Doctor was ‘dumbfounded’ to find ICU patient dead
A ‘family meeting’ on life support did not occur, Dr. Josef Dolezel says at nurse’s manslaughter trial
Dr. Josef Dolezel was “dumbfounded” when he went to examine his ICU patient Deanna Leblanc’s leg and found she was dead, he testified Tuesday.
It was only a week later, when the head nurse asked him if he gave orders to take Leblanc off life support, that he learned what had happened.
Nurse Joanna Flynn had taken her off life support without authorization from Dolezel or any other doctor at Georgian Bay General Hospital.
Dolezel was the doctor in charge of the intensive care unit (ICU) on March 2, 2014, the evening that Leblanc, 39, was declared dead, 16 hours after she had a cardiac arrest at her home in Midland, Ont.
Flynn is on trial for manslaughter and criminal negligence causing death. She has pleaded not guilty to both charges, but has admitted she took Leblanc off life support without authorization of a doctor and that by doing so, she hastened Leblanc’s death.
The Crown alleges she coerced Leblanc’s husband, Michael, into consenting to taking his wife off life support.
Dolezel took over Leblanc’s care from Dr. James Fahy around 2:30 p.m., he told the court.
He said that it was clear she’d suffered serious brain damage and she was being supported with a ventilator and medication.
She was in a “deeply comatose” state, he said.
He said he did not make a diagnosis that she was “brain-dead.”
“I never give up on anybody who has a flicker of life within.” DR. JOSEF DOLEZEL
Though other doctors thought her condition had been caused by a blood clot resulting from her routine knee operation two days prior in Newmarket, he thought she might have an infection in her blood and ordered some tests.
Her condition was “likely to be irreversible,” he testified.
However, he said that he did not give up on her.
“I never give up on anybody who has a flicker of life within,” he said.
He told the court that he could not recall his exact words to Michael at around 5 p.m. after a10- or15-minute examination, but said something like “she is very ill and the prognosis is poor and that we will support her as much as we can.”
He returned later — he isn’t sure when — to complete his examination by measuring Leblanc’s knee so he could see if it would change over time.
Fifteen minutes prior to this, he had a conversation with Flynn about Leblanc, he told the jury.
“(Flynn) was moving fast and I do remember her words: ‘He wants to stop everything,’ ” Dolezel said.
Dolezel said he responded, “That is new, we have to discuss it.” He said he could not recall how Flynn responded.
“I interpreted it as (Michael) wanted to stop life-support measures,” Dolezel testified.
He said by discussing it, he meant that, as per hospital protocol, a “family meeting” would have to be called “with Mr. Leblanc to discuss declarations for care . . . what kind of life support he wants us to carry on with.”
That meeting would include a nurse, the husband (who had power of attorney), a respiratory therapist and himself. He said that whatever decision was made would be noted down with the time.
That family meeting never happened, he said.
When he got to Leblanc’s room, Flynn was there. Michael was not, he said.
“I didn’t know she died, not until I entered the room,” he said. “The pa- tient was pale, she looked like she had expired.” He said he saw that the ventilator was stopped and that there was a flat line on the heart monitor.
He said he measured Leblanc’s leg anyway even though it was unnecessary and declared her dead at around 8 p.m.
He only had one brief exchange with Flynn in the room, he said.
He said she asked him: “Did you realize she is dead?”
He replied he didn’t know until he came to the room.
Dolezel testified he got Michael’s phone number and called him to inform him that his wife had died, that an autopsy would likely be done and how sorry he was for his loss.
Earlier in the trial, Michael testified that this interaction took place in person. He also testified he was in the room when Dolezel came in and measured Leblanc’s leg. He said this was confusing to him since Leblanc had already been taken off life support.
During cross-examination, Flynn’s lawyer Samantha Peeris asked whether Dolezel was sure Michael was not in the room.
“If the husband of the deceased person was in the room, while you were measuring the deceased person’s leg, you would notice that,” she said.
He said he did not recall Michael being present.
Dolezel testified he never had any discussion with anyone about taking Leblanc off life-support. No family meeting took place. No “code” was called so that CPR could be started when Leblanc’s heart stopped.
He did not know at the time that Flynn had stopped the ventilator, he testified.
In a note he dictated shortly after declaring Leblanc dead, he said that do-not-resuscitate instructions had been obtained from the husband. He testified he knew this because Flynn had said Michael “wanted to stop everything.”
During cross-examination, Peeris suggested when Flynn told Dolezel about Michael’s wishes, he replied that it could wait for Dr. Fahy on Monday (the following day). Dolezel said he did not recall that. Peeris also suggested Flynn came back a few minutes later and told Dolezel that Michael was “insisting on removing life support that evening and did not want to wait until tomorrow.”
Dolezel said he could not recall that information being provided to him and that it probably did not happen.
Peeris suggested that after Flynn told him this, Dolezel did not respond.
Instead, he picked up an art pamphlet with an image of a white-haired woman on it, pointed to it and said: “Is this you?”
Dolezel said he does not recall the pamphlet or saying that.
The trial continues.