Nurse testifies she was following family’s wishes
Woman accused of manslaughter told court the patient’s husband wanted her to take his wife off life support
BARRIE, ONT.— A nurse accused of manslaughter and criminal negligence causing death for taking a patient off life support testified this week that she was simply following the wishes of the patient’s husband.
“(He) had already made up his mind. The family was all aware of his decision and not one single person said ‘no, don’t do this.’ Everyone was aware of his decision, why he was making his decision including the physician,” nurse Joanna Flynn, 51, told a jury Wednesday.
“I was trying to honour her wishes and do what she wanted, as relayed though her husband, the substitute decisionmaker.”
Flynn took Deanna Leblanc, 39, off life support without a doctor’s order, and by doing so, she hastened her death on March 2, 2014.
Deanna was rushed to the hospital after going into cardiac arrest at her Midland home early in the morning. She died at 8 p.m. later that same day at Georgian Bay General Hospital, one hour after Flynn started her shift.
The trial has zeroed in on whether Flynn followed hospital and regulatory body policies for discontinuing life support.
The jury has heard a Georgian Bay General Hospital policy call it a “medical decision” and requires a family meeting be called and documented by a doctor.
It also stipulates a doctor be present when the patient is taken off the ventilator.
Flynn testified she was not aware of this policy and did not believe she needed a doctor’s order to take Deanna off life support.
She said she only needed the informed consent of Deanna’s substitute decision-maker, her spouse Michael.
She said she also spoke to the Leblanc family and gave them “ample opportunity” to ask questions.
The Crown is alleging Flynn coerced Michael into consenting to have his wife taken off life-support.
Michael Leblanc, 51, has testified it was Flynn who first broached the subject of taking his wife off life support. He said Flynn told him his wife was brain-dead and that her heart would explode if she were left on the ventilator.
“It was watch that or shut the machines off so she could go peacefully. That was my choice,” he said.
Flynn testified Michael first raised wanting Deanna to be taken off life support and that she told him at least three times to sleep on it and wait until the next day.
“She wouldn’t want to be hooked up to machines, she wouldn’t want to live like this,” Flynn said Michael told her shortly after her shift started at about 7 p.m.
Flynn maintained that she tried to tell this to Dr. Josef Dolezel, the physician in charge of the ICU that evening, but that Dolezel told her it could wait for the doctor who would be in the next day.
When she told Dolezel a second time that Michael was insisting on withdrawing treatment that evening he “dismissed me by turning his back on me while I was trying to relay important information,” she said.
In an incredulous tone, she said Dolezel instead asked her about an art pamphlet. When asked by the Crown why she didn’t demand Dolezel to pay attention, why she “did not speak up for Deanna,” Flynn replied that in hindsight she should have tried harder.
She said she intended to complain about Dolezel’s behaviour the next day.
“I was upset about the situation,” she said.
“I’m trying to be a nurse doing everything I am supposed to do for this patient and her husband and I’m not getting any feedback from the most responsible physician. I’m trying to include him in this and he is ignoring me.”
Dolezel has testified Flynn told him that Michael “wanted to stop everything” but he said that was new information and they needed to discuss it, by which he meant have a family meeting.
He said he did not recall another conversation with Flynn where he said another doctor should deal with the situation the next day. He said he was “dumbfounded” when he went to Deanna’s room shortly after speaking to Flynn and found that Deanna was dead.
The jury has heard Deanna was gravely ill and suffered severe brain damage.
Two doctors who saw her said they diagnosed her as brain-dead and said that she was almost certainly not going to survive. Dolezel said her condition “was likely irreversible” but that he was not giving up on her.
Crown prosecutor Bhavna Bhangu said Deanna’s condition was not “irreversible, irreparable and terminal- ly ill” when Flynn took her off life support.
Flynn said her understanding was that Deanna was not going to survive and that there was no treatment that could be done.
“I believe everybody, all the health care professionals, expected she was going to die, the family understood she was going to die. So yes, that was an expected death,” she said.
She testified she told Michael and the family that “on the off-chance that (Deanna) survives she will never be the same” because you can never know for sure what will happen.
Bhangu suggested Flynn did not know key details about Deanna’s condition and her plan of care and did not take reasonable steps to find out.
Flynn said she was not aware Deanna had been prescribed an antibiotic and that she did not know what other orders Dolezel was planning on making.
She also did not tell Michael that Dolezel said the end-of-life decision should wait until the next day.
“If the doctor was contemplating orders and if he thought they were that important perhaps he should have gone to the patient himself,” she said.
She said she was focused on looking out for the needs of Michael and Deanna Leblanc.
The trial continues.