Expert blames suicide on Vista Health, doctor
Posted on Wednesday, May 14, 2008
An expert witness testified Tuesday that a mental health facility and its psychiatrist should have accepted Judy Caldiero for inpatient treatment five days before she committed suicide in 2005.
A Washington County jury is expected to conclude this wrongful death trial today before 4 th Judicial Circuit Judge William Storey. The estate of Judy Caldiero and Andy Caldiero, her husband, is seeking unspecified damages against two separate defendants - Vista Health in Fayetteville and Dr. Lewis Britton, the psychiatrist who reviewed an assessment of Caldiero.
Caldiero was 58 when she shot herself at home with a handgun she bought at a pawn shop - five days after her family tried to get her admitted into Vista Health. Dr. Joel Reisman of Memphis, Tenn., said he concluded after reviewing the intake assessment of Caldiero and other documents that Vista Health wrongly concluded on Nov. 25, 2005, that Caldiero was at moderate risk of suicide. Reisman said Caldiero was at severe risk because she had attempted suicide a week before the assessment and had suicidal thoughts earlier that day. He also cited insomnia, behavioral changes, social withdrawal and changes in eating habits as factors that should have been weighed more heavily.
Training blamed Reisman also testified that he concluded Vista Health failed to properly train Karen Hatch, the needs assessment coordinator in November 2005. She failed to check off some of the warning signs for suicide on the assessment form.
"They basically threw her out there on her own without any training," Reisman said. "She was sent to a job very ill-prepared."
Hatch testified that she had been on the job about a month and completed between five and 10 assessments on her own before interviewing Caldiero and her husband and daughter. Her training included shadowing two assessment coordinators, she said. She had a degree in criminal justice and had worked for 12 years as a probation officer before going to work for Vista Health.
She testified that Caldiero had suicidal thoughts the morning before she came in for the assessment but was not considered an immediate suicide risk during the evaluation because she did not have a specific plan to commit suicide.
Conflicting testimony Reisman said Britton is to blame for making the wrong decision about not admitting Caldiero for inpatient care based on Hatch's testimony.
"If we take Karen Hatch's version, Dr. Britton breached the standard of care," Reisman said.
Hatch testified that she spent about 15 to 20 minutes with Dr. Britton, who reviewed the assessment and a medical history prepared by Caldiero's family. Britton referred Reisman for outpatient care with a local psychiatrist, not inpatient care.
Britton testified that he did not recall ever looking at the assessment prepared by Hatch. He recalled discussing the evaluation with Hatch by telephone.
Britton would not say Hatch's testimony was wrong because he could not specifically remember discussing this assessment more than two years ago.
Most assessments are conducted by phone, witnesses said.
Britton said he looked at the assessment after Caldiero's death and said he would have taken the risk more seriously if he had seen the assessment. Still, he testified that outpatient care was the correct decision based on available information.
"I still do not think it would require admission," he said.
' Slam dunk'The expert refused to say whether the hospital or the doctor was to blame after an attorney for Vista Health pointed out that he lumped the two defendants together in his analysis. Reisman said that question is for the court to decide. "The (doctor ) makes the decision of suicide risk based on the information given to him," Reisman said. "Had (Hatch ) been trained better, she could have emphasized the importance of (the suicide risk to the doctor ). "He agreed under crossexamination that mental health providers can disagree on the best course of action for a patient, but he refused to imply that applied in this case. "This was not a judgment call," Reisman said. "This was a slam dunk."
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