen LLC pumped 23.9 million gallons of water from the Nolichucky River in October, according to a report filed this week with the Tennessee Department of Environment and Conservation.
The October total was up substantially from September when 19.53 million gallos were pumped from the river. The Greene County company, which obtained state permits to use the water in its production of ammonium nitrate, also reported discharging 7.5 million gallons of excess water back into the Nolichucky during the month.
That compares to 8.8 million discharged into the river in September. According to the report 1.4 million gallons were pumped to the company on Oct. 29 and 30 while 1.3 million gallons were pumped on Oct. 12.
The company discharged minimal amounts back into the river on the first three days of the month. Water discharged into the river totaled 5.4 million gallons on three days including Oct.6. The October twere up substantially from September when 19.53 million gallons were pumped from the river and 8 Contact: wfrochejr999@gmail.com

Tyrone Hospital Cited for Delays

By Walter F. Roche Jr.

A patient at a Blair County hospital was kept waiting for more than eight hours for transfer to a larger facility and first became unconscious and then went into cardiac arrest before the transfer finally took place.
The recent incident at the Penn Highlands Tyrone hospital was detailed in a Sept. 19 report just made public by the state Health Department.
The seven-page report cites the facility for "failure to ensure that transfer arrangements were made" for patients requiring transfer to higher level facility.
The report notes that under a federal law, the Emergency Medical Treatment and Labor Act, hospitals are required to promptly assess and treat emergency patients within 30 minutes of arrival.
The eight hour delay came as workers at the Tyrone facility attempted to transfer the patient, who eventually had to be intubated, to another Penn Highlands facility rather than seek a bed at the closest available facility. Eventually the patient was sent to a competing UPMC hospital.
The hospital filed a plan of correction addressing some but not all of the violations. Hospital officials did not immediately respond to questions about the report.
The same report states that in five of 19 cases reviewed the hospital failled to provide prompt triage treatment. In one case the patient wasn't triaged for 158 minutes.
State health surveyors also found that hospital personnel were treating emergency patients in an area only authorized for triage.
An unnamed employee at the facility told health department officials "the facility struggles "when there is a surge of patients that need to be triaged.
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