1049 1 IN THE CIRCUIT COURT OF THE NINTH JUDICIAL CIRCUIT IN AND 2 FOR ORANGE COUNTY, FLORIDA 3 LAWRENCE M. DESTEFANO, 4 Plaintiff, 5 vs. CASE NO.: 48-2000-CA-007265-O 6 ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE 7 CORPORATION; ADVENTIST HEALTH SYSTEM/SUNBELT, INC.: ROLLINS 8 BEDFORD CORPORATION, d/b/a Sunbelt Healthcare & Subacute 9 Center; SHCC SERVICES, INC., and ORLANDO REGIONAL 10 HEALTHCARE SYSTEM, INC., 11 Defendants. 12 ------------------------------------------------------ 13 VOLUME IX 14 The transcript of the proceedings held on 15 Thursday, October 20, 2005, beginning at 8:50 o'clock 16 a.m., at the Orange County Courthouse, Orlando, Florida, 17 Courtroom 19-D, before the Honorable Renee A. Roche, 18 Judge of the Circuit Court. 19 A P P E A R A N C E S: 20 WILLIAM G. OSBORNE, ESQUIRE 21 538 East Washington Street Orlando, Florida 32803 22 For the Plaintiff. 23 24 25 CENTRAL FLORIDA REPORTERS, INC. 1050 1 A P P E A R A N C E S: - CONT. 2 BRADLEY CONWAY, ESQUIRE 390 North Orange Avenue, Suite 3 Orlando, Florida 32801 4 For the Plaintiff. 5 TRACY MARSHALL, ATTORNEY and DYANA PETRO, ATTORNEY of 6 Gray Robinson, P.A. 301 East Pine Street, Suite 1400 7 Orlando, Florida 32801 8 For the Defendant/Adventist. 9 LARRY J. TOWNSEND, ESQUIRE and DAVID EVANS, ESQUIRE of 10 Mateer and Harbert, P.A. 225 East Robinson Street, Suite 500 11 Orlando, Florida 32801 12 For the Defendant/ORHS. 13 14 15 16 17 18 19 20 21 22 23 24 25 CENTRAL FLORIDA REPORTERS, INC. 1051 1 I N D E X - VOLUME IX 2 VIDEOTAPED DEPOSITION OF RACHEL BEAN - CONT. 3 Direct Examination - Cont. by Mr. Conway 1052 Cross Examination by Mr. Townsend 1128 4 Cross Examination by Mr. Grower 1130 Direct Examination by Mr. Glick 1136 5 Cross Examination by Mr. Grower 1221 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CENTRAL FLORIDA REPORTERS, INC. 1052 1 THE COURT: Mr. Osborne, ready to go? 2 MR. OSBORNE: Yes, ma'am. 3 THE COURT: Bring them in. 4 MR. OSBORNE: Judge, if you can stay later 5 than the jury, we can resolve Kelly Pipkin and 6 the -- 7 THE COURT: Yeah, that's what I'm thinking. 8 MR. OSBORNE: -- and the Dr. Krop privileges, 9 that's fine. 10 THE COURT: They want to come back and start 11 tomorrow, they said 6:30. I said I don't think 12 6:30 is possible but maybe 7:30 is. 13 COURT DEPUTY: They don't open the doors 'til 14 7:30. 15 THE COURT: 8:00 is about the best we can do. 16 COURT DEPUTY: Yeah. 17 (Whereupon the Jury entered the courtroom.) 18 THE COURT: And be seated. Go ahead. 19 (Whereupon the videotaped deposition of Rachel 20 Bean was resumed.) 21 DIRECT EXAMINATION - CONT. 22 BY MR. CONWAY: 23 Q What -- when you made that initial call to 24 Children and Families, what, what was it that you 25 recorded? CENTRAL FLORIDA REPORTERS, INC. 1053 1 A I reported the inappropriate kissing and that 2 there was blood on the pad and just his behavior in the 3 facility. 4 Q What was the significance of the blood on the 5 pad to you? 6 A Well, it was important enough that he brought 7 it to my attention, that, you know, he accused the 8 facility that we had caused a decubitus from not taking 9 proper care of his mother. I know there was blood 10 without an explanation. 11 Q Did, did the blood mean any -- anything to you 12 at that point? 13 A All it meant, there was blood on a pad that 14 there was no explanation for. 15 Q Did you have any suspicions about it? 16 A That's not my job to, to question. I found 17 the pad with the blood on it that he brought to my 18 attention and, and I reported it. That's what I'm 19 mandated to do. 20 Q Right. But what I'm asking is whether you had 21 any suspicions or not? 22 A It's not my job to judge or to accuse. 23 Q I realize that. But did you -- I mean, 24 your -- 25 A Well, I had asked him did his mother have CENTRAL FLORIDA REPORTERS, INC. 1054 1 hemorrhoids. I mean, that would be a logical reason for 2 bright red blood to be on a pad where somebody's rectal 3 area is. Other than that -- I mean, that's why the 4 doctor was called and she was transferred for further 5 evaluation. 6 Q Okay. But still the question is on the table, 7 do you have any suspicions? I know that you're 8 reporting it factually, but what I'm asking is did you 9 have suspicions about where that blood came from? 10 A My only suspicion was could it be 11 hemorrhoids -- 12 Q Okay. 13 A -- as I asked him. 14 Q So that was your concern, that there was 15 possibly blood coming from the hemorrhoid? 16 A That would be a logical explanation. 17 Q And is that the only suspicion that you had in 18 regard to that blood? 19 A Yes. 20 Q Okay. And you reported that, along with the 21 kiss, to HRS? 22 A Yes. 23 Q Anything else? 24 A I believe that was it at that time, yes. 25 Q Okay. When, when you spoke to Carol Boze and CENTRAL FLORIDA REPORTERS, INC. 1055 1 told her to come in and document what, what she had seen 2 the day before, was that a long conversation on the 3 phone or a short one? 4 A I don't -- I don't remember. 5 Q Okay. Did she tell you about anything that 6 she had seen? 7 A She did during the course of her shift. Yes, 8 she did tell me. 9 Q When did she tell you that? 10 A I don't know exactly at what time. She told 11 me that -- I have to look in her notes. That she had 12 gone inside into the resident's room to bring her her 13 supper and found patient's son lying on top of her 14 kissing her repeatedly on patient's mouth. Patient's 15 son stopped kissing her when he saw a nurse entering the 16 room. 17 Q Do you know if she observed this before you 18 and Mary Thornton entered the room and observed 19 Mr. Destefano kissing his mom? 20 A Yes. It was a late entry from 9/20. 21 Q Okay. And when did you find out about what 22 Carol Boze saw? 23 A When she came in to do her documentation. 24 Q And was that the same time that she was coming 25 in to do the late entry on the bandage -- dressing? CENTRAL FLORIDA REPORTERS, INC. 1056 1 A Yes. It was during her shift, yes. 2 Q Okay. And did she tell you at the same time, 3 oh, by the way? 4 A I -- I'm not sure. I think that she told me 5 at a later time. And that's when I said to her, you 6 know, you -- why didn't you put this in a nurses' note? 7 That's information that needs to go in the record. 8 Q And did you tell her to chart it? 9 A I told her she needed to make a late entry, 10 yes. 11 Q Do you remember when you told her that? 12 A No. It was on the 21st. I don't know when. 13 Q Did you check to make sure that she did her 14 entries? 15 A Later that evening, yes. 16 Q Were you there when she did the entries -- the 17 late entries? 18 A I was in the building, but I was not with her, 19 no. 20 Q Did you tell her what to write? 21 A Absolutely not. 22 Q Were you present when she made any of her late 23 entries? 24 A No. 25 Q Okay. Did you ever take the chart away from CENTRAL FLORIDA REPORTERS, INC. 1057 1 her while she was making entries? 2 A No. 3 Q Did you ever refuse to let her make entries? 4 A No. 5 Q Is this the type of thing that you would 6 normally expect to enter intermediately? 7 A Yes. 8 Q Did you ask her why she didn't put anything in 9 the chart about this kiss? 10 A I'm sure I questioned her why the 11 documentation wasn't there, yes. 12 Q Do you recall if she gave you an answer? 13 A I, I don't remember what -- why she didn't do 14 it. 15 Q Would she have the same obligations as you in 16 terms of reporting inappropriate behavior as a nurse? 17 A Yes. 18 Q Let's, let's take a look at the notes, nursing 19 notes. Are you at the beginning? Can you identify that 20 first note? The writing is hard to read. Do you know 21 who that nurse is? 22 A Melissa Healy. 23 Q And then the next one that's 9/29/99? 24 A Deborah Jarrell. 25 Q And that's at 10:00 a.m.? CENTRAL FLORIDA REPORTERS, INC. 1058 1 A Yes. 2 Q And then 9/21/99? 3 A Marie Nicholas. 4 Q Nicholas, she starts at 0500? 5 A Right. Where it says vital signs, 130 over 6 68, that's the beginning of her note. 7 Q And then there's the 9/20/99 late entry? 8 A Uh-huh. 9 Q That's Carol Boze? 10 A Correct. 11 Q And is that the entry that you directed her 12 to, to put in in regard to the dressing? 13 A I asked her to document what had happened with 14 the dressing, yes. 15 Q Okay. And is it your understanding that 16 that's, that's the first documentation as to the 17 dressing? 18 A Yes. 19 Q Okay. And do you know what time she wrote 20 that? 21 A No, I don't. 22 Q Can you tell from the notes? 23 A No, because she didn't write a time. 24 Q Go over to the next page. The next note is 25 from Jarrell? CENTRAL FLORIDA REPORTERS, INC. 1059 1 A That is a note from Carol Boze on the top, 2 very top. 3 Q And then Deborah Jarrell is the next one? 4 A Yes. 5 Q Is -- that note from Carol Boze on the top, is 6 that just a continuation of the page before? 7 A Yes. 8 Q Okay. I'll get back to that in a minute. 9 Mary Thornton starts charting on 9/21/99 at 8:30 a.m. 10 Is that when she was writing that or is that when this 11 occurred? 12 A I'll have to read the note to tell you. 13 Q Sure. 14 A I don't know if it was during the course of 15 the day. I can't tell from reading the note whether she 16 documented at that time at 8:30. I mean, I know that's 17 the time of the incident, but I don't know if -- what 18 time she documented that. 19 Q Do you know if it was after you did your notes 20 or before? 21 A I can only tell you I documented at 4:00 p.m. 22 because that's what I wrote. I don't know when she 23 documented. 24 Q So you don't know when? 25 A No. CENTRAL FLORIDA REPORTERS, INC. 1060 1 Q Do you know how Carol Boze was able to make 2 the late entry regarding the dressing change on 9/20/99, 3 and then the next notes that she put in there are again 4 late entries that have to do with the kiss that she 5 observed? 6 A Because she later gave the information 7 regarding the kiss, and I told her that that was -- 8 needed to be documented as an incident that happened. 9 Q She observed the kiss in the same evening that 10 the dressing change altercation began, correct? 11 A Yes. 12 Q And that's my question, whether you know why 13 it is she documents the dressing change and the 14 altercation that began there, but she doesn't put 15 anything in there about the kiss until a page and a half 16 later? 17 A Because she came in, she did the documentation 18 on the dressing change per our discussion, and then she 19 later informed me of the incident when she went into the 20 room to bring the meal. And when -- then I asked her 21 why she didn't document that. That's a situation that 22 needs to be documented, so she made another late entry. 23 Q So the only reason that she put this late 24 entry in is because you told her she needed to document 25 that? CENTRAL FLORIDA REPORTERS, INC. 1061 1 A Yeah. She needed to document the situation, 2 yes. 3 Q And you were sure that she already knew about 4 it, just hadn't documented it? 5 A Absolutely. She's the one who informed me of 6 that. 7 Q Did she describe it to you in detail? 8 A She described exactly what she wrote in her 9 nurses' note, that she went to the room to bring the 10 meal, found the son laying on top of his mother kissing 11 his mother until he realized she was there -- 12 Q Did she -- 13 A -- and then he stopped. 14 Q Did she give you any more information than 15 that? 16 A She just said that it was inappropriate that 17 he was lying on his mother kissing her. 18 Q Did you ask her how he was kissing her or did 19 you just accept what she said and that was the end of 20 it? 21 A I may have asked her at the time to describe 22 it. 23 Q Do you remember if she gave you any specific 24 details about the description of -- 25 A I don't remember. CENTRAL FLORIDA REPORTERS, INC. 1062 1 Q Okay. Did the two of you sit down and discuss 2 this in detail or was it -- 3 A No. She told me about the incident, and I 4 said then she needed to document that, just as other 5 employees have come up and said that they had seen 6 things. And basically what I told my staff, if you're 7 not willing to put it on paper and document it, then I 8 don't want to hear about it. 9 Q Okay. Did you advise her to call HRS in 10 regard to what she saw? 11 A No, I had already called HRS. 12 Q Okay. So you felt like that phone call 13 covered it? 14 A Yes. 15 Q Did -- at what point did -- Carol Boze told 16 you she signed the note that Mr. Destefano gave her? 17 A I'm not sure. I mean, I knew from Larry that 18 she had signed it -- 19 Q Did she -- 20 A -- or somebody had signed it. I'm not sure if 21 he told me who she was or if I looked back to see who 22 the nurse was. I knew somebody had signed the note. 23 Q Did she ever say to you I'm the one that 24 signed it? 25 A Yeah. CENTRAL FLORIDA REPORTERS, INC. 1063 1 Q Do you remember when that occurred? 2 A I'm not sure if it was on the telephone or 3 when she came in. 4 Q Okay. Would it have been on the 21st of 5 September, '99? 6 A Yes. 7 Q Okay. Do you know if she told you that she 8 was the one that signed the note before she told you 9 about the kiss? 10 A Well, if she had told me on the phone then, 11 then, yes, it would have been before that, but I can't 12 tell you whether it was on the phone or in my office 13 that she told me. 14 Q Okay. And you don't know what the -- what the 15 time frame is -- 16 A No. 17 Q -- in terms of when you got the information, 18 the kiss, the note, et cetera? 19 A No. 20 Q Okay. We talked earlier about the, the 21 nursing notes and the way they were working, and yours 22 are set apart from the rest of the late entries? 23 A Uh-huh. 24 Q Is that because of what you told me earlier 25 about the chart being separate from nursing notes? CENTRAL FLORIDA REPORTERS, INC. 1064 1 A Right. I mean, there are nurse's notes in the 2 charts -- 3 Q Right. 4 A -- but the way that they get those nurses' 5 notes is that there's a pad of actual nurses' notes, and 6 I just took the pad and wrote my information down. 7 Q Okay. And then you just added those into the 8 nursing notes -- 9 A Right. 10 Q -- in the chart? Okay. Can we go through 11 your notes? 12 A Uh-huh. 13 Q Let's go through it line for line. Starting 14 with 9/21/99, 4:00 p.m., and you did note in there it 15 was approximately 9:00 a.m. So you're charting 4:00 16 p.m. what occurred that morning, right? 17 A Correct. 18 Q And that's the appropriate way to do it, 19 right? 20 A Yes. 21 Q Okay. Just read, read the first few sentences 22 there for me. 23 A At approximately 9:00 a.m. my cell phone rang 24 as I entered the nurse management floor. The nurse 25 manger told me that Mr. Destefano had been in her office CENTRAL FLORIDA REPORTERS, INC. 1065 1 early yelling at her and pointing his finger in the 2 nurse manager's face. 3 Mary asked him repeatedly to wait for the DON 4 to come. I immediately went to room 307, and Mary 5 accompanied me and we knocked on the door. We entered 6 the room at the time. We witnessed Mr. Des -- 7 Q Just go ahead and stop there. 8 A Uh-huh. 9 Q Do you know where Mrs. Destefano -- 10 Destefano's chart was at this point, any idea? 11 MR. GROWER: Which point? 12 BY MR. CONWAY: 13 Q 9:00 a.m. As all this was happening with Mary 14 Thornton, do you know where the chart was? 15 A It could be at the nurses' -- I mean, it 16 wasn't with me. 17 Q Okay. 18 A I -- 19 Q Do you know if Mary Thornton had it? 20 A I don't know. 21 Q Okay. Go ahead from witnessed Mr. Destefano 22 kissing his mother. 23 MR. GROWER: Wait a minute. Start with the 24 top of the line, we entered. 25 A We entered the room. At the time we entered CENTRAL FLORIDA REPORTERS, INC. 1066 1 Mr. Destefano was kissing his mother intimately on the 2 lips. When he saw us he stopped. He walked over to the 3 door and let me by and went on to shut the door in 4 Mary's face. 5 Q Stop there for a second. Did you say anything 6 to him about, about the kiss? 7 A No. 8 Q Did Mary? 9 A No. 10 Q Okay. Go ahead and continue with -- on that 11 line. 12 A I then introduced myself and stated I heard 13 you had some concerns. We can go to my office and 14 discuss them. He said no, we can talk here while I care 15 for my mom. I said okay. He was all over the room. He 16 then put water in -- 17 Q Stop there a second. When you say he was all 18 over the room, what do you mean? 19 A He was just pacing back and forth. 20 Q Okay. Was he talking to you while he was 21 pacing? 22 A Yes. 23 Q Okay. And what was he talking about? 24 A He was talking about the dressing. He was 25 talking about having the nurse sign it, about the CENTRAL FLORIDA REPORTERS, INC. 1067 1 residents signing it. 2 Q Okay. Go ahead and continue. 3 A Where was I? He then put water in his 4 mother's mouth. He was holding her head and kept 5 telling her to swallow and was kissing her face. 6 Q How was he kissing her face at that point? 7 A At that point he was just like you would give 8 somebody a peck. Just kissing her like from side to 9 side. 10 Q On, on, on the cheeks? 11 A Yes. 12 Q You're indicating the cheeks? 13 A Yes. 14 Q Both cheeks, one cheek? 15 A It was pretty much all over her, her face. 16 Q Okay. And was he holding her in any way? 17 A Well, he was -- 18 Q Was he holding her face? 19 A Not at that time, no. He had to have been 20 holding her to support her to sit up. She couldn't sit 21 up on her own. 22 Q Okay. What position was she in while he was 23 giving her the water? 24 A He -- she was on the edge of the bed and he 25 was holding her up. CENTRAL FLORIDA REPORTERS, INC. 1068 1 Q Were her legs in the bed or outside the bed? 2 A I believe her legs were outside of the bed. 3 She was on the edge of the bed. 4 Q Okay. Then you said she -- was she able to 5 steady herself or she needed the support? 6 A No -- 7 Q Okay. 8 A -- she needed the support. 9 Q Was there anything inappropriate about the way 10 that he was kissing her at that point in your -- in your 11 mind? 12 A Well, it wasn't inappropriate. It was just a 13 little -- it was a little bizarre. He was kind of manic 14 the way he was pacing around the room, and then he was 15 giving her water and telling her to swallow and kissing 16 her. It was -- 17 Q If, if you had seen these kisses -- forget 18 about the one -- the first one, would you have been 19 concerned about the way he was kissing her at that 20 point? 21 A No. I just would have thought he was a little 22 bizarre but -- 23 Q Okay. Go ahead. 24 A I addressed the issues regarding having the 25 nurse sign the paperwork. I explained that we had CENTRAL FLORIDA REPORTERS, INC. 1069 1 policy and procedure, and our policy is to document in 2 the nursing notes. He became upset and stated that the 3 Constitution allows him to have staff sign his forms. 4 I explained that my staff would be informed 5 that they're not to sign any paperwork. And then he 6 said that he would -- I'll get a resident to document. 7 I'll ask every resident in here or get a stranger off 8 the street. I explained to him that he would be 9 infringing on the rights of others, other residents. He 10 then stated staff are not turning his mother and caused 11 her to bleed. I noted -- 12 Q Is, is that when you examined her yourself? 13 A Yes. I noticed bright red blood on the pad 14 under his mother. I questioned did she have hemorrhoids 15 and he stated no, she had an open area which we caused 16 to bleed. 17 Q Okay. Stop there for a second. I think that 18 I asked you this earlier, so if I did I apologize. Do 19 you remember roughly the, the shape of that blood spot? 20 A No. 21 Q The best way you can describe it is just an 22 approximate size and you don't really know the shape? 23 A It's been so long ago. 24 Q Okay. Go ahead. 25 A I told him I'd like to look at her bottom, and CENTRAL FLORIDA REPORTERS, INC. 1070 1 I did assess the area which was excoriated and appeared 2 to have ointment on it. There was no bleeding noted. 3 Q Did you -- were you able to notice any 4 hemorrhoids? 5 A No. I didn't -- I didn't examine her. 6 Q And did you even look for the -- did you even 7 look for hemorrhoids? 8 A No, no, because she could have internal 9 hemorrhoids that -- 10 Q Internal? Okay. Did you at that point -- let 11 me interrupt you real quick. Did you at that point 12 think that maybe a doctor needs to do the examination or 13 were you satisfied that there was nothing more that 14 really needed to be done immediately? 15 A Well, I was satisfied that she didn't have an 16 open area which, you know, he alleged we caused. So 17 much to my relief I didn't see that. But there still 18 was blood on the pad that there was no explanation and 19 it would require a physician to examine her. 20 Q So is it fair to say your primary concern at 21 this point was that she had an open wound? 22 A Yes. 23 Q Okay. And you were able to find out that she 24 did not? 25 A Correct. CENTRAL FLORIDA REPORTERS, INC. 1071 1 Q Okay. Go ahead. 2 A Okay. We then discussed the dressing on her 3 right ankle which resident's son claimed had not been 4 changed yesterday. Documentation states that the 7:00 5 to 3:00 nurse had changed it. The 3:00 to 11:00 -- 6 Q I want you to stop there. Documentation 7 states the 7:00 to 3:00 nurse had changed it. How did 8 you know that? 9 A Because by then I would have looked at the 10 treatment record. 11 Q So at that point you were -- you'd reviewed 12 the chart? 13 A To see if the dressing had been changed, yes. 14 Q Okay. And because you advised Carol Boze to 15 come in and do the late entry. Where did you find that 16 in the chart? 17 A If I had seen documentation it must have been 18 on the treatment record, and it wouldn't have been Carol 19 Boze's documentation. She's a 3:00 to 11:00 nurse. It 20 would have been the 7:00 to 3:00 nurse, whoever that 21 would have been. 22 Q Okay. Would that be in the nursing notes that 23 we're looking at now? 24 A When you have a treatment record or a 25 medication record, you only need to document on the CENTRAL FLORIDA REPORTERS, INC. 1072 1 treatment record. If you put your initials that you -- 2 under a dressing change order, that means that you've 3 done it. There's nothing that requires you to write 4 additional documentation in the nurses' notes. It's 5 double documentation. 6 Q So is that -- to the best of your knowledge 7 did, did this entry come from the chart that you're 8 describing? 9 A Yes. 10 Q Okay. Do you recall who that 7:00 to 3:00 11 nurse would have been or was? 12 A No. Not without looking through the record, 13 no. 14 Q Do you think you can find that in the record? 15 Do you have that here? If you can take a look at 16 that -- 17 A Uh-huh. 18 Q -- and show me where, where you got that 19 information from. 20 A Actually Carol Boze had to initial under the 21 7:00 to 3:00. 22 Q And is that the chart that you reviewed and, 23 and made the determination -- 24 A Yes. 25 Q -- that the dressing had been done and put in CENTRAL FLORIDA REPORTERS, INC. 1073 1 your notes? 2 A Yes. 3 Q Okay. And you're saying now that that's Carol 4 Boze? 5 A Yes. 6 Q Okay. 7 A Back to the notes? 8 Q Yeah, back to the notes. 9 A Okay. 10 Q Go ahead and pick up where you left off. 11 A The 3:00 -- the 3:00 to 11:00 nurse applied a 12 dressing in the presence of resident's son. 13 Q And can you tell me where you got that 14 information from? 15 A Well, he had told me she had put the dressing 16 on when he demanded it and she signed the paper. 17 Q Okay. So that particular sentence is 18 coming -- that information is coming from Mr. Destefano 19 himself? 20 A Yes. 21 Q Okay. Do you know who that 3:00 to 11:00 22 nurse would be or did he just say the 3:00 to 11:00 23 nurse did it? 24 A I don't know if he used her name. He -- I 25 don't know if he said her name or the nurse. CENTRAL FLORIDA REPORTERS, INC. 1074 1 Q Do you know who that would have been? 2 A I believe Carol Boze was the evening nurse 3 that had signed the information that the dressing wasn't 4 there and then she put one on. 5 Q Okay. That's confusing to me because, because 6 we got the 7:00 to 3:00 nurse, which you're saying was 7 Carol Boze, who documented that she changed it, and then 8 supposedly the 3:00 to 11:00 nurse also did it. Two 9 separate dressings? 10 A It, it may be. I, I don't know. When I 11 document it I look at the treatment record, if there's 12 initials there that somebody did the dressing change. 13 So I take that information and say, okay, they signed it 14 off. They did -- they did the dressing. 15 Q So you have to trust the charts you're looking 16 at? 17 A Yes. He then wanted to see the chart, which 18 we went to the nurses' station. Resident's son made 19 statements several times in the room that he would like 20 a mat on the floor so he could stay at the facility with 21 his mother when the admissions director had told him 22 this was not allowed. 23 I did look into the chart and the 3:00 to 24 11:00 nurse had not documented in the chart. I told him 25 there was not a note for last evening and that the nurse CENTRAL FLORIDA REPORTERS, INC. 1075 1 may have been under the impression that she signed his 2 papers so a note was not needed. I explained she would 3 be called immediately to come to the facility and 4 document a late entry note. 5 Q Okay. Stop there. Is that when you called 6 Carol Boze? 7 A Well, I didn't call her that minute, no. 8 Q Okay. Do you know when you did call? 9 A I, I don't know what time. 10 Q Okay. 11 A He started scream -- 12 Q Hang on one second. 13 A Okay. 14 Q When you say you explained when -- that the 15 nurse may have been under the impression, where did that 16 idea come from? 17 MR. GROWER: Form. 18 A Well, he had told me that he had her document 19 on a piece of paper that there wasn't a dressing and 20 that she signed the paper. 21 Q So were you just guessing? 22 A I didn't know why she didn't do the 23 documentation. And the only thing that I could think of 24 at that time was she didn't document it because she had 25 signed his paper, which was documentation for him that CENTRAL FLORIDA REPORTERS, INC. 1076 1 it wasn't done. 2 Q Okay. And you weren't aware at this point 3 that she had observed the kiss? 4 A No. 5 Q Okay. Okay. Rachel, let's pick up where we 6 left off in the nursing notes that you wrote out 7 starting 9/21/99 at 4:00 p.m. And I think we were at 8 the part where the sentence begins he then. 9 MR. GROWER: Well, I think it was at he 10 started. 11 A Yeah. He state -- he started screaming. 12 Q Okay. 13 A -- at the bottom. 14 Q Go ahead. 15 A Okay. He started screaming at me and pointing 16 his finger in my face. He was banging on the chart 17 causing residents and staff to all come to the nurses' 18 station. He kept coming forward as I was backing up. I 19 asked him to please calm down, that this was a nursing 20 home and we could not behave like this. He was yelling 21 and going down the hall. I explained I would have to 22 call 911 and have him removed from the property. 23 Q Where, where were you when this was happening 24 physically? 25 A At the nurses' station. CENTRAL FLORIDA REPORTERS, INC. 1077 1 Q Okay. 2 A I explained I would -- oops. I'm sorry. 3 MR. GROWER: He stated. 4 A He stated I don't care. I'm not leaving my 5 mother. I did call 911. OPD arrived and resident's son 6 refused to come to my office and speak with them. 7 Q And this was when you were with the OPD 8 officers explaining to them what had happened earlier? 9 A Well, I wasn't with them. I went down -- they 10 asked me to go to the room and have Larry come to my 11 office. 12 Q Okay. 13 A They, OPD, went to the room. They were able 14 to get resident's son outside in courtyard. At this 15 time he was cited with a trespass warrant. He stated he 16 would picket on the sidewalk. Resident was assessed by 17 Dr. Black at our facility and new order obtained. 18 Q Were you present when Dr. Black -- when you 19 write your notes assessed, what do you mean by assessed? 20 A That he went in and he examined the resident. 21 Q Okay. Were you there when he examined her? 22 A I'm not sure. I don't remember. 23 Q Did he examine her in her room at Sunbelt? 24 A Yes. 25 Q Okay. How do you know he did that? CENTRAL FLORIDA REPORTERS, INC. 1078 1 A He wrote a progress note stating that he did 2 examine her. 3 Q Okay. And do you know that from examining 4 that note or did Dr. Black tell you in person that he 5 had done it or both? 6 A We did have a conversation. I'm not sure if 7 during that conversation he told me he had examined her, 8 but I know that it's in his documentation that he did. 9 Q Okay. Do you know what he examined her for? 10 And feel free to -- I mean, you can refresh your 11 recollection at any point. 12 A No obvious source of bleeding identified. See 13 admission sheet for exam. 14 Q And you're looking at the doctor's progress 15 notes? 16 A Yeah. 17 Q What's the date on that? 18 A 9/21/99, 12:00 noon. Do you want me to 19 continue reading his -- yeah. 20 Q Uh-huh. 21 A No obvious source of bleeding was identified. 22 See admission sheet for exam. Patient has frequent 23 impaction and this presumably could account for the 24 bleeding, but further evaluation is clearly needed. 25 Will transfer to ER for evaluation. CENTRAL FLORIDA REPORTERS, INC. 1079 1 Q Okay. Did Dr. Black discuss any of these 2 issues with you or did he just confine it to the notes 3 and give you an overview? 4 A I know that we, we talked. I don't know 5 exactly what the extent of the conversation was. 6 Q Okay. And it was your understanding that he 7 found no evidence of external hemorrhoids? 8 A I'm, I'm not sure what the conversation -- he 9 said there's no obvious source of bleeding identified. 10 Q Is that your understanding from the notes that 11 he would have found no -- 12 A I need to look. All I can tell you is that he 13 didn't find any obvious source of bleeding. 14 Q Okay. Go ahead and continue on your notes. 15 A My notes now? Okay. 16 Q And actually let me just -- I'm sorry, let me 17 back up a second. Do you know, was this just an 18 external visual examination or do you know if Dr. Black 19 went in-depth? 20 A I'm not sure what he did. 21 Q Okay. 22 A You'd have to refer to his notes. 23 Q That's -- 24 A See MD progress notes. I, I phoned son to let 25 him know that resident was being transferred to ORMC. CENTRAL FLORIDA REPORTERS, INC. 1080 1 He was -- 2 Q What was the reason for the transfer to ORMC? 3 A Being that Florida Hospital was a sister 4 facility to Sunbelt, we just felt that ORMC would be 5 neutral grounds. 6 Q And when you say we, who, who was involved in 7 that decision? 8 A Myself. I talked to Chuck Sherer about it and 9 Dr. Black and we agreed. 10 Q So it was a consensus among the three of you 11 that ORMC was the place? 12 A Right, because it was neutral grounds. There 13 wasn't any association with, with Sunbelt. 14 Q Okay. Go ahead. 15 A He was very upset with transfer. Resident was 16 transferred to ORMC secondary to son being so 17 dissatisfied with her care here at Florida Hospital. 18 Being affiliated with us, ORMC would be neutral grounds. 19 The son proceeded to call me in the early afternoon, was 20 threatening me, and I told him I was -- 21 Q Stop there a second. 22 A Uh-huh. 23 Q When you say threatening, please explain that 24 to me. What exactly does that -- 25 A The son proceeded to call me in the early CENTRAL FLORIDA REPORTERS, INC. 1081 1 afternoon and was threatening me, and I told him I was 2 not going to listen to this and said good-bye. 3 Q Okay. 4 A I don't remember the exact extent of the 5 conversation. I do know that picketing -- he talked 6 about picketing the building. 7 Q Okay. What I'm trying to find out is do you 8 feel like he was directly threatening you or making 9 threats to picket? 10 A I don't remember the exact conversation that, 11 that we had, but I'm sure if I wrote he was threatening 12 me, then at that point I felt like he was threatening 13 me. 14 Q But you just don't remember what the specific 15 threats would have been? 16 A There has been so many conversations and it 17 was so many years ago, I don't know exactly what the 18 conversation was, no. 19 Q Okay. Continue. 20 A He then was outside. And I wrote son, and 21 it's supposed to be sign, picketing the facility. I 22 received a call from Dr. Black at approximately 1:00 23 p.m. in regards to inappropriate behavior at the 24 hospital from the son. 25 Q And what did Dr. Black tell you about -- CENTRAL FLORIDA REPORTERS, INC. 1082 1 define inappropriate behavior in terms of that 2 conversation with Dr. Black. 3 A Okay. It's right here in my documentation. 4 Dr. Steely had passed on that resident's son was kneeing 5 her in the back telling her to stand up and was 6 literally dragging her across the room telling her to 7 walk causing the dressing to come off. 8 Q Okay. Do you know, is that Dr. Steely telling 9 Dr. Black who is telling you or was this Dr. Steely 10 telling you? 11 A No. I never spoke to Dr. Steely. 12 Q Okay. So can you clarify that for me? Is 13 it -- is this what Dr. Black is telling you that 14 Dr. Steely had told him that? 15 A Yes. 16 Q Okay. Go ahead. 17 A I had called HRS 1-800-9 -- 96ABUSE hotline 18 and spoke with Donna in the a.m. I also followed up in 19 the afternoon with updated information. Report given at 20 5:00 p.m. to Lillian, nurse case manager, regarding 21 family history and the incidents of today. 22 Q Let me stop you there. What exactly did you 23 tell Lilly in terms of -- Lillian in terms of family 24 history first? And then we'll, we'll move on to the 25 next -- CENTRAL FLORIDA REPORTERS, INC. 1083 1 A It would have been in regards to the 2 information that Dr. Black had relayed that Dr. Steely 3 had told him. 4 Q Okay. So specifically you were telling 5 Lillian Folley that Dr. Steely gave Dr. Black the 6 information in regard to the son? 7 A Uh-huh. 8 Q Okay. Anything else? 9 A No. 10 Q Okay. Did you pass on to Lillian Folley any 11 type of other medical history? 12 A I probably -- well, she would have received 13 the chart -- the information from Florida Hospital which 14 stated that the son had said that he impacted -- 15 disimpacted his mother on a regular basis I believe is 16 what the chart had said. 17 Q Do, do you recall telling Lillian that 18 yourself or was that something that would have been 19 contained in the chart and you didn't get into? 20 A We may have discussed that, but she would have 21 received that in the record. 22 Q Okay. How come you say you may have discussed 23 it? 24 A Because I don't know if we discussed it. I 25 don't want to say yes, I discussed something with CENTRAL FLORIDA REPORTERS, INC. 1084 1 somebody and not -- and have it not be the truth. 2 Q Okay. 3 A It's been a long time. 4 Q Okay. But you think that might have been a 5 topic of conversation? 6 A We, we might have discussed that, yes. 7 Q Okay. And, and then you put re family history 8 and the incidents of today. What are you referring to 9 in there? 10 A We just discussed that. That would have been 11 the information that Dr. Black called me with, that 12 Dr. Steely had told him that the resident's son had been 13 kneeing her in the back telling her to stand up and was 14 literally dragging her across the room telling her to 15 walk causing the dressing to fall off. 16 Q Okay. That's what you're talking about when 17 you refer to and the incidents of today? 18 A Yes, that would have been the family history. 19 And the incidents of today would have been that he was 20 kissing his mother and he -- when we walked into the 21 room and that he was upset and backing us into a corner 22 and pounding on the desk and yelling at us. 23 Q Okay. Did you at that point know about the 24 situation that Carol Boze observed, and did you also 25 pass that on? CENTRAL FLORIDA REPORTERS, INC. 1085 1 A I don't know because I don't know at what time 2 I talked to Carol Boze. 3 Q So you're not sure whether you knew or passed 4 it on at that time? 5 A Correct. 6 Q Okay. 7 A Do you want me to -- 8 Q Any other information that you remember 9 passing on that I haven't asked you about? 10 A No. 11 Q Okay. Go ahead and continue. 12 A Just received a call back from Dr. Wilson at 13 6:10 p.m. regarding resident. Dr. Wilson states son was 14 inappropriate at ORMC and the police were called there 15 and he was removed from the property. 16 Q Okay. Let me ask you about that. You put in 17 here was inappropriate. Do you recall what Dr. Wilson 18 told you? 19 A No. 20 Q You don't recall anything? 21 A I, I don't remember what the conversation was, 22 no. 23 Q Do you have in your mind a flavor of the 24 conversation? 25 A No. CENTRAL FLORIDA REPORTERS, INC. 1086 1 Q Okay. Did anybody other than Dr. Wilson tell 2 you that the police were called and that Mr. Destefano 3 was removed from the property? 4 A Not that I remember. 5 Q Okay. Okay. Go ahead and continue. 6 A Spoke with Lilian regarding dis -- discharge 7 plans at ORMC. Spoke with Dr. Popcock and Dr. Young 8 regarding possible readmission. Facility very unwilling 9 to take resident back secondary to instability and son's 10 behaviors. Working to find appropriate placement. 11 At approximately 6:30 p.m. Officer Padilla 12 called regarding information on Mr. Destefano and may be 13 coming to the facility to retrieve pad with blood on it 14 for evidence. Will continue to work on placement. 15 Q Okay. Did -- how many conversations did you 16 have with Lillian Folley, separate conversations? 17 A I don't know because until you say her name, I 18 don't even know who she is. 19 Q Okay. Did you not even remember her name 20 until reviewing your own notes? 21 A Correct. 22 Q Okay. Do you believe that you would have 23 documented in your notes each conversation with Lillian 24 or anybody from ORMC? 25 A I believe I would have. CENTRAL FLORIDA REPORTERS, INC. 1087 1 Q Okay. Is it fair then to say that the 2 conversations that you had between Sunbelt and ORMC are 3 mentioned in your notes? 4 A I would think so. My note is pretty concise 5 as to the happenings of that day, yes. 6 Q Okay. All right. Let me back you up here, 7 and I'm going to do what I said earlier, which is I'm 8 going to further refine things and ask you more 9 specifics, okay? 10 A Uh-huh. 11 Q When OPD showed up that morning in order to do 12 the trespass, was there any suggestion at that time 13 about keeping the bed pad from OPD? 14 A Not that I remember, no. 15 Q And did it occur to you at that point that 16 maybe you should keep that for any reason? 17 A No. 18 Q Okay. They were aware of it, though, right? 19 You told them about the pad and the blood on it? 20 A I told you before, I don't remember if we 21 discussed it or not. 22 Q Okay. 23 A I don't know. 24 Q You don't know if you discussed the pad? 25 A I don't remember the conversation. CENTRAL FLORIDA REPORTERS, INC. 1088 1 Q Okay. Well, do you think that you mentioned 2 it? 3 A I'm not going to speculate whether I think or 4 not. I don't remember the conversation. 5 Q Okay. The, the documentation as to the 6 dressing that you went back and you looked at the, the 7 notes -- the other notes that were initialled by Carol 8 Boze -- 9 A Uh-huh. 10 Q -- does it seem strange to you that a 3:00 to 11 11:00 nurse is, is charting something that she 12 supposedly did on a 7:00 to 3:00 shift? 13 A It doesn't seem strange because a lot of times 14 the day shift may not even get to a treatment, and then 15 the evening shift would pick up from there and do the -- 16 do the dressing or do a treatment. That's not strange 17 at all. 18 During the course of the day you don't always 19 get to do what you need to do, and especially if an -- 20 if something is ordered once a day, it really doesn't 21 matter if it's done at 7:00 a.m. or 3:00 p.m. or 9:00 22 p.m. as long as it gets done in the course of the day, 23 you know. 24 Q Would it be normal for her being on 3:00 to 25 11:00 shift -- if it only got done once a day and she's CENTRAL FLORIDA REPORTERS, INC. 1089 1 the one that did it, would it be appropriate for her to 2 chart it as being done on the 3:00 to 11:00 shift or 3 7:00 to 3:00? 4 A She probably should have written the time 5 that, that she had, had done it, put her initials and 6 put the time that it was done. I mean, it's appropriate 7 that she wrote it under the 7:00 to 3:00 order because 8 that's when it's ordered. But, yeah, technically she 9 should have put the time that she did it. 10 Q Okay. Did that cause you any concern at all? 11 A Well, I don't know at the time that I made 12 this documentation if I even knew who had done it, when 13 it was -- do you know what I'm saying? I looked at the 14 treatment record. I saw there were initials there that 15 it was done. 16 Q So you were satisfied it was done and you just 17 didn't go further than that? 18 A Yeah, I mean, I was satisfied. There was 19 initials there. The treatment had been done. 20 Q Okay. When you and Mary Thornton knocked on 21 the door, loud knocks? 22 A I mean, I didn't bang on the door. I knocked 23 on the door. 24 Q Like one time? 25 A I don't know how many times I knocked on the CENTRAL FLORIDA REPORTERS, INC. 1090 1 door. 2 Q Okay. Were you startled by what you saw? 3 A Shocked, yes. 4 Q Did you feel like maybe you should say 5 something about it at that time? 6 A No. 7 Q Tell me why. 8 A Because it was very evident from the 9 conversation that Mary told me that he was upset and 10 yelling at her and backing her into the corner that I'm 11 not going to be alone in a room with somebody who had 12 just done that to her and, and bring up an incident like 13 this. That would -- it wouldn't have been very smart on 14 my behalf to have done that, no. 15 Q Okay. So you decided just to let it -- let it 16 go 'til later? 17 A I was hoping that I could go in the room, have 18 an adult conversation, diffuse the situation, take care 19 of the complaint. As a director of nursing you get 20 complaints all the time. It's not uncommon. And that's 21 my job, to diffuse a situation, to hear what the 22 complaint is and to fix the problem and make things 23 better. 24 And generally that's the end of a discussion, 25 you know. It's not a perfect world and there's problems CENTRAL FLORIDA REPORTERS, INC. 1091 1 in every building, and you fix the problems and you go 2 on. 3 Q Was it separate kisses or was it one long kiss 4 for the ten to 15 seconds? 5 A It was one kiss. 6 Q So there wasn't lips touching lips, break? 7 A No. 8 Q Okay. 9 A No. 10 Q And I'm still trying to get -- I'm trying to 11 picture it in my mind and -- was his back towards you 12 one way or the other? Which -- 13 A He was like at an angle. 14 Q With his back facing more towards the head of 15 the bed or the foot of the bed? 16 A The foot of the bed. 17 Q Okay. And you described that kiss as being 18 inappropriate. Do you think it's wrong to kiss a parent 19 on their lips? 20 A No. No. 21 Q Do you think that you could have 22 misinterpreted the kiss? 23 A I wish I had. 24 Q You're sure that it couldn't have been a kiss 25 of a son comforting his mother? CENTRAL FLORIDA REPORTERS, INC. 1092 1 A Absolutely not. I'm positive on what I saw. 2 Q Do you think that it was inappropriate because 3 of the length or was it the position of their mouths? 4 A It's inappropriate to kiss your parent or your 5 child for an extended period of time on the mouth, yes. 6 Q Okay. So it was the length of it that's, 7 that's kind of the indicator for you? 8 A Yes. 9 Q Okay. You started charting at 4:00 p.m. 10 Roughly how long did it take you to get these notes 11 done -- 12 A I finished -- 13 Q -- if you remember? 14 A Obviously I had breaks in the note because I 15 started at 4:00, and there were incidents that happened 16 at 6:30. So I started my note at 4:00, and then there 17 were things that happened along the way. I stopped 18 charting, and then I would go back and chart as things 19 happened. 20 Q Okay. So it wasn't one continuous note, you 21 had to stop and pick up? 22 A I had to have if I started at 4:00 and at 6:00 23 I'm referring back to 6:30. Yes, I would have had to 24 have stopped my documentation. 25 Q Okay. CENTRAL FLORIDA REPORTERS, INC. 1093 1 A As you see, I made phone calls, received phone 2 calls. There's no way that I could have done the 3 documentation and not stopped. 4 Q Right. Did you discuss the kiss again with 5 Mary Thornton that day? 6 A Yes. We, we discussed it, yes. 7 Q And did you discuss it the next day? 8 A We may have. I mean, the building was very 9 upset. People were very upset. I'm sure that -- you 10 know, and then Larry started picketing out front, and 11 then it became the topic of the building for months. 12 Q Talk about disimpaction earlier. 13 A Uh-huh. 14 Q Did you ever observe Mr. Destefano 15 disimpacting his mother? 16 A No. 17 Q Did any nurse that you're aware of observe 18 that? 19 A No. 20 Q Did he ever tell you he disimpacted her in the 21 hospital? 22 A No. I read it in the Florida Hospital record. 23 Q Before we went off the record, we were talking 24 about disimpaction and where you got that information 25 from. To the best of your recollection, where did that CENTRAL FLORIDA REPORTERS, INC. 1094 1 information come to you from? 2 A From the Florida Hospital notes. 3 Q And do you remember at what point you reviewed 4 those notes and, and discovered that disimpaction was 5 one of the things that Mr. Destefano performed on his 6 mother? 7 A It would have been after his mom had left the 8 facility. 9 Q Anybody ever tell you that information 10 verbally or did you get that from the notes? 11 A I remember reading it in the notes. 12 Q Okay. Did you think that was odd that a son 13 would be disimpacting his own mother? 14 A If he was at home and he was the caregiver 15 taking care of his mother and there was nobody else to 16 provide the care then, then no. I mean, he was 17 providing care to keep his mother comfortable. So no, 18 not, not in a home setting. 19 Q Is there a point where that would be a strange 20 incident to you? 21 A If somebody was in the nursing home or in a 22 hospital setting, that would be a little bit strange 23 because once you enter that setting, then you -- the 24 responsibility lies with the nursing staff and the 25 medical staff to provide those -- do those procedures. CENTRAL FLORIDA REPORTERS, INC. 1095 1 Q Okay. Did, did you report to anybody that 2 Mr. Destefano disimpacts his mother? 3 A When I spoke to ORMC, I did let them know 4 that, that, that I had read that in the record. 5 Q What was the significance of reporting that to 6 ORMC? 7 A Well, that if -- you know, after reading that 8 in the record and she had some unexplained blood, that 9 that -- it could be caused by disimpaction. And 10 Dr. Black had also made reference to that, that it could 11 be caused by disimpaction. 12 Q Did you have any suspicions that she was being 13 disimpacted by Mr. Destefano while at your facility? 14 A It was a possibility that it -- that that's 15 where the blood could have come from. 16 Q And are you saying it's a possibility simply 17 because that's what you reviewed in the notes and -- 18 A It would be the logical explanation. 19 Q Can you think of any other logical 20 explanations for blood that might appear? 21 A Hemorrhoids, which can be caused by 22 disimpaction. 23 Q Did you at any time tell anybody that she was 24 medically checked and found to be bleeding from the 25 rectum? CENTRAL FLORIDA REPORTERS, INC. 1096 1 A Let me just see the time I called. I may have 2 told them that Dr. Black had, had come in to see her. 3 Q Okay. But my question is, did you tell 4 anybody that she was checked and was bleeding from the 5 rectum? 6 A No. 7 Q Are you aware of anybody else that would have 8 made this phone call and made that statement? 9 A No. 10 Q Okay. Did you tell him that you suspected son 11 disimpacted his mother this morning? 12 A I may have said that that could have caused 13 bleeding if the son had disimpacted her. 14 Q Okay. Do you know from your review of the 15 records whether she was ever disimpacted while in, in 16 Sunbelt facility? 17 A Not that I'm aware of, no. 18 Q Okay. When you called Children and Families 19 on the initial call, what other information did you give 20 them, if any? 21 A I called in the situation that had happened 22 that morning. 23 Q Did you describe the kiss to them? 24 A Yes, I did. 25 Q Did you do that in detail, as we did here CENTRAL FLORIDA REPORTERS, INC. 1097 1 today, or did you just do a general he was kissing her? 2 A I said that it -- that it was a passionate 3 kiss, yes. 4 Q Okay. What else did you say about the kiss? 5 A I explained to them the position that -- when 6 we entered the room, that he was leaning over his mother 7 and kissing her on the lips. 8 Q Did you describe to them why you considered it 9 a passionate kiss or inappropriate kiss? 10 A Yes. 11 Q Okay. Did Mr. Destefano ever say to you or 12 did you find in any notes that Mr. Destefano claimed 13 that the disimpaction caused the bleeding? 14 A We did not talk about disimpaction. 15 Q It never came up with Mr. Destefano, right? 16 A No. I got it in the chart. 17 Q Did you see anywhere in the chart 18 Mr. Destefano making the statement that disimpaction 19 sometimes causes bleeding? 20 A I may have read that. I don't know without 21 reviewing the chart. 22 Q Do you recall that off the top of your mind? 23 A No. Not without reviewing the chart, no. 24 Q Do you know where that information came from? 25 A I do remember when Dr. Black did the CENTRAL FLORIDA REPORTERS, INC. 1098 1 examination that he had felt that there were internal 2 hemorrhoids, but ORMC disagreed with that. 3 Q Okay. Is that information that he gave to you 4 indirectly or is that something that you got -- 5 A No, that was -- that was a verbal 6 conversation. 7 Q With -- that you had with Dr. Black? 8 A Yes. 9 Q Do you recall when that occurred? 10 A It was after he had come to the facility to 11 examine her. 12 Q That examination that he did at the facility? 13 A Yes. 14 Q Do you believe that conversation occurred 15 within an hour of an examination or two hours or three 16 hours? Can you pin down it all? 17 A I'm sure it was within an hour. 18 Q Okay. So very promptly relayed to you? 19 A Yes. 20 Q And tell me the gist of what he said. 21 A He, he had felt that she had internal 22 hemorrhoids -- 23 Q Okay. 24 A -- which could have been why there was 25 bleeding. CENTRAL FLORIDA REPORTERS, INC. 1099 1 Q But that he found no evidence of bleeding 2 himself? 3 A Correct. 4 Q Did he tell you that as -- okay. Okay. I 5 think I asked you this earlier. Were you present when 6 Dr. Black did the exam on Ms. Destefano? 7 A I don't remember. 8 Q Okay. But the conversation that you had in 9 regards to his examination, was that in person or on the 10 phone? 11 A In person. 12 Q And where was that? 13 A We were in the facility. I don't know if we 14 were in the resident's room or if we were in my office. 15 Q So you were at Sunbelt? 16 A Yes. 17 Q Okay. And you said earlier you didn't recall 18 what time, that it was prompt? 19 A Right. 20 Q Okay. Was it the 21st of September? 21 A Yes. 22 Q Okay. The same day that we're talking about? 23 A Yes. 24 Q Okay. Do you remember how he forced her mouth 25 open, do you know? CENTRAL FLORIDA REPORTERS, INC. 1100 1 A He held her mouth like this and took the water 2 and dumped it in and told her to swallow. 3 Q Did, did she cough? Did she have any problems 4 swallowing that you can recall? 5 A I don't remember. 6 Q Okay. Did you have any concerns or suspicions 7 regarding sexual abuse based on the kiss that you saw? 8 A No. There was never any discussion of sexual 9 abuse, just that it was an inappropriate kiss. 10 Q Did you feel that that kiss was sexually 11 abusive? 12 A I felt that he was inappropriately kissing his 13 mother, and I was mandated to report it to HRS, and then 14 it's their job to do their investigation. 15 Q Did, did you convey to HRS any concerns about 16 sexual abuse? 17 A No. 18 Q Were all of the -- was all of the information 19 that you gave to Children and Families or HRS centered 20 on abuse in general as opposed to sexual abuse? 21 A There was never a discussion of sexual abuse. 22 Q Okay. Which issues were you concerned about? 23 The kiss obviously, the water. 24 A Absolutely. She was at risk for aspiration, 25 which could lead to her death. CENTRAL FLORIDA REPORTERS, INC. 1101 1 Q Okay. Anything else that you observed that 2 you gave to HRS? 3 A Yes, just the kiss and the water. 4 Q Okay. Did you observe anything else that you 5 passed on to them? 6 A No. 7 Q Okay. When -- who came to transport Carolina 8 Destefano from Sunbelt to ORMC? How was she 9 transported? 10 A I believe she went non-emergency, and I'm not 11 sure who the -- who the service was that came. 12 Q I think my last question was do you know how 13 she was transported to ORMC from your facility? 14 A She went Rural/Metro -- 15 Q Okay. 16 A -- non-emergency. 17 Q Did you have any discussions with any of the 18 EMTs -- or I'm not sure what their appropriate title 19 would be, but any of the people transporting 20 Ms. Destefano, did you have discussions with them? 21 A I don't remember having any discussions with 22 them. 23 Q Okay. What would have gone with her when she 24 was transported? Would the nursing notes from your 25 facility go with her? CENTRAL FLORIDA REPORTERS, INC. 1102 1 A I'm not sure what they sent with her. Every 2 facility does it -- does it differently. And I never 3 transferred anybody out of Sunbelt because that wasn't 4 my role, so I don't know what they would have sent with 5 her. 6 Q Okay. Do you know what time she was 7 transferred? 8 A I'm seeing a time on this. I'm not seeing a 9 time on here unless I'm missing it. 10 Q That's okay. If you don't know, that's all 11 right. 12 A I don't. 13 Q Did you participate in any of the preparations 14 to transfer her? 15 A I don't remember participating in anything. 16 Q Okay. Once she was out of your facility, who 17 was the next contact you had in regard to Carolina 18 Destefano? Did you ever make a phone call or did you 19 receive a phone call? 20 A I don't remember. 21 Q Okay. Do you remember when the next time that 22 you addressed any of the issues involving Carolina 23 Destefano was? 24 A Regarding? 25 Q Regarding her medical history. CENTRAL FLORIDA REPORTERS, INC. 1103 1 A I spoke to many people during the course of 2 that day. I, I don't know. 3 Q Well, let me back up then and ask you this 4 way. She leaves your facility. She's gone now. Who is 5 the next person you come in contact with in regard to 6 Carolina Destefano? 7 A I believe the next person I spoke to was Larry 8 to let him know that she was going to ORMC. 9 Q Okay. We went through that in your nursing 10 notes, and he was upset about that. Who was the next 11 person? 12 A Let me go back to my nursing notes. Well, I'm 13 not sure what time she left. I know I spoke with Larry 14 because I called to let him know she was being 15 transferred. 16 Q Uh-huh. 17 A And I'm not sure if I spoke to HRS next or if 18 I spoke -- well, I believe the time was 12:00 -- 12:09 19 with them. So I would have spoke with them. I presume 20 they would have been next. 21 Q Let me ask you the question in a different 22 way. When was the first time you spoke to somebody from 23 ORMC in regard to Ms. Destefano? 24 A According to my nurse's notes, I spoke with 25 Lillian, the case manager, at 5:00 p.m. CENTRAL FLORIDA REPORTERS, INC. 1104 1 Q And what day would that have been? 2 A The 21st. 3 Q The 21st? Do you remember that conversation? 4 A No. 5 Q And is the only way you recall that is based 6 on your notes? 7 A Yes. 8 Q Okay. We covered that already, so I'm not 9 going to go into that in detail right now. 10 Let me -- can we get to the Orlando Regional 11 Healthcare? Let's get to those. There's a case 12 management document that I want you to take a look at. 13 Let me see where it starts. Just so you know what I'm 14 looking for -- 15 A Right here? 16 Q Start at the top, Rachel, if you would. Start 17 reading from received. 18 A Received consult from nursing staff for a 19 dis -- discharge planning. Patient is a 71-year-old 20 white female with history of end stage Alzheimer's 21 disease, per nursing supervisor Sunbelt SNF. Presented 22 with rectal bleeding after patient's son was witnessed 23 disimpacting her states Rachel, RN, at Sunbelt. 24 Q Did you make that statement to anybody at 25 ORMC? Again, I'm going to ask you that question. CENTRAL FLORIDA REPORTERS, INC. 1105 1 A No, I didn't. I said that there was a history 2 of the son disimpacting her. 3 Q It clearly states in here -- it says witnessed 4 and attributes that statement to you. Are you sure you 5 didn't say that to anybody? 6 A Positive. It also says she presented with 7 rectal bleeding so -- and I thought there was no further 8 bleeding that was noted. 9 Q Would anybody else to your knowledge have been 10 relaying this information to ORMC? 11 A I specifically told ORMC that there's a 12 history of the son disimpacting the resident. 13 Q Do you know of anybody else contacting ORMC in 14 regard to Carolina's condition or situation at Sunbelt? 15 A I believe Chuck Sherer had talked to them. 16 Q And why do you believe that? Did he tell you 17 that? 18 A Because there were numerous phone calls going 19 back and forth between Florida Hospital, ORMC and 20 Sunbelt because they wanted the resident to come back to 21 our facility. 22 Q Okay. Continue on -- continue reading down 23 there. 24 A Sunbelt is refusing to take patient back, 25 states Rachel, because of son's inappropriate behavior. CENTRAL FLORIDA REPORTERS, INC. 1106 1 See something note. Sunbelt has trespassed son from 2 their facility and has reported to 1-800-96ABUSE. 3 Q Is that information that you conveyed to ORMC? 4 A Yes. 5 Q So you did tell them that we're refusing to 6 take Ms. Destefano back? 7 A Yes. 8 Q And you did tell them that was because of his 9 inappropriate behavior? 10 A Yes. 11 Q So that part of this is accurate? 12 A Yes. 13 Q All of that part was accurate, right, all the 14 way down to the 1-800-96ABUSE? 15 A Yes. 16 Q Okay. Go to the next page. I just want to 17 see -- I'm not sure if I've got mine in order or not. 18 Yeah. Go ahead and read that top -- that notation is 19 dated what? 20 A 9/21 at 1630. Received consult from nursing 21 staff for dis -- discharge planning. See initial DC 22 planning assessment. Per telephone call to Sunbelt SNF, 23 Rachel, RN, supervising 898-5051. Patient's son was 24 witnessed laying on top of the patient who has a GCS of 25 seven, kissing her with his mouth open in a way son CENTRAL FLORIDA REPORTERS, INC. 1107 1 would not kiss his mother. 2 Q All right. Stop there. That's the correct 3 number for your facility? 4 A Yes. 5 Q And was this information that you were 6 relaying to ORMC? 7 A I may have said that another staff member had 8 witnessed him lying on top of his mother. 9 Q Okay. And which staff member would you have 10 been talking about? 11 A Carol Boze. 12 Q Okay. So it's fair to say that on -- well -- 13 this note was made at 4:30 on 9/21/99? 14 A Uh-huh. 15 Q Is it fair for me to say that at that point 16 you'd had the conversation with Carol Boze in regard to 17 what she saw? 18 A Yes, because she worked the 3:00 to 11:00 19 shift. 20 Q And is it your belief that this notation is -- 21 was made based on you relaying Carol Boze's situation 22 and not your own? Is that clear? 23 A Yes. 24 Q Okay. And you're saying, yes, you think that 25 this was you relaying what Carol Boze told you as CENTRAL FLORIDA REPORTERS, INC. 1108 1 opposed to what you witnessed yourself? 2 A I'm sure. During the conversation we 3 discussed what I had seen, what other staff members had 4 seen. And it's very easy for someone to then take that 5 information and go to a chart and write something down 6 and not remember exactly, well, was it me who saw that 7 or another nurse? 8 Q Do you think that in this conversation you 9 advised ORMC that both of you had seen it? 10 A Seen what? 11 Q Seen the kissing. I apologize. 12 A Yes. 13 Q So you think you told them, look, I saw it and 14 also one of my nurses reported what she reported? 15 A Yes. 16 Q Okay. Well, I'm not sure if that refers back 17 to what -- the lying on top of the mother or, or 18 something else, so let me clarify that. Keep reading 19 down for me. 20 A Sunbelt sent patient to ORMC because of rectal 21 bleeding. 22 Q No, one sentence up -- 23 A Oh, I'm sorry. 24 Q -- which would be -- 25 A In a way son would not kiss his mother. CENTRAL FLORIDA REPORTERS, INC. 1109 1 Q Which is what you described? 2 A Correct. 3 Q So you think those are your words? 4 A Yes. I believe that those are my words. 5 Q And do you think those relate to what you saw 6 that morning? 7 A I did not tell her that I witnessed the son 8 lying on top of his mother. 9 Q Okay. 10 A I did tell her that I witnessed the son 11 kissing his mother in a way that a son would not kiss 12 his mother, yes. 13 Q Okay. 14 A I didn't state that his mouth was open. 15 Q Well -- and that's what I was asking you 16 earlier about the kiss, and I was getting very specific 17 about it. 18 A Uh-huh. 19 Q And I understood you to say that his mouth was 20 open. 21 A I said I couldn't tell. 22 Q Okay. 23 A I said his lips were on her lips. I could not 24 tell if her mouth was open. 25 Q You couldn't tell if her mouth was open? CENTRAL FLORIDA REPORTERS, INC. 1110 1 A Or his mouth was open. 2 Q Or you couldn't tell if his was open? 3 A Correct. 4 Q Okay. So would you have reported to anybody 5 that he was kissing her with his mouth open? 6 A I may have said that a staff member witnessed 7 that, but I did not say that I witnessed that. 8 Q Okay. And you're sure that you never said to 9 anybody that you personally witnessed the kiss being 10 with his mouth open or her mouth open? 11 A No. All I could see was his lips were on her 12 lips. 13 Q Okay. Just give me one moment. I'm going 14 through here to make sure we don't have to go over 15 things that are unnecessary. 16 Okay. When -- do you remember the name Kelly 17 Pipkin or have you encountered that in reviewing for 18 today's deposition? 19 A In reviewing, yeah. 20 Q Okay. Do you recall conversations that you 21 had with Ms. Pipkin? 22 A No. 23 Q Okay. Do you recall her describing witnessing 24 an inappropriate conduct -- did she ever describe 25 anything like that to you? CENTRAL FLORIDA REPORTERS, INC. 1111 1 A I don't know if I ever even talked to this 2 person. 3 Q Okay. I'm going to ask you just -- I'm going 4 to be real specific so I don't have any 5 misunderstanding. You don't remember talking to her? 6 A Correct. I don't remember if I had a 7 conversation with her or not. 8 Q Is it possible that you did talk to her? 9 A It's possible. I spoke to many people that 10 whole day, but I don't remember having a conversation 11 with her. 12 Q Do you recall how many different people at 13 ORMC you described the kiss you observed to? 14 A No. 15 Q Do you know if it was one? 16 MR. GROWER: Previously asked and answered. 17 A I don't know. 18 Q Do you know if there was anyone there you 19 described it to? 20 A Yes. 21 Q Okay. We know there's got to be one, right? 22 A Yes. 23 Q Okay. Is one all you can commit to that you 24 know? 25 MR. TOWNSEND: Form. CENTRAL FLORIDA REPORTERS, INC. 1112 1 MR. GROWER: Object to the form, 2 argumentative. 3 A Yes. 4 Q Start reading at the top portion. 5 A Patient transported from nursing home with 6 reports of finding bright red blood on sheets of bed. 7 Status post discussion with son by nursing home staff. 8 Para reports per nursing home staff her son disimpacted 9 her Sunday. 10 Q Do you know where that information came from? 11 A No, because I didn't call the report to the 12 hospital. 13 Q Okay. Ms. Bean, I'm going to refer you to a 14 written statement by Lillian Folley from Orlando 15 Regional Medical Center. You have that in front of you, 16 correct? 17 A Yes. 18 Q Okay. Start with that first line and start 19 reading there, okay? 20 A I received a consult to facilitate discharge 21 of the patient from the hospital. Kelly Pipkin, RN, 22 notified me that the patient came here from Sunbelt 23 Skilled Nursing Facility with rectal bleeding and 24 Sunbelt refused to accept the patient back. I phoned 25 Sunbelt regarding this and spoke to Rachel, RN, nursing CENTRAL FLORIDA REPORTERS, INC. 1113 1 supervisor. 2 Q Okay. Stop there. Do you recall that 3 conversation? 4 A Well, I documented in my nurse's notes that I 5 had a conversation with her, yes. 6 Q Okay. And that's what I'm getting to. Is 7 this the conversation that you documented in your notes? 8 MR. GROWER: Form. 9 A She has 1817 for a time. I think my time 10 might be different. Let me check my time. I have that 11 I spoke with her at 5:00 p.m. 12 Q Okay. Does it sound like the content of that 13 conversation where she's saying Sunbelt refused to 14 accept patient back? 15 A That's correct. They did -- we did refuse to 16 take her back. 17 Q Okay. Go ahead, keep -- continue reading. 18 A Rachel confirmed the above and added the 19 patient's son displayed inappropriate behavior when 20 visiting his mother at Sunbelt, including kissing his 21 mother on the lips in a way you don't kiss your mother, 22 lying fully on top of his mother kissing her on the lips 23 with his mouth open, and disimpacting her, inserting a 24 finger into the rectum and digitally breaking up and 25 removing stool, yelling at the nursing staff. Rachel, CENTRAL FLORIDA REPORTERS, INC. 1114 1 RN, states all the above were witnessed in her facility. 2 Q Okay. Stop there. Do you recall this 3 conversation now -- I'm going to ask you the same 4 question again. Do you recall the conversation now that 5 you've seen it in more detail in somebody else's notes? 6 A Like I had told you before when I read in her 7 case management, no. This is basically verbatim the 8 same thing. We did discuss that we would not take her 9 back into the building. I did discuss with her what I 10 had witnessed and what other staff members had 11 witnessed. 12 Q Okay. Let me go line by line on the things 13 that, that she attributes to you and just tell me 14 whether you said those or you did not say those. It 15 starts with including kissing his mother on the lips in 16 a way you don't kiss your mother. Is that something you 17 would have said? 18 A Yes, I said that and I witnessed that. 19 Q Okay. Lying fully on top of his mother 20 kissing her on lips with his mouth open. I'm going to 21 stop at the end. Is that something that you recall 22 reporting to her? 23 A I reported that, but I did not witness that. 24 Q Okay. And that would have been witnessed by 25 Carol Boze? CENTRAL FLORIDA REPORTERS, INC. 1115 1 A Correct. 2 Q Okay. So you were relaying it -- in that 3 sentence what Carol Boze told you? 4 A Yes. 5 Q I'm going to leave that part out of my 6 question and I'm going to ask you, did you tell her that 7 Mr. Destefano was disimpacting Carolina Destefano? 8 A I told her that I had read in the record where 9 he had stated that, yes, he disimpacted his mother. 10 Q Okay. Are you sure that you were clear on 11 that coming from the record as opposed to being 12 witnessed by other staff members? 13 A Absolutely, because nobody witnessed that in 14 our building. 15 Q Okay. And the next question I have is why, 16 why would you report the disimpaction along with 17 the -- along with the incident you witnessed, as well as 18 what Carol Boze witnessed? 19 A Because at this point we have blood on a pad 20 that we didn't know where, where it came from, and this 21 would explain where the blood could have come from. 22 Q Was the disimpacting -- was the disimpaction 23 of his mother in some way related to the inappropriate 24 kissing that you observed and that Carol observed -- 25 Carol Boze related to you? CENTRAL FLORIDA REPORTERS, INC. 1116 1 A The disimpaction had nothing to do with the 2 kissing. 3 Q Okay. Did the disimpaction have anything to 4 do with yelling at the nursing staff? 5 A No. 6 Q I'm asking you this because I'm looking at, at 7 various different statements that, that don't seem to 8 have anything to do with each other. And I'm asking you 9 why did you feel it was important to report the 10 disimpaction along with the kisses as well as the 11 yelling at the nursing staff and the behavior related to 12 how you felt about that? 13 A We had a conversation about different things 14 that happened in the building, different situations, 15 things that I had read, and I felt that this was 16 important as a whole. Not that when I gave her this 17 information it wasn't in this context that these are the 18 reasons why we're not taking the resident back. This is 19 her summary of a conversation that we had, and she may 20 be putting things together that aren't necessarily -- 21 that necessarily shouldn't go together. 22 Q Okay. Was it your intention then in reporting 23 these things to associate the disimpaction with the 24 kisses -- with the kiss that you observed and that Carol 25 Boze told you about? CENTRAL FLORIDA REPORTERS, INC. 1117 1 A No. 2 Q Go ahead with the next line. 3 A Rachel, RN, states all the above were 4 witnessed in her facility. Rachel, RN, stated -- 5 Q Did, did you say that? 6 A No, I did not. 7 Q Okay. 8 A Rachel, RN, stated she and her staff felt very 9 threatened by and scared of the son who makes health 10 care decisions for the patient. 11 Q Did you tell her that, Lillian Folley? 12 A Not in that context. 13 Q Do you remember the context with which you 14 used -- 15 A I did tell her that the staff felt afraid and 16 threatened, but it never was in the context that -- then 17 yes, he's the health care -- makes all her health care 18 decisions. 19 Q Okay. Keep reading. 20 A Rachel indicated she had trespassed the son 21 based on the above from Sunbelt and had reported the 22 above to 1-800-96ABUSE/Donna. 23 Q Okay. Did you relay to Lillian Folley exactly 24 what you reported to the 96ABUSE number? 25 A We discussed many things that day. I CENTRAL FLORIDA REPORTERS, INC. 1118 1 don't -- I told her that I had reported him to HRS, but 2 I don't remember exactly what I told her was reported. 3 Q Okay. You're sure that you told her you 4 reported it, but you just don't know what the content -- 5 A Yes. 6 Q Okay. 7 A Do you want me to go on? 8 Q Let me make sure you're not -- you're not 9 included in any of the rest of these. I just wanted to 10 address the statements that were attributed to you. 11 Now, let me go back and ask you some of the 12 similar questions I asked you earlier, which is do you 13 believe that the part about disimpacting her -- do you 14 think that that was misinterpreted by somebody else? 15 A I don't know how this person interpreted the 16 information that I relayed to her. I had a chart. I 17 had information. I relayed all the information that I 18 could to her. 19 Q And you're sure that you didn't make those 20 statements to her, though? 21 A Absolutely. 22 Q Okay. The statement regarding this being 23 witnessed is what I'm referring to specifically. 24 A No, I did not tell her that -- some of these 25 things, yes, were witnessed in the building. Some were CENTRAL FLORIDA REPORTERS, INC. 1119 1 witnessed by myself. Some were witnessed by Carol Boze. 2 The disimpaction was never witnessed in our building. 3 Q And so -- that's actually -- that was a poor 4 question and I apologize for that. I asked -- what I'm 5 asking is you -- or what I'm saying is you did not 6 report that disimpaction was witnessed? 7 A Correct. 8 Q So if she writes down that you said that, she 9 would be incorrect? 10 A Correct. 11 Q Okay. Do you recall -- first of all, do you 12 recall speaking to an officer or detective named 13 Padilla? 14 A I remember the name, yes. 15 Q Okay. Can you tell me whether that was a 16 phone conversation or a conversation that took place in 17 person or both? 18 A I'm not sure. 19 Q Okay. Third paragraph down -- are you with 20 me? 21 A Uh-huh. 22 Q It begins I spoke. 23 A Do you want me to read it? 24 Q Yes, please. 25 A I spoke to Nurse Bean who works at the Sunbelt CENTRAL FLORIDA REPORTERS, INC. 1120 1 Nursing Home. Nurse Bean told me that other nursing 2 staff had reportedly seen Carolina's son Larry 3 displaying inappropriate behavior toward his mother 4 Carolina. Bean said that the behavior included lying in 5 bed with his mother and kissing her, his mother. 6 Q Is that -- is that what was witnessed by Carol 7 Boze that, that you're relaying to Officer Padilla or 8 Detective Padilla? 9 A Yes. 10 Q Okay. Did you also tell him what you 11 witnessed? 12 A I -- I'm sure I did. 13 Q Okay. 14 A It's not in here but -- 15 Q Well, that's what I'm asking because I know 16 that it's not in there. 17 A Right. 18 Q I'm just trying to clarify what, what you told 19 him that may have been omitted. And you're sure that 20 you did tell him what you and Mary Thornton witnessed? 21 A Yes. 22 Q Okay. Did you also tell him about the 23 trespass incident that morning? 24 A Yes. 25 Q Okay. And you reviewed this and it's not in CENTRAL FLORIDA REPORTERS, INC. 1121 1 his report, so again that's what I'm asking you. 2 A It -- it's here in his report. 3 Q I'm sorry, you're right. 4 A On page two -- 5 Q You're right. 6 A -- in the second paragraph. 7 Q Uh-huh. Okay. Next paragraph down, that 8 would be the bottom paragraph on that first page. 9 A Uh-huh. 10 Q Go ahead and start. 11 A On today's date the son complained to Nurse 12 Bean about the blood on his mother's bed. The son 13 claimed that the nursing home care was inadequate 14 causing the blood on the mattress pad. Nurse Bean told 15 me that Dr. Black had examined Carolina. Dr. Black of 16 the nursing home claimed that a hemorrhoidal tissue was 17 extruding from Carolina's anus causing the blood. 18 Dr. Black allegedly stated that this extruding 19 hemorrhoid may have been caused by digital penetration. 20 Q Okay. Can you tell from this -- is this 21 information that you're relaying to Padilla? 22 A I may have told him that, yes, Dr. Black had 23 said that this could be caused by this, yes. 24 Q Okay. And, and when you're telling Detective 25 Padilla that Dr. Blan -- Dr. Black had examined CENTRAL FLORIDA REPORTERS, INC. 1122 1 Carolina, you're talking about the examination that he 2 did at Sunbelt, correct? 3 A Yes. 4 Q Okay. The one that you were present but not 5 in the room? 6 A I was at the facility. I can't remember if I 7 was in the room or not. 8 Q Okay. 9 MR. GROWER: Do you want her to read the rest 10 of that paragraph? 11 A Nurse Bean told me that the son claims that he 12 routinely evacuates his mother's rectum due to her 13 constipation. 14 Q Okay. Again, is that information that you're 15 relaying from the review of the medical records? 16 A The review of the medical records, yes. 17 Q Okay. And where did -- if you know, it says 18 Dr. Black of the nursing home claimed that a 19 hemorrhoidal tissue was extruding from Carolina's anus. 20 Did you ever report that to Detective Padilla? 21 A I may have, but from my recollection it was 22 internal hemorrhoids, but when she went to ORMC there 23 was -- it was conflicting. They didn't feel that that 24 was true. 25 Q Okay. Do you remember Dr. Black saying that CENTRAL FLORIDA REPORTERS, INC. 1123 1 there was an extruding hemorrhoid? 2 A Like I just said, I remember him saying that 3 she had internal hemorrhoids. 4 Q Okay. And an internal hemorrhoid would be 5 different from an extruding one, if you know, correct? 6 A One is in and one is out, yes. 7 Q Okay. Not to be simplistic, but an extruding 8 hemorrhoid would be visible without an internal 9 examination? 10 A Correct. 11 Q Okay. And did you tell him that Dr. -- did 12 you tell Detective Padilla that Dr. Black stated that 13 this extruding hemorrhoid may have been caused by the 14 digital penetration? 15 A I don't remember saying that it was an 16 extruding hemorrhoid, but I did say that this could be 17 caused from disimpaction, yes. 18 Q Do you remember ever using the word extruding 19 hemorrhoid? 20 A No, because from my recollection he had said 21 that they were internal hemorrhoids. 22 Q Could you have said that by mistake? 23 A Extruding hemorrhoids -- I mean, extruding -- 24 it's not even a medical term, extruding hemorrhoids, not 25 that I've ever heard but -- CENTRAL FLORIDA REPORTERS, INC. 1124 1 Q Okay. Okay, let's go to the next paragraph. 2 A I asked Nurse Bean if the son had been the 3 sole health care provider for Carolina and Nurse Bean 4 answered affirm -- affirmatively. I then asked Nurse 5 Bean would it not be in fact routine for the son to 6 perform this duty for his mother since he was the sole 7 medical care provider? Nurse Bean agreed that it would 8 be routine except for the fact that the mother is now in 9 the nursing home where the procedure would be performed 10 by the staff. 11 Nurse Bean told me that, that as a result of 12 the son's anger about the blood, a small disturbance was 13 caused at the nursing home, and the Orlando Police 14 Department officer trespassed son from the nursing home. 15 Q Do you remember that part of the conversation? 16 A I did say that he was trespassed from the 17 facility, but I don't remember saying that it was as a 18 result of the blood. I mean, he would -- he was angry 19 about many things. 20 Q Okay. 21 A It wasn't specifically related to just that. 22 Q Is that part of what Detective Padilla has put 23 in his report? To the best of your knowledge, is that 24 accurately portrayed? 25 MR. GROWER: Which part, I'm sorry? CENTRAL FLORIDA REPORTERS, INC. 1125 1 BY MR. CONWAY: 2 Q The -- well, that's a bad question. Strike 3 that question. 4 Did this detective -- do you know if he's the 5 one that retrieved the bed pad? 6 A I don't know. 7 Q Do you know where the pad was retrieved from? 8 A No. We discussed that earlier. I don't know. 9 Q Okay. Do you recall if you directed anyone to 10 pack it up? 11 A I don't remember. 12 Q Okay. Has anybody -- did anybody say to you 13 at any point I'm the one that did that? 14 A Not that I remember. 15 Q Do you recall anybody saying to you, oh, an 16 officer from OPD came by and I gave them the bed pad? 17 A I don't remember. 18 Q We're going to show you the bed pad that was 19 taken by the Orlando Police Department. 20 A Okay. 21 Q Okay? Does that look like the pad that was 22 lying under Carolina Destefano? And I'm not talking 23 about specific. I'm talking about general pad. Is this 24 the type of pad? 25 A That's the type of pad we had, yes. CENTRAL FLORIDA REPORTERS, INC. 1126 1 Q Okay. Do you recognize this pad? 2 A I wouldn't know if this was the same pad or 3 not. 4 Q Okay. There's one, maybe two blood stains on 5 that pad. Do you recognize either one of those? 6 MR. TOWNSEND: Object to the form. 7 MR. GROWER: Yeah, form. There's identified 8 to be more than that. 9 A I wouldn't know after all these years. 10 Q Okay. Do any of the stains on this pad look 11 like the ones that you observed on 9/21/99? 12 A I don't remember. I mean, I can tell that 13 they're blood stains, but other than that I don't 14 remember. 15 Q Okay. Could this be a pad from anywhere as 16 far as you remember? 17 A It looks to me like it's a bed pad with blood 18 stains on it. That's all I can tell you. 19 Q And you don't recognize it as the same one 20 that you observed when you examined Ms. Destefano? 21 A I wouldn't remember after all these years. 22 Q Okay. Were you ever present with Mary 23 Thornton when she took a look at a bed pad? Wait a 24 minute. 25 Were you ever present with Mary Thornton when CENTRAL FLORIDA REPORTERS, INC. 1127 1 she looked at the bed pad laying under Carolina 2 Destefano? 3 A I don't remember. 4 Q Okay. Do you remember doing more than one 5 examination of Ms. Destefano and the bed pad? 6 A I can remember doing -- looking at her bottom 7 with Larry. Other than that, I don't remember if I 8 looked at it again. 9 Q Okay. Okay. Do you ever remember Carol 10 Boze -- when you called her in to do the late entries, 11 do you remember yelling at her? 12 A Yelling at her? 13 Q Uh-huh. 14 A No. 15 Q If she said that you reamed her out, would 16 that be accurate? 17 A I wouldn't call it reaming somebody out. I 18 always look at it when you have an employee and they do 19 something that isn't up to standards or isn't according 20 to the nursing practice as an educational piece, that 21 you bring them in and you teach them the right way to do 22 things. It's not reaming somebody out. If you -- I 23 guess it depends on the person. It's constructive 24 criticism and it's, it's a learning process. We learn 25 every day. CENTRAL FLORIDA REPORTERS, INC. 1128 1 Q After these late entries were made, do you 2 believe that you addressed her in a professional manner 3 in terms of the things that she neglected to do? 4 A Yes. 5 Q Okay. Did you ever speak to Margarita Walters 6 about, about the kiss that you observed? 7 A I'm not sure. 8 Q Okay. Did Margarita -- Did Margarita Walters 9 ever talk to you about one of the nursing staff 10 observing an inappropriate kiss? 11 A Not that I remember. I don't remember. 12 Q Okay. Do you recall having any conversations 13 with Margarita Walters about any of the incidents 14 involving Larry Destefano's mother? 15 A I don't remember. 16 - - - - - 17 CROSS EXAMINATION 18 BY MR. TOWNSEND: 19 Q Ms. Bean, my name is Larry Townsend. I 20 represent Orlando Regional Healthcare System and I have 21 just a very few questions for you. 22 I believe that several hours ago at the 23 beginning of this deposition you said that you did not 24 know a person named Kelly Pipkin, is that correct? 25 A That's correct. CENTRAL FLORIDA REPORTERS, INC. 1129 1 Q And you do not know a person named Lillian 2 Folley. You know who she is from our discussions? 3 A Correct, but I don't know her personally. 4 Q And that, that was true prior to 5 Mrs. Destefano being transferred to Orlando Regional on 6 the 21st of September, 1999, correct? 7 A That's correct. 8 Q Have you seen or spoken to either one of those 9 ladies since November 21st, 1999? 10 A No. 11 Q It's my understanding you've never spoken to 12 Kelly Pipkin, is that correct? 13 A I don't remember ever speaking to her. 14 Q All right. And as I understand your 15 testimony, you were not involved in the specifics of the 16 transfer, the actual physical transfer of Mrs. Destefano 17 to Orlando Regional, is that correct? 18 A Correct. 19 Q And it's customary for a nurse to call report 20 to the receiving facility, is that correct? 21 A Correct. 22 Q And when we see references to a nurse giving 23 report to Kelly Pipkin, you're saying that would not 24 have been you, is that correct? 25 A Correct. CENTRAL FLORIDA REPORTERS, INC. 1130 1 Q Have you ever spoken with anyone from Orlando 2 Regional Healthcare System other than you've testified 3 here today about Mrs. Destefano? 4 A No. 5 Q Have you told us everything you can with 6 regard to the conversations that you had with anyone at 7 ORMC? Have you testified about that today? 8 A Yes. 9 Q And you've given us the extent of your 10 recollection of any of those discussions? 11 A Yes. 12 Q Did you ever request anyone at Orlando 13 Regional to make up anything -- facts about what 14 happened at Orlando Regional in order to support your 15 version of what happened at Sunbelt? 16 A No. 17 Q Did anyone at Orlando Regional ever volunteer 18 to you that they would make up facts that did not occur 19 in order to support anything that happened at Sunbelt? 20 A No. 21 - - - - - 22 CROSS EXAMINATION 23 BY MR. GROWER: 24 Q Ms. Bean, let's go through in chronological 25 fashion as near as you can recall your contacts with CENTRAL FLORIDA REPORTERS, INC. 1131 1 Mr. Destefano. The first one obviously being on 2 September 21st, 19 -- 3 A '99. 4 Q -- 99, correct? 5 A Yes. 6 Q That was the contact you had with him at the 7 nursing home facility, correct? 8 A Yes. 9 Q When was the next time you had a contact with 10 him? 11 A Well, I had called him that day, also, to let 12 him know that his mother would be transferred to ORMC. 13 Q Okay. Next time? 14 A I believe the next day he was out picketing in 15 front of the building. 16 Q And he had a sign in front of him at the time? 17 A Yes, he did. 18 Q And did he stay in front of the building for a 19 period of months? 20 A Yes. 21 Q And did you have contact with him during those 22 months that he was picketing in front of the facility? 23 A Well, he had contact with me, yes. 24 Q What, what was the nature of that contact? 25 A When I would come in to work daily, he would CENTRAL FLORIDA REPORTERS, INC. 1132 1 yell out, Rachel Bean, have you found a new job yet? 2 You're going to need one. You're going to be sorry. 3 He, he had a video camera, whether it was on or not. He 4 would point -- 5 Q Did it appear that he was videotaping? 6 A It, it appeared that he was. When I would go 7 to lunch with my mother or my husband, he'd videotape. 8 He'd videotape when I would come into the building and 9 when I would leave the building. 10 Q Did there ever come a time that he would 11 scream at you? 12 A Yes, he would scream at me, call me names. 13 Q Now, a few moments ago you made reference to a 14 deposition that you gave, and I have that deposition 15 with me here today. I believe the deposition was taken 16 on June 13th, 2000, in the case of State of Florida 17 versus Larry M. Destefano. Do you recall that depo? 18 A Yes. 19 Q That depo was taken by Mr. Conway? 20 A Yes. 21 Q Now, Mr. Conway mentioned a few moments ago in 22 some of his questions that he asked you about making an 23 agreement with him or providing him with certain 24 information. Is that conversation contained in this 25 deposition? CENTRAL FLORIDA REPORTERS, INC. 1133 1 A No, it was off the record. 2 Q What, what do you understand off the record to 3 mean? 4 A Meaning that it wouldn't be in the deposition, 5 in the transcript. 6 Q Okay. We're here today and we have a 7 videographer and your deposition is being videotaped, 8 and we have a court reporter here to my left who is 9 taking down every word we say. Are you familiar with 10 this process? 11 A Yes. 12 Q Okay. Now, when Mr. Conway wished to discuss 13 with you this, this agreement that he wanted you to 14 make, did he put that in the deposition that you had 15 given in this case? 16 A When I reviewed the deposition, I did not see 17 it in there. 18 Q It was not there at all? All right. Now, 19 Exhibit No. 5, this is the letter that Mr. Conway sent 20 to your home? 21 A Correct. 22 Q And is it signed by someone other than 23 Mr. Conway? 24 A Yes. Larry Destefano. 25 Q All right. And it makes -- it makes CENTRAL FLORIDA REPORTERS, INC. 1134 1 reference, does it not, to the safety of your family? 2 A Yes. 3 Q I believe you told us earlier that your family 4 consists of six children ages what to what? 5 A Five -- almost 15 to four. 6 Q 15 to four? All right. And did 7 Mr. Destefano's behavior and his activities and this 8 letter cause you to have fear for your family? 9 A Yes, it did. 10 Q All right. Now, when is the next time you had 11 a conversation with Mr. Destefano or had the opportunity 12 to see him? I believe you indicated he came to your 13 place of business. 14 A He came to my work on the Vitas unit. 15 Q Tell, tell the jury what the Vitas unit is. 16 A The Vitas unit is a unit that specializes in 17 the end of life or symptom control for people who choose 18 to have comfort measures when they have a diagnosis for 19 terminal disease. 20 Q Is that -- is that Hospice? Is that what we 21 were talking about a moment ago? 22 A Yes. 23 Q And as I understand it, he came to your 24 workplace? 25 A Yes. CENTRAL FLORIDA REPORTERS, INC. 1135 1 Q After this letter of June 17th or before? 2 A It was before the letter, but it was after the 3 conversation that I had with Mr. Conway. 4 Q Okay. And what did he do when he got to your 5 place of business? 6 A He came to the unit, and I was documenting so 7 I was looking down and I heard his voice. He was asking 8 one of the nurses how to get to the front of the Winter 9 Park building. 10 Q Okay. And what was your reaction to that? 11 A Well, when I heard his voice I looked up and 12 saw that it was him, and he just stared at me and then 13 he walked off. I thought that it was kind of strange 14 that he would be coming to the Vitas unit to find out 15 how to get to the front of Winter Park Hospital 16 considering his mother passed away on that unit. 17 Q How did you feel about his presence at your 18 workplace? 19 A I felt intimidated and scared once again and 20 contacted security there. 21 Q And is that the Winter Park Hospital? 22 A Yes. 23 Q All right. And I believe you said you also 24 took a couple days -- or you were placed on paid leave? 25 A I was placed on paid leave because -- I'm not CENTRAL FLORIDA REPORTERS, INC. 1136 1 sure if he went to the main office at Vitas or he 2 contacted them and continued to go into the story about 3 what had happened at Sunbelt. And that as long as I was 4 in the building, that he would continue to picket us at 5 Winter Park, the Hospice unit. 6 DIRECT EXAMINATION 7 BY MR. GLICK: 8 Q All right. Mrs. Bean, I want to direct your 9 attention right away to the bed pad that we have behind 10 you right here. And I'm going to try to move over here 11 with a microphone. It's going to be kind of tough. But 12 let me ask you, first of all, this is the type of bed 13 pad that was commonly used at the Sunbelt Nursing Home 14 when you were the director of nursing there, is it not, 15 ma'am? 16 A Yes. 17 Q And do you have any reason to believe by 18 looking at this bed pad that this is not the bed pad of 19 Carolina Destefano? 20 A I have no way of knowing if this is the bed 21 pad. It's been too long. 22 MR. GROWER: Mr. Glick, if it'll help you, we 23 will stipulate this is in fact the bed pad. 24 MR. GLICK: Okay. Thank you, Mr. Grower. 25 BY MR. GLICK: CENTRAL FLORIDA REPORTERS, INC. 1137 1 Q All right. Now, you testified earlier in this 2 case that you have examined this bed pad, but since 3 Mr. Grower has stipulated that this was the bed pad of 4 Carolina Destefano, you testified that you examined this 5 bed pad and you found -- and on one occasion is the 6 only -- you only examined it one time, is that correct, 7 ma'am? 8 A That I can recall, yes. 9 Q All right. And what you found was a dime 10 sized pin -- piece of blood, a dime size -- I don't know 11 what the word is for -- a piece of blood or a -- or a 12 remnant of blood? 13 A As I said yesterday in my deposition, that to 14 the best of my recollection, if I had to estimate and 15 remembering back, a dime size. 16 Q Okay. All right. And you also testified I 17 believe yesterday that you couldn't tell us whether it 18 was made -- you know, how, how fresh it was, but it was 19 something that had happened within the last couple of 20 hours? 21 A Yes. 22 Q Okay. And the stain that you found was in 23 the -- under the buttocks area, where around the 24 buttocks of Carolina Destefano would be, correct, ma'am? 25 A Well, the pad would have been located under CENTRAL FLORIDA REPORTERS, INC. 1138 1 her bottom, but I can't remember the exact position that 2 the pad was in when I saw the pad. 3 Q Okay. Do you recall that the pad was -- you 4 said it was located around her buttocks area? 5 A Well, that's generally where the pad would be, 6 yes. 7 Q Okay. And, and do you have any reason to 8 believe in this case it was anywhere else? I mean, do 9 you remember it being down at her feet? 10 A No. 11 Q Do you remember it being up at her head? 12 A No. 13 Q Okay. You remember it being around her 14 buttocks area, correct? 15 A It would be in that area, yes. 16 Q Okay. All right. Now, let me ask you, is 17 this to the best of your recollection as far as the 18 stains, the blood stains that are on here, how the pad 19 looked on September 21st, 1999 when you examined 20 Mrs. Destefano? 21 A I told you yesterday in my deposition that I 22 cannot remember if this is the pad. I can't remember. 23 I mean, it's been over three years. 24 Q Okay. You -- what you're telling us is you 25 can't remember if this is how the pad that was under CENTRAL FLORIDA REPORTERS, INC. 1139 1 Carolina Destefano looked when you examined her on 2 September 21st, 1999? 3 A Yes. 4 Q Okay. And the examination -- we talked about 5 that you only looked at the pad one time, but as far as 6 examining Mrs. Destefano's buttocks area, you told us 7 yesterday that you only examined her one time, correct, 8 ma'am? 9 A I told you yesterday that I only remember one 10 time. 11 Q One time? 12 A It could have been more. I don't remember. 13 Q All right. By the way, did you have an 14 opportunity to review your deposition? 15 A I started to look at it last evening and after 16 about two pages went to sleep. 17 Q Okay. All right. Now, did you try to 18 determine when you examined Mrs. Destefano where the 19 blood came from? 20 A The only thing I tried to determine was -- is 21 that Mr. Destefano had told me that we had caused an 22 open area on his mother's bottom for lack of care. So 23 that was my priority, to look at her bottom to see if 24 indeed she had a decubitus ulcer, which she didn't. 25 That was the only thing that, that I examined. I looked CENTRAL FLORIDA REPORTERS, INC. 1140 1 at her buttocks and saw that she had an excoriated area 2 which had ointment on it, an area that looked like 3 diaper rash. 4 Q Did you -- did you look at any other parts of 5 her body to determine if she had any cuts or bruises or 6 abrasions, anything that would cause blood on, on the 7 bed pad? 8 A As I said yesterday, I don't remember. I 9 believe I -- at that time we looked at the ulcer on her 10 ankle. I know that sometime I had looked at the ulcer. 11 I don't know if it was at that time or another time. 12 Q And you've told us that wouldn't have caused 13 the blood, though? 14 A Well, I can't determine that. 15 Q Okay. All right. Okay. Now, as far as 16 examining the -- Mrs. Destefano's buttocks area or the 17 bed pad itself with Mary Thornton, you don't recall ever 18 doing that? 19 A I don't remember. 20 Q Okay. Did you ever find -- do you have a 21 recollection sitting here today of find -- of being with 22 Mary Thornton and finding a blood stain on 23 Mrs. Destefano's bed pad that was a baseball size? 24 A No. 25 Q You, you are sure that you did not see a CENTRAL FLORIDA REPORTERS, INC. 1141 1 baseball-size blood stain or something of that type on 2 Mrs. Destefano's bed pad? 3 A As I told you yesterday, that to the best of 4 my recollection it was dime size. 5 Q Okay. And you would agree with me that a dime 6 and a baseball are vastly different? 7 A Absolutely. If she had a baseball-size amount 8 of blood there, she would be hemorrhaging from 9 somewhere. 10 Q All right. Now, the -- at 9:00 or 9:30 is 11 around -- is that about the time you were in the room 12 with Mr. Destefano and he allegedly pointed out to you 13 that his mother was, was bleeding? 14 A It would have been in, in the area between 15 9:00 and 9:30, yes. I don't know the exact time. 16 Q And according to the records -- and if I can 17 show -- and Mr. Grower has all these records, also. The 18 trespass warrant was signed at 10:10 in the morning. 19 All right. Do you have the trespass warning in front of 20 you, ma'am? 21 A Yes. 22 Q And that says that you trespassed 23 Mr. Destefano at 10:10 a.m. on September 21st, 1999, 24 correct? 25 A Correct. CENTRAL FLORIDA REPORTERS, INC. 1142 1 Q All right. Now, at that time you had already 2 seen the bed pad? 3 A Correct. 4 Q All right. Orlando Police Department comes to 5 the nursing home, and do you or do you not tell them 6 about the blood on the bed pad or about the bed pad? 7 A As I told you yesterday in my deposition, I 8 don't recall if I told them or not. 9 Q Okay. All right. Let me turn to your 10 deposition. Let me ask you -- 11 MR. GROWER: Which page, please? 12 MR. GLICK: Page 126, lines -- starting at 13 line 21. 14 BY MR. GLICK: 15 Q And tell me if you remember giving this 16 question and answer. "Do you know how the Orlando 17 Police Department knew that there was a pad that had 18 blood on it?" Answer, "I'm sure, sure that I had told 19 them when they came." Question, "Told who?" The police 20 officers when they came to do the trespass warrant. 21 Do you remember giving those answers in 22 response to those questions? 23 A Yes. 24 Q All right. Let me ask you also on -- turning 25 to page 181 line four -- beginning on line four. CENTRAL FLORIDA REPORTERS, INC. 1143 1 A Okay. 2 Q Question, "They were aware of it, though, 3 right? You told them about the pad with the blood on 4 it?" Answer, "I told," I guess "You before, I don't 5 remember if we discussed it or not. I don't know." 6 Question, "You don't know if you discussed the pad? I 7 don't remember the conversation." Question, "Well, do 8 you think that you mentioned it?" Answer, "I can't 9 speculate whether did I or not. I can't remember the 10 conversation." 11 So what I'm asking you now in light of those 12 two passages from your deposition, Ms. Bean, is whether 13 or not you told them about the bed -- the bloody bed pad 14 at that time or you just -- or if you do not remember 15 whether you told them? 16 A I don't remember having the conversation, but 17 if they knew that there was blood on the pad and they 18 called me back to retrieve it, then I must have had the 19 conversation. I don't remember the specific 20 conversation. 21 Q The -- all right. That is -- that is how you 22 believe that they would have known about the bed pad? 23 A Correct. In my nurse's note, I did not write 24 any reference to that. At this time it's been three 25 years. I cannot remember the conversations that I had CENTRAL FLORIDA REPORTERS, INC. 1144 1 with every single person that day. 2 Q Okay. Do you know of any record -- and if the 3 answer is I don't know, that's the answer that we will 4 accept. But do you know of any record that shows that 5 you told the police at 10:10 or thereabouts about the 6 bloody bed pad? 7 A I have not seen any record. 8 Q Thank you. Do you know of anybody else who 9 told the Orlando Police Department at the time that they 10 came to trespass Mr. Destefano about the blood on the 11 bed pad? 12 A If I don't remember my conversation, I don't 13 remember anybody else's. 14 Q Well, okay. The, the answer is no then, you 15 don't? 16 A The answer is no. 17 Q All right. Let's talk about the -- a little 18 bit about the, the kiss. The kiss that we talked about 19 yesterday that you testified that you witnessed 20 Mr. Destefano kissing his mother in room -- in her room, 21 do you recall that, ma'am? 22 A Which kiss? Because there were two different 23 occasions. 24 Q Okay. How -- did you witness more than one 25 kiss? CENTRAL FLORIDA REPORTERS, INC. 1145 1 A Yes. We discussed it yesterday. There was 2 the kiss when Mary Thornton and I came to the door -- 3 Q Yes. 4 A -- and then there was the kiss when I was in 5 there where he was kissing her face all over. 6 Q Okay. All right. I'm talking about the kiss 7 that, that you allegedly saw and Mary Thornton allegedly 8 saw. That one. 9 A Okay. 10 Q The one on the lips. 11 A Okay. 12 Q The only one you've told us I believe that was 13 inappropriate. 14 A Correct. 15 Q All right. Did you inform the Orlando Police 16 Department about that kiss when they came to trespass 17 Mr. Destefano at 10:00 -- 10:10 in the morning? 18 A As I told you, I don't remember the 19 conversation that we had. 20 Q Okay. All right. Now, in -- are you able to 21 point to any record in -- their records, your records, 22 any record, any document that shows that you did in fact 23 inform them when they came to trespass Mr. Destefano of 24 this inappropriate kiss? 25 A I would have to review my nurse's note once CENTRAL FLORIDA REPORTERS, INC. 1146 1 again and -- 2 Q You can feel -- 3 A -- there's a lot of records, so I don't know 4 if there's any record stating that. 5 Q Okay. 6 A According to my nurse's note, there's nothing 7 stating that. 8 Q Okay. So at this point in time at 10:00 -- 9 between 10:00 and 11:00 o'clock in the morning on 10 September 21st, 1999, you are not able to tell us 11 whether or not you informed the Orlando Police 12 Department of the bloody pad or of an inappropriate kiss 13 by Mr. Destefano on his mother's lips? 14 MR. GROWER: Objection. 15 A As I told you before, I don't remember the 16 exact conversation, no. 17 Q Do you remember telling them that 18 Mr. Destefano was being unruly or not behaving in the 19 nursing home? 20 A I didn't use those exact terms. I'm sure 21 those aren't words that I would use, but I did let 22 him -- them know the behavior. That's why we called 911 23 and had him trespassed. 24 Q All right. That was the reason that you -- 25 that you called them? CENTRAL FLORIDA REPORTERS, INC. 1147 1 A Yes. 2 Q All right. Now, at that time the Orlando 3 Police Department did not take the bed pad with them, 4 correct? 5 A As we discussed before, no, they did not. 6 Q Do you recall what happened to the pad? 7 The -- where did it go from the time that the Orlando 8 Police Department left and trespassed Mr. Destefano 9 until the time that they came into possession of it 10 again? 11 A As I stated yesterday, I don't know where the 12 pad went. I don't remember who gave it to the police 13 department. 14 Q Would it be safe to say that the -- that this 15 bed pad stayed in the custody of the Sunbelt nursing 16 facility until the police retrieved it? 17 A Yes, the pad stayed in the building. 18 Q Now, do you know if it was in your office or 19 in Mary Thornton's office or where it was? 20 A As I told you yesterday and I've told you 21 today, I don't know where the pad went. 22 Q Okay. All right. Let me show you a document 23 that we can have marked -- what we've handed you now, 24 Mrs. Bean, is Exhibit No. 7. Let me ask you first of 25 all -- because this was produced by your counsel to me CENTRAL FLORIDA REPORTERS, INC. 1148 1 in discovery in this case. Let me ask you, first of 2 all, do you recognize the handwriting on that? 3 A Yes, I do. 4 Q And whose handwriting is that? 5 A I think Chuck Sherer's. 6 Q Okay. Can you read that note to us, please? 7 A Sure. Police OPD called, and I can't read the 8 next word. Sorry. In parenthesis it said, spoke to -- 9 spoke with Rachel about 7:00 p.m. asking about bloody 10 pad, in parenthesis, is in Mary T's office. Indicated 11 to Rachel that they were going to probably arrest the 12 son this evening. 13 Q Okay. Do you remember, first of all, that 14 conversation with Mr. Sherer? 15 A No. 16 Q Okay. Does it refresh your recollection by 17 looking at that document that the bloody pad was in Mary 18 Thornton's office? 19 A That's what this statement says, but I, I 20 don't remember the conversation and I don't -- as I told 21 you before, I don't know where the pad was. 22 Q Okay. 23 THE COURT: Let's take a brief recess, please. 24 Okay. Why don't we take a ten or -- about a five 25 to ten-minute break. Try to make it quick. If you CENTRAL FLORIDA REPORTERS, INC. 1149 1 would stay in the jury room, please, and we'll call 2 you back in in just a few minutes. 3 (Whereupon the Jury exited the courtroom.) 4 THE COURT: Anything before our recess? 5 MR. OSBORNE: No, ma'am. 6 THE COURT: The only other request, to make 7 the jury as comfortable as possible, is our 8 deputies are generously donating coffee for the 9 jurors. They have also donated a coffee pot back 10 there for them. I wonder if one of you would just 11 be there to bring some coffee so they could have 12 that so our deputies don't have to spend their 13 money and -- 14 MR. TOWNSEND: Are you talking about just 15 ground coffee to use in the pot? 16 THE COURT: Yes, because they have a pot. 17 MR. TOWNSEND: That's no problem. 18 THE COURT: Thank you very much. 19 (Whereupon, there was had a recess from 2:32 20 o'clock p.m., to reconvene at 2:57 o'clock p.m., in 21 the presence of the Jury.) 22 THE COURT: Thank you. Corporal, would you 23 take this to Ms. Rodriguez? This is a letter for 24 your employer, Ms. Rodriguez, that simply states 25 you're in jury service. And I've had that done for CENTRAL FLORIDA REPORTERS, INC. 1150 1 you and I've signed it. 2 MS. RODRIGUEZ: Thank you very much. 3 THE COURT: I hope that's satisfactory. 4 MS. RODRIGUEZ: Okay. Thank you. 5 THE COURT: You're welcome. Go ahead. 6 (Whereupon the videotaped deposition of Rachel 7 Bean was resumed.) 8 BY MR. GLICK: 9 Q Okay. All right. You've told us you don't 10 know where the pad was, but yet you were the person who 11 was basically coordinating the transfer to ORMC of 12 Carolina Destefano, correct? 13 A I didn't coordinate the transfer. I spoke 14 with Dr. Black and I spoke with Chuck Sherer regarding 15 that it would be better for Mrs. Destefano to go to 16 ORMC, being that it was neutral grounds, and Florida 17 Hospital was our sister facility. 18 Q And you were the one, though, that was 19 basically handling this Larry Destefano matter, correct? 20 A Well, there were a few people that were, were 21 involved in the incident. Myself, Chuck, the nurses 22 that discharged the resident to the hospital. 23 Q Okay. Was Chuck basically supervising your 24 involvement in this? 25 A Well, he was the administrator so -- I mean, I CENTRAL FLORIDA REPORTERS, INC. 1151 1 wouldn't exactly use the word supervising but, I mean, 2 he knew what was going on and we discussed things, yes. 3 Q Okay. But -- I mean, you were the -- why 4 wouldn't you use the word supervising? I mean, what did 5 you mean by that, that you wouldn't use the word 6 supervising? 7 A Because he wasn't technically supervising what 8 I was doing. I mean, I was the director of nursing and 9 he was the administrator. And as far as any clinical 10 matters, Chuck didn't have an understanding of that. He 11 didn't have a clinical background. So I don't think 12 supervising is, is a correct term for that. 13 Q Okay. But as far as this Larry Destefano 14 matter and, and everything surrounding it, the trespass, 15 the transferring of Carolina Destefano, the reporting 16 the matter to DCFS, reporting the matter to the Orlando 17 Police Department, all of this, you were the person 18 basically running the show? 19 A Well, if that's how you want to put it. I 20 mean, yes, I am mandated, because I am a nurse and I am 21 in the health care profession, that if I see something 22 that is considered abusive or out of the ordinary, that 23 it is my duty by law to report it. So if that's 24 considered running the show then, then yes. 25 Q Did, did you consider the, the kiss that you CENTRAL FLORIDA REPORTERS, INC. 1152 1 termed an intimate kiss yesterday to be abusive? 2 A I felt that was inappropriate. I felt that it 3 was abusive to take water and put that into somebody's 4 mouth who had swallowing difficulties and was at a risk 5 for aspiration, which means that the fluid would go into 6 her lungs and it could, could lead to her death. That, 7 that is considered abuse. 8 Q Okay. But the -- actually you witnessed 9 Mr. Destefano pouring the water into his mother's mouth, 10 correct? 11 A Yes, as I told you yesterday. 12 Q And did she gag? 13 A As I told you yesterday, I don't remember. 14 Q Okay. Did -- so the -- your -- in your 15 opinion the kiss itself was not abusive? 16 A No. That was inappropriate. 17 Q Okay. All right. And -- 18 A And maybe I should clarify something for you. 19 Q Go ahead. 20 A When somebody is at risk for aspiration, it 21 doesn't mean that every time they take a drink of water 22 they're going to gag. People are silent aspirators, 23 which means that when they take a drink and it goes down 24 the wrong hole -- and you have no indication of that 25 without an x-ray. So somebody gagging wouldn't CENTRAL FLORIDA REPORTERS, INC. 1153 1 necessarily mean that they're aspirating or if they 2 didn't gag that they didn't aspirate. So maybe that 3 clears that up. 4 Q Okay. Now, while you were kind of the 5 hands-on person as far as this, this entire matter was 6 concerned, Mr. Sherer was kept apprised of everything? 7 A Yes. 8 Q And he was -- you didn't do anything that he 9 didn't -- did you do anything that he told you not to 10 do? 11 A No. 12 Q He acquiesced in everything that you did? 13 A Can you rephrase that, please? 14 Q Yeah. He, he approved of everything that you 15 did? 16 A Well, I, I don't want to put words into Chuck 17 Sherer's mouth, but there was never any question about 18 what I was doing. 19 Q He didn't object to anything that you did that 20 you know? 21 A Not that I know of, no. 22 Q Okay. And he didn't voice anything to you? 23 A No. 24 Q Okay. All right. All right. So you've told 25 us that you didn't know where the pad was from the time CENTRAL FLORIDA REPORTERS, INC. 1154 1 that you -- from the time that you last saw it in 2 Mrs. Destefano's room, which was just before the 3 trespass, until when -- until when? When did you next 4 see the bed pad? 5 A I told you I don't remember. 6 Q Okay. Do you -- can you tell us if you ever 7 saw the bed pad again? 8 A I told you I don't remember. 9 Q All right. Now, you had a conversation with 10 Officer Padilla at about 6:30 in the evening. Do you 11 recall that? 12 A I recall it from the nurse's notes -- 13 Q Okay. 14 A -- because the documentation is here that I 15 spoke with him at 6:30 -- approximately 6:30, yes. 16 Q And at that time there was a conversation 17 between and you Officer Padilla, and he told you that he 18 was going to come and retrieve the bed pad, correct, 19 ma'am? 20 A Well, I don't remember if he said he would be 21 coming, but according to my nurse's note that it said 22 and may be coming to the facility to retrieve pad with 23 blood on it for evidence. 24 Q Now, do you know for a fact -- well, strike 25 that. Let me ask you this question. CENTRAL FLORIDA REPORTERS, INC. 1155 1 Did -- at that time when Officer Padilla -- do 2 you recall where Officer Padilla was calling from? 3 A I don't recall that because I don't even 4 remember that it was even Officer Padilla that I talked 5 to. The only reason I know that is according to my 6 documentation that that's who I spoke with. 7 Q Okay. And at that time did you inform Officer 8 Padilla that there was blood on a bed pad and that you 9 had it? 10 A I told you that I don't even remember the 11 conversation. 12 Q And you don't remember the turning over of the 13 bed pad to Crime Scene Technician Rogers, do you, ma'am? 14 A No, I don't remember. 15 Q All right. So you've told us that from early 16 that morning when Mr. Destefano allegedly pointed out 17 the blood to you on the bed pad, that the pad was in the 18 Sunbelt facility until the police came and got it? 19 A Yes, that's what I said. 20 Q All right. And during that time period, did 21 you leave the facility at all? 22 A I don't remember. 23 Q Were you in the facility most of the day? 24 A I don't remember. I mean, I don't know if I 25 went out for lunch. I mean, I'm sure I was there most CENTRAL FLORIDA REPORTERS, INC. 1156 1 of the day. I was on the phone. Obviously you can see 2 from my documentation I was there until at least 6:30. 3 Q Okay. So you were there pretty much of the 4 time? 5 A I would say yes. 6 Q Would -- 7 A I mean, I can't tell you exactly. 8 Q All right. Would you agree with me that you 9 had the opportunity during that entire day to do almost 10 anything you wanted to do with that bed pad? 11 A No. I wouldn't agree with you. I was very 12 busy. I had this whole incident. I was on the phone 13 with HRS according to my nurse's note twice. No. 14 Q Let me ask you a question, Mrs. Bean. Let me 15 retrieve my microphone before I -- I'm pointing here to 16 this blood stain. Do you see this right here? 17 A Yes. 18 Q Do you have any idea how that blood stain got 19 there? 20 A As I told you before, no. 21 Q Does that look like any type of blood stain 22 you had ever seen before in your career as a nurse? 23 A It's kind of a strange question. No, I 24 mean -- 25 Q Do you recall if Mrs. Destefano had a Hep-Lock CENTRAL FLORIDA REPORTERS, INC. 1157 1 in her? 2 A No, I don't recall. 3 Q Do you recall if she had a saline lock? 4 A A Hep-Lock and saline lock are the same thing. 5 So, no, I don't recall. 6 Q Okay. Do you -- do you remember if Carolina 7 Destefano had any blood work done that day? 8 A I wouldn't know if she had blood work done. 9 Q Did you withdraw blood from Carolina 10 Destefano? 11 A Absolutely not. 12 Q Do you know of anybody who withdrew blood from 13 her? 14 A Absolutely not. 15 Q Did you in fact withdraw blood from her and 16 place blood on the bed bad there? 17 A If I just told you I didn't draw blood from 18 her, how could I place it on the pad? Absolutely not. 19 Q You understand that anybody who did that, that 20 would be a criminal act? 21 A Sure. 22 Q Okay. When did you come into -- for this 23 deposition? 24 A I flew in Friday evening. 25 Q And did you meet with Mr. Grower at that time? CENTRAL FLORIDA REPORTERS, INC. 1158 1 A No, I didn't. 2 Q When did you meet with him? 3 A I met with him Sunday afternoon. 4 Q Had you ever met with Mr. Grower before that 5 time? 6 A We met on one occasion. 7 Q And had you spoken on the phone on several 8 occasions? 9 A I don't believe I ever spoke with Mr. Grower 10 on the phone. I spoke with Chrissie in his office. 11 Q And what, what documents have you reviewed in 12 preparation for the depositions here? 13 A As I told you yesterday, I reviewed the chart 14 and the hospital records. 15 Q All right. Mrs. Bean, you told us yesterday 16 that -- you said I believe -- and I -- this may not be 17 your exact words, but you basically saw nothing wrong 18 with Larry Destefano disimpacting his mother at home 19 since he was the primary caregiver. 20 A Correct. 21 Q Would you also agree with me that to provide 22 comfort to his mother doing that for her at home, 23 assuming he was the primary caregiver, was actually a 24 pretty admirable thing to do? 25 A Yes. It's a comfort measure, yes. CENTRAL FLORIDA REPORTERS, INC. 1159 1 Q But there was no reason for Larry Destefano to 2 do that in a nursing home such as Sunbelt? 3 A That's correct. 4 Q Do you know why he -- he -- let's assume that 5 he did do that. Do you know why he would have done 6 that? 7 A I don't know why he would do anything. 8 Q I mean, there, there were many nurses there 9 that were capable of performing that task, correct? 10 A Yes. 11 Q And it was in the records that his mother had 12 a disimpaction problem. Mr. Destefano had told the 13 hospital -- the nursing home on admission that she had a 14 problem with constipation and needed to be disimpacted, 15 correct? 16 A I'm not sure what he told on admission. I'd 17 have to review the records. 18 Q Could you take a look at the admission note 19 and see if it was noted there that Mrs. Destefano was 20 constipated and needed to be disimpacted on a regular 21 basis? 22 A According to this admission note written by 23 Melissa Healy, the admission nurse, I don't see anything 24 about impaction. If you'd like for me to read it for 25 you, I'd be glad to. CENTRAL FLORIDA REPORTERS, INC. 1160 1 Q I'm -- the -- what I'm talking about is the 2 admission and physical note. I think Dr. Black wrote 3 it. 4 A Oh, according to Dr. Black, okay. Yes. 5 According to Dr. Black's records, yes. 6 Q Okay. Now, when, when did you learn that 7 Mrs. Destefano -- strike that. Let me ask it this way. 8 When did you learn that Larry Destefano would 9 disimpact his mother? When did you find that out? 10 A I can't tell you the exact time. I know that 11 I reviewed her record and I saw it in the Florida 12 Hospital record. I don't know if it was that day, the 13 next day. I don't know. 14 Q I think early yesterday you told us that it 15 was after she was discharged from the facility. 16 A Yes, it was when she was discharged, but I 17 don't know when. 18 Q You don't know if it was the 21st or the 22nd 19 or 23rd -- 20 A Correct. 21 Q -- or something like that? Okay. All right. 22 Do you know if -- so just going back, to do -- for Mr. 23 Destefano to do -- to disimpact his mother in the 24 facility while there were nurses very capable of doing 25 it and had knowledge that this was something that needed CENTRAL FLORIDA REPORTERS, INC. 1161 1 to be done, for him to do it would be very strange, 2 wouldn't it? 3 A It would be very strange for a family member 4 to perform duties that nurses would do. I mean, that's 5 the purpose of being in a nursing home, that you become 6 the responsibility of the nursing home and all care 7 that's provided to you should be provided by the nursing 8 home staff. 9 Q And to do this -- do you know if Mr. Destefano 10 enjoyed doing this? 11 A I would not know that. 12 Q In any event, you never saw Larry Destefano 13 disimpacting his mother in the nursing home, correct? 14 A I have no knowledge of his mother ever being 15 disimpacted by anybody in the nursing home. 16 Q And no one told you they ever saw Larry 17 Destefano disimpacting his mother in the nursing home? 18 A When I reviewed the record, that's when I 19 found out that she had a history of constipation, that 20 he had to disimpact her. 21 Q Okay. But no one told you that they saw Larry 22 Destefano disimpacting his mother while she was in 23 Sunbelt? 24 A No, because I didn't know anything about the 25 disimpaction until I reviewed the record. CENTRAL FLORIDA REPORTERS, INC. 1162 1 Q I, I understand that. Okay, that's fine. 2 Well, let me ask you this. 3 Did, did the records show -- the Florida 4 Hospital records or the Sunbelt records show that Larry 5 Destefano had disimpacted his mother while in either of 6 those two facilities? 7 A To the best of my recollection, no. 8 Q Okay. Now, however you had your suspicions 9 that -- well, let me ask you this question. 10 Did you ever tell anybody, anybody from DCFS 11 or anybody from Orlando Regional Medical Center or 12 anybody from the Orlando Police Department that Larry 13 Destefano did disimpact his mother while in the nursing 14 home? 15 A No, I did not. 16 Q But you had your suspicions that he did, 17 correct? 18 A No, I did not have any suspicions. 19 Q All right. Let me direct your attention to 20 page 190 of your deposition that was taken yesterday, 21 and let me ask you if you remember these questions and 22 these answers. 23 MR. GROWER: Counsel, wait, wait, wait. 24 MR. GLICK: I'm going to tell you the line. 25 Page 190, line five. CENTRAL FLORIDA REPORTERS, INC. 1163 1 BY MR. GLICK: 2 Q "Did you have any suspicions that she was 3 being disimpacted while -- by Mr. Destefano while at 4 your facility?" Answer, "It was a possibility that 5 that's where the blood could have come from. And are 6 you saying it's a possibility simply because that's what 7 you reviewed in the notes and --" Answer, "It would be 8 the logical explanation." 9 Do you remember those questions and those 10 answers? 11 A I do, but I don't think that -- that that's 12 being suspicious of somebody. That's saying that 13 there's a possibility that could have happened and it 14 would be a logical explanation for the blood. But that 15 doesn't make me suspicious of somebody. I think when 16 you're suspicious of somebody that you're, you're 17 looking at them in a bad light, and that wasn't what was 18 happening. 19 Q You weren't looking at Mr. Destefano in a bad 20 light? 21 A Not in regard to disimpaction. I thought that 22 he was out of control as far as his behavior, that he 23 didn't act very professional or very adult like. But as 24 far as the disimpaction, as I said before, that -- when 25 he was at home with her, that would be a normal CENTRAL FLORIDA REPORTERS, INC. 1164 1 occurrence. No, it wouldn't be a normal occurrence for 2 anybody to do that in a facility that is not a medical 3 person. 4 Q Would you consider that to be abuse of the 5 elderly if a non-medical person in a nursing home dis -- 6 attempted to disimpact their relative? 7 A No, it's not abuse but it's not appropriate. 8 There's a big difference. 9 Q Okay. All right. Now, did you tell the DCFS 10 worker that you suspected that the son disimpacted his 11 mother this morning? 12 A No, I did not. 13 Q And did you -- did you say that you may have 14 said that that could have caused bleeding if the son had 15 disimpacted her? Do you remember saying that to them? 16 A I don't remember the exact conversation, no. 17 Q Okay. Does -- is that something possibly that 18 you said? 19 A I don't remember the conversation, so I don't 20 want to say if it's possible or not. 21 Q All right. Do you remember at page -- when we 22 took your deposition yesterday on page 195, line ten -- 23 A Okay. What is the question? 24 Q Line six -- page 193, line six. I'm sorry. 25 Did you give that information to Children and Families?" CENTRAL FLORIDA REPORTERS, INC. 1165 1 Answer, "I may have told them in the record that the son 2 disimpacts her on a weekly basis." Question, "Did you 3 tell them that you suspected son disimpacted his mother 4 this morning?" I may have said that that could have 5 caused bleeding if the son had disimpacted her." 6 Do you remember giving those questions and 7 answers? 8 A Yes. 9 Q So, in fact, you did tell DCFS that that could 10 be the cause of the bleeding if the son had disimpacted 11 her? 12 A If he had disimpacted her, yes, that could be 13 the cause. 14 Q All right. And you told DCFS that? 15 A I may have said that. 16 Q Okay. All right. Now, let's take a look now 17 at the Orlando Regional Medical Center records. I want 18 you to turn to the -- it is labeled Defendant's Exhibit 19 27 from a deposition taken July 19th, 2002. It says on 20 the top of it case management, initial discharge, 21 planning assessment, adult medical/surgical. 22 I want you to take a look at the comments 23 portion and -- first of all, do you see where this is 24 signed by Lillian Folley, RN, case manager? 25 A Yes. CENTRAL FLORIDA REPORTERS, INC. 1166 1 Q Dated 9/21/99? 2 A Yes. 3 Q Do you see where it also says about the third 4 line down of the comments, patient's son was witnessed 5 disimpacting her, parenthesis, states Rachel, RN, close 6 parenthesis, at Sunbelt? Do you see where that was 7 written? 8 A Yes. 9 Q Did you in fact tell Lillian Folley that 10 Mr. Destefano was witnessed disimpacting his mother at 11 Sunbelt? 12 A As I told you during the deposition yesterday, 13 that what was told to Lillian Folley, which I don't even 14 recall who she is -- I mean, I know I had a conversation 15 with her according to the records -- that when I 16 reviewed the Florida Hospital record that it stated in 17 there that the son had a history -- that the resident 18 had a history of disimpaction -- or constipation, excuse 19 me, and which the son had disimpacted her. That was the 20 information that I relayed to her. 21 Q Okay. So what you are telling us is that you 22 did not tell her that the patient's son was witnessed 23 disimpacting her at Sunbelt? 24 A I did not tell her or anyone else that 25 information. CENTRAL FLORIDA REPORTERS, INC. 1167 1 Q Now let's turn to -- and, I'm sorry, I don't 2 have the numbers on there. For some reason I don't, but 3 it's the Orlando Regional Healthcare System adult 4 department data record. And the first note on it is 5 1310. 6 All right. I want you to assume that -- first 7 of all, that the initials there on the 1310 entry are 8 Kelly Pipkin's, okay? 9 A I won't assume that. I can see that those are 10 the initials. 11 Q Okay. All right. So KP, you see that? 12 A Yes. 13 Q All right. And you see on the third line 14 down -- well, let me just read the whole thing. It says 15 patient transported from nursing home with reports of 16 finding bright red blood on sheets of bed status post 17 discussion with son by nursing home. Para reports per 18 nursing home staff her son dis -- disimpacted her SUN, 19 which I assume means Sunday. Would you assume that that 20 means Sunday, also? 21 A One thing I learned in nursing school, you 22 don't assume anything. 23 Q Okay. All right. Did, did you in fact report 24 to the paramedic who transferred Mrs. Destefano from 25 Sunbelt to ORMC that Mr. Destefano had disimpacted her CENTRAL FLORIDA REPORTERS, INC. 1168 1 the day before? 2 A Like I told you yesterday during my 3 deposition, I don't even remember having a conversation 4 with the paramedics, so I don't even know if I spoke 5 with them. 6 Q Okay. Now, the -- take a look at the adult 7 emergency department data record, this page right here. 8 There it says nursing home staff reports, and part of 9 mine is -- I'll tell you what. Can I ask you to read 10 that because part of mine is rubbed out. 11 A Nursing home staff reports questionable 12 impaction, I don't know what the next word is, to bright 13 red blood found on bed linen. Prior medical history, 14 impactions. 15 Q All right. Did you in fact report to somebody 16 at Orlando Regional Medical Center that there was bright 17 red blood found on a bed linen or a bed pad possibly due 18 to impaction? 19 A Like I told you yesterday, I don't remember 20 who I spoke with. I don't remember having that 21 conversation. 22 Q But yet it appears in this medical record? 23 A What appears in this medical record is that 24 Kelly Pipkin did an initial assessment in the ER and 25 that she states that the nursing home staff reports. CENTRAL FLORIDA REPORTERS, INC. 1169 1 The nursing home staff could be any number of people. I 2 never remember talking to Kelly Pipkin, and I don't 3 believe I was the person that called ORMC to give them a 4 report, so I don't know. 5 Q Okay. Do you know who from Sunbelt Nursing 6 Home other than yourself spoke to anybody at Orlando 7 Regional Medical Center regarding Carolina Destefano? 8 A No, I don't. 9 Q Can you give us the name of one person from 10 Sunbelt Nursing Home who spoke to Orlando Regional 11 Medical Center besides yourself? 12 MR. GROWER: Object to the form. No pred -- 13 A You just asked me the same question and I said 14 I don't know. 15 Q All right. Next take a look at the triage 16 care record. I want you to take a look at -- about 17 halfway down it says 71-year-old -- patient is 18 71-year-old white female with history of dementia, 19 dementia. Nursing home staff reports chronic 20 constipation and is status post decompaction and has 21 bright red blood per rectum. 22 With, with correct -- with those corrections, 23 do you recall reporting to the Orlando Regional Medical 24 Center that Mrs. Destefano suffered from chronic 25 constipation and is status post decompaction? CENTRAL FLORIDA REPORTERS, INC. 1170 1 A I may have told them she has a history of 2 chronic constipation. I may have told Lillian Folley 3 because I know I had a conversation with her. I never 4 said that it was status post decompaction. And this is 5 a physician -- a physician's assessment and it's saying 6 nursing staff reports. This could be ORMC's nursing 7 staff. It doesn't specify whether it's Sunbelt or ORMC. 8 So I have no way to know who, who that physician is 9 referring to. 10 Q Okay. Okay. Now, were you -- and I, I know 11 you've answered this question, Mrs. Bean, but I want 12 to -- did you play any role in the transfer of Carolina 13 Destefano to ORMC? 14 A Like I -- like I told you yesterday, I know 15 that I spoke with Chuck Sherer and I spoke with 16 Dr. Black regarding the transfer to ORMC. Other than 17 that, I don't remember playing any part of, of the 18 transfer. 19 Q Do you remember signing the sheet to transfer 20 her? 21 A The sheet that you're referring to is a 22 transfer discharge summary, which is a sheet that 23 everybody has in the facility, and it has nothing to do 24 with an actual transfer. 25 Q Okay. It -- on it it says transferred to CENTRAL FLORIDA REPORTERS, INC. 1171 1 hospital and you sign it? 2 A Absolutely. That's the part that says 3 director of nursing signs. I sign for everybody who 4 goes out of the building. 5 Q Okay. All right. All right. So you don't 6 play an active role in the transfer, but you play some 7 type of -- somewhat of a formal role to, to, to 8 facilitate the transfer? 9 A No, I would say that that's incorrect. This 10 is an interdisciplinary discharge summary which is a 11 part of every resident's record. And on the bottom it 12 has a part where director of nursing signs off and 13 that's all that I do. 14 Q Okay. Do, do you recall who it was that was 15 physically involved in, in, in making sure that she was 16 transferred to ORMC? 17 A No, because the physician wrote the order 18 specifically so that wouldn't be my call. The physician 19 wrote the order to transfer her to ORMC. 20 Q Okay. All right. Let me show you this 21 document, and I'll let your counsel see it first. 22 All right. Let me move on now to the, the 23 issue of -- stepping away from disimpaction for a second 24 and just talking about rectal bleeding. The only remote 25 evidence, would you agree with me, of possible rectal CENTRAL FLORIDA REPORTERS, INC. 1172 1 bleeding that you saw or that you learned from any 2 record was a dime-size spot that was found on the bed 3 pad? 4 A Repeat your question. 5 Q Isn't it a fact that the only evidence that 6 you are aware of of rectal bleeding from Carolina 7 Destefano while at Sunbelt was the dime-sized spot that 8 you referred to earlier? 9 A There was a dime size of blood, and dime size 10 is approximate, but I have no way to know if that was 11 related to rectal bleeding. I don't know where the 12 blood came from. 13 Q Do you know of any evidence that Carolina 14 Destefano was bleeding from the rectum while at Sunbelt? 15 A I told you before that I witnessed bright red 16 blood on a pad and I did not know where the blood was 17 coming from. That's why the doctor was called in to 18 evaluate. 19 Q Okay. That doesn't answer my question, ma'am. 20 The question is do you know of any evidence of 21 rectal -- of, of -- that Carolina Destefano was bleeding 22 from her rectum while at Sunbelt? It's a yes or no 23 answer, and then you can explain your answer. 24 A No, I don't know any evidence. 25 Q Thank you. And as a matter of fact, CENTRAL FLORIDA REPORTERS, INC. 1173 1 Dr. Black, who you have testified examined Carolina 2 Destefano, found no obvious source of bleeding when he 3 examined her? Do, do you know if Dr. Black found any, 4 any obvious source of rectal bleeding? 5 A According to Dr. Black's progress note, no 6 obvious source of bleeding identified. 7 Q Okay. And Dr. Black didn't tell you at any 8 time that he found any source of bleeding, did he? 9 A Dr. Black and I had a discussion, which we 10 talked about yesterday, that it could be internal 11 hemorrhoids. 12 Q Okay. Did Dr. Black tell you that he in fact 13 found internal hemorrhoids? 14 A I don't remember if he told me he had found 15 them or not. 16 Q Now, the -- would you agree with me that when 17 Carolina Destefano left Sunbelt Nursing Home facility, 18 you did not have any clear evidence that she was 19 bleeding from her rectum? 20 A No, I didn't. 21 Q All right. Back to the ORMC records. Do 22 you -- in the ORM -- well, let me go -- let me go page 23 by page because I know that your counsel is going to 24 object if I just ask you as a whole. But looking at the 25 case management, Exhibit -- page number 16, 16, the CENTRAL FLORIDA REPORTERS, INC. 1174 1 comments portion that -- where Lillian Folley writes 2 presented with rectal bleeding, did you inform Lillian 3 Folley that -- well, strike that. Let me ask you this. 4 Could you go ahead and read from the comments 5 portion there that Lillian Folley writes? 6 A Received consult from nursing staff for 7 discharge planning. Patient is a 71-year-old white 8 female with history of end stage Alzheimer's disease per 9 nursing supervisor Sunbelt SNF. Presented with rectal 10 bleeding after patient's son was witnessed disimpacting 11 her states Rachel, RN, at Sunbelt. 12 Sunbelt is refusing to take patient back 13 states Rachel because of son's inappropriate behavior. 14 See, I don't know what that word is, note. Sunbelt has 15 trespassed son from their facility and has reported to 16 1-800-96ABUSE. 17 Q Okay. Did you tell Lillian Folley that 18 Carolina Destefano was bleeding from her rectum? 19 MR. GROWER: Previously asked and answered. 20 A No, I didn't. And, and then the way that this 21 is worded, presented with rectal bleeding, would lead 22 anybody to believe that, that she came to the ER and 23 presented there with rectal bleeding. 24 Q All right. It says presented with rectal 25 bleeding. What's the sign after that? CENTRAL FLORIDA REPORTERS, INC. 1175 1 A After. 2 Q All right. Now look at what is -- it's 3 Exhibit 28. It's a -- we haven't looked at this 4 document today yet. Ancillary services progress notes. 5 Can you start reading -- I'm just going to ask you to 6 read the first note, the 1630 note. 7 A Sure. Received consult from nursing staff for 8 D -- discharge planning. See initial -- received 9 consult from nursing staff for discharge planning. See 10 initial discharge planning assessment. Per telephone 11 call to Sunbelt SNF/Rachel, RN, nursing supervisor, 12 898-5051, patient's son was witnessed lying on top of 13 the patient who has a GCS of seven -- 14 Q What does that mean, GCS of seven? 15 A That's a Glasgow scale, and it's not something 16 that, that I'm really familiar with. I know what it is, 17 but it's more of a neurological testing. It's not 18 something that we do. 19 Q Okay. 20 A Kissing her with his mouth open in a way son 21 would not kiss his mother. Then it goes back to, 22 parenthesis, who has a GS seven, parenthesis, kissing 23 her with his mouth open, quotes, in a way son would not 24 kiss his mother, quote. Sunbelt sent patient, arrow, 25 ORMC because of rectal bleeding. Rachel, RN, and this CENTRAL FLORIDA REPORTERS, INC. 1176 1 is in quotes. 2 We sent her to ORMC as neutral ground because 3 the son doesn't want the patient at Sunbelt and Sunbelt 4 is associated with Florida Hospital. Quote, patient's 5 primary care provider is at Florida Hospital. Rachel 6 has spoken with Donna, ID number 0021, at HRS regarding 7 the situation of the son. 8 Q All right. I have a few questions with regard 9 to this passage. Number one, when Carolina Destefano 10 was transferred, did you consult Larry Destefano as to 11 where to transfer her? 12 A I'm not a physician and I don't write orders. 13 It's out of my scope of practice to write orders. 14 That's up to the physician. He made the order and that 15 would be up to him to speak to the son, not for me. 16 Q Okay. So you did not? 17 A No. 18 Q All right. Who made the decision to transfer 19 Carolina Destefano to ORMC as opposed to Florida 20 Hospital or anywhere else? 21 A As I told you yesterday, that was my 22 recommendation. 23 Q Okay. And when -- and it -- why did you make 24 that recommendation? 25 A As I told you yesterday, ORMC is not CENTRAL FLORIDA REPORTERS, INC. 1177 1 affiliated with Sunbelt, Florida Hospital is, and we 2 felt it would be neutral grounds. 3 Q Okay. And who is we? 4 A Myself, Chuck Sherer, the administrator, and 5 we talked with Dr. Black and he agreed. 6 Q Okay. Now, in this note, would you agree with 7 me that it says that Sunbelt sent the patient to ORMC 8 because of rectal bleeding? 9 A That's what the note says, yes. 10 Q Was that the reason that Sunbelt sent the 11 patient to ORMC? 12 A Sunbelt didn't send the patient to ORMC, 13 Dr. Black sent the patient to ORMC. And the patient was 14 sent there for further evaluation due to blood that was 15 found on a bed pad. 16 Q Okay. All right. Now, of course, Dr. Black 17 sound -- signed the order, just like you signed the 18 order for the transfer? 19 A I did not sign an order for a transfer. 20 Q Just like you signed the transfer sheet? 21 A I signed an interdisciplinary discharge 22 summary form. 23 Q Okay. All right. But as far as why she was 24 being transferred to ORMC, what did you understand to be 25 the reason why she was being transferred? CENTRAL FLORIDA REPORTERS, INC. 1178 1 A I just told you, she was sent to ORMC because 2 there was blood on a bed pad, we didn't know where the 3 source was, for further evaluation. 4 Q All right. And did you in fact tell ORMC that 5 the patient was being sent there because of rectal 6 bleeding? 7 A I didn't transfer the patient so I wouldn't 8 have made that call. And, no, I did not tell Lillian 9 Folley that either. 10 Q Okay. It appears in this record, does it not, 11 that they gained that information from you? 12 A No. It appears in the record that it says 13 Sunbelt sent the patient to ORMC because of rectal 14 bleeding. It then says that Rachel, RN -- we sent her 15 to ORMC as neutral grounds. 16 Q All right. And do you see one, two, three, 17 four lines above that where it says per telephone 18 conference to Sunbelt SNF Rachel, RN, nursing 19 supervisor, patient's son was witnessed lying on top of 20 the patient, parenthesis, who has a GCS seven, closed 21 parenthesis, kissing her with his mouth open in a way 22 son would not kiss his mother, and then it says Sunbelt 23 sent patient to ORMC because of rectal bleeding? 24 A Yes, I see that. 25 Q All right. Now, let's take a look at the CENTRAL FLORIDA REPORTERS, INC. 1179 1 triage care record, which is page six of the ORMC 2 records. Could you read for me in the -- towards the 3 upper left-hand corner assessment -- 4 A By Kelly Pipkin? 5 Q Correct. 6 A Is that who you're referring to? 7 Q Yes, ma'am. 8 A Nursing home staff reports bright red blood on 9 pad -- excuse me. There's a parenthesis in there. I 10 think it's supposed to be a parentheses before bright. 11 At rectum. I believe that's what that says. Abdomen 12 non-soft. 13 MR. TOWNSEND: That's a quote, not a 14 parenthesis. 15 THE WITNESS: Oh, I'm sorry. A quote. 16 BY MR. GLICK: 17 Q All right. Do you know -- did you in fact 18 report that there was bright red blood on the pad at the 19 rectum to Kelly Pipkin? 20 A As I told you before, I don't remember ever 21 speaking to Kelly Pipkin, and this note -- her 22 assessment says nursing home staff. That could be 23 anybody. 24 Q Okay. Do you know if anybody in fact from 25 Sunbelt reported bright red blood on the pad at the CENTRAL FLORIDA REPORTERS, INC. 1180 1 rectum to Kelly Pipkin? 2 A I have no idea. 3 Q Also on the -- you see where it says HPI on 4 that same page? 5 A Yes. 6 Q And the first line says rectal bleeding per 7 nursing home? 8 A Yes. I'm sorry. 9 Q Where it says cc -- 10 A Yeah. Above -- yes. 11 Q All right. Did you in fact provide that 12 information? 13 A As I told you before, no, I did not. 14 Q Okay. Do you know who provided that 15 information? 16 A No, I do not. 17 Q I'm not sure if we covered this or not, but 18 I'm just going to ask you again at the risk of an 19 objection. It says bright red blood per rectum a few 20 lines down from that. Do you see that? 21 A Yes. We reviewed this. 22 Q Okay. And did you in fact provide that 23 information to ORMC? 24 A As I told you before, no, I did not. 25 Q And do you know who did? CENTRAL FLORIDA REPORTERS, INC. 1181 1 A No, I do not. 2 Q All right. Would you agree with me that there 3 is notations in the Orlando Regional Medical Center 4 records and the DCFS records that we've just gone over 5 that Carolina Destefano was bleeding from her rectum? 6 A Yes, there is notation of that. 7 Q All right. And are you aware that Dr. Black 8 did not find any bleeding from her rectum? 9 A According to Dr. Black's notes, there were -- 10 his progress note stated there was no obvious source of 11 bleeding. 12 Q All right. And do you also understand that 13 Orlando Regional Medical Center found no bleeding from 14 her rectum? 15 A I haven't reviewed the record to find that. 16 Q Okay. Do you know of anyone actually that 17 found that she was bleeding from her rectum? 18 A No, I do not. 19 Q But yet these statements appear in the DCFS 20 records and the Orlando Regional Medical Center records, 21 correct, ma'am? 22 A That is correct, but when you tell somebody 23 and you're giving a report that there's bright red blood 24 on a pad that normally goes under somebody's buttocks 25 area, it's very likely somebody would assume that it's CENTRAL FLORIDA REPORTERS, INC. 1182 1 rectal bleeding. 2 Q Okay. Do you know for a fact that that's what 3 they assumed at DCFS and at ORMC? 4 A They're the ones that wrote the statement of 5 rectal bleeding. There's nothing in my nurse's notes 6 stating rectal bleeding so -- 7 Q So you don't know? 8 A I don't know. 9 Q All right. Let's switch gears a little bit, 10 and I want to talk to you about the time when you went 11 down to Larry Destefano's room -- excuse me, Carolina 12 Destefano's room. And you've told us yesterday in your 13 deposition about you discovered Mr. Destefano kissing 14 his mother intimately on the lips I believe are words 15 you used or words to that effect, correct, ma'am? 16 A Correct. 17 Q All right. Now, when you came to the room, 18 was the door -- describe for us the, the door. Was it 19 open -- I mean closed? Partially open, partially 20 closed? 21 A As I told you yesterday, the door was 22 completely closed. 23 Q Okay. All right. Now, did you knock on the 24 door? Did you knock on the door? 25 A As I told you yesterday, yes, I knocked on the CENTRAL FLORIDA REPORTERS, INC. 1183 1 door. 2 Q Did Mary Thornton knock or -- 3 A I knocked on the door. 4 Q How many times? 5 A I told you yesterday, I don't know. 6 Q Can you describe how hard you knocked on the 7 door? 8 A As I told you yesterday, I don't know. 9 Q Okay. Well, I mean, can you give us any type 10 of indication as to -- I mean, was it a tap on the door? 11 Was it a bang on the door? Was it -- can you -- can you 12 hit the table and let us know? 13 A It was three years ago. Do you know how many 14 doors I've knocked on since then? No, I don't remember. 15 Q Okay. Is there a normal way that you knock on 16 the door when you go to a resident's room? 17 MR. GROWER: Form. 18 A I don't know. It depends on the resident. If 19 I know they're hard of hearing, yeah, there is a way. I 20 would -- I would knock louder on the door. 21 Q All right. Did you announce yourselves when 22 you knocked on the door? 23 A Why would I announce myself to a closed door? 24 No. 25 Q Well, I mean, a lot of times people may knock CENTRAL FLORIDA REPORTERS, INC. 1184 1 on the door and say, Mrs. Destefano, this is Rachel 2 Bean. 3 A No. 4 Q Okay. I mean, you understand that this is 5 their home that you're coming into, correct? 6 A I'm very aware of what the setting is, yes. 7 Q All right. Mrs. Bean, I want to direct your 8 attention to the Orlando Police Department records, 9 specifically the statement of Lillian M. Folley. 10 MR. TOWNSEND: For the record, it's Folley. 11 MR. GLICK: Okay. Folley. 12 MR. GROWER: Exhibit 4 from yesterday? 13 MR. GLICK: Right, that's it. 14 BY MR. GLICK: 15 Q I'm not sure -- some of that's blocked out, 16 but in any event, you went over this yesterday, didn't 17 you, Mrs. Bean? 18 A Yes, I did. 19 Q Do you see the part where -- one, two, three, 20 four -- the end of the fifth line it says Rachel? 21 A Yes. 22 Q And it says Rachel, RN, nursing supervising. 23 Rachel confirmed the above and added that the patient's 24 son displayed inappropriate behavior when visiting his 25 mother at Sunbelt, including kissing his mother on the CENTRAL FLORIDA REPORTERS, INC. 1185 1 lips in a way you don't kiss your mother, lying fully on 2 top of his mother, kissing her on the lips with his 3 mouth open, and disimpacting her, parenthesis, inserting 4 a finger into the rectum and digitally breaking up and 5 removing the stool, close parenthesis, yelling at the 6 nursing staff. Rachel, RN, states all the above were 7 witnessed in her facility. 8 Do you recall making the statement to Lillian 9 Folley that Larry Destefano was witnessed disimpacting 10 his mother? 11 A As I told you yesterday and I told you today, 12 I did not make that statement. 13 Q Okay. Do you have any idea why Lillian Folley 14 would have written that if you did not make that 15 statement to her? 16 A As I had told you before, that I had indicated 17 to Lillian Folley that according to the Florida Hospital 18 records, that it states in there the resident has a 19 history of constipation and that the son has to 20 disimpact the resident. 21 Q That would be -- is that your explanation as 22 to why Lillian Folley wrote that you told her that, that 23 it was witnessed in the facility that Larry Destefano 24 was disimpacting his mother? 25 A I don't know why Lillian Folley would write CENTRAL FLORIDA REPORTERS, INC. 1186 1 that. Some of these statements in here are things that 2 were witnessed in the facility. I'm sure during our 3 conversation we discussed things that were witnessed, 4 things that I write in a chart, things that I had seen 5 myself, things that other people had seen, and she was 6 confused on the context. 7 Q Okay. Let's go back to where we were when we 8 took our break. We talked about that you knocked on the 9 door, that you couldn't describe for us how many times 10 or how hard you knocked on the door, but that at 11 that -- at some point in time after knocking you, you 12 opened the door. And did you open the door all the way 13 or did you just open it a certain amount, a foot, you 14 know, two feet or did you open it all the way? 15 A I can't remember how far I opened it. I 16 opened the door far enough to have full view of what was 17 going on in the room. 18 Q Okay. And when you say full view of what was 19 going on in the room, from the -- from the door -- did 20 you have to step into the room to actually see -- have a 21 full view of what was going on in the room or were you 22 able to see everything from the doorway? 23 A As I told you yesterday, I don't remember. 24 Q Okay. When you -- when you were in the 25 doorway or when you took one step into the room, were CENTRAL FLORIDA REPORTERS, INC. 1187 1 you able to see Carolina Destefano's head? 2 A I was able to see like a side view, yes. 3 Q Okay. Side view of her head? 4 A Of her face, yes, which would include her 5 head. 6 Q All right. Would that -- would her head not 7 have been blocked by the bathroom stem wall or the wall 8 to the bathroom? 9 A It was not blocked. I could see what was 10 going on. 11 Q Did you have to walk past that -- the wall of 12 the bathroom to see that or could you see that from the 13 doorway or before you passed the entire wall? 14 A As I told you, I don't remember if we walked 15 into the room or not. 16 Q Now, as far as Larry was concerned, I think 17 you told us yesterday that, that his back was kind of 18 angled toward you? 19 A Uh-huh. 20 Q Is that yes? 21 A Yes. 22 Q Okay. Now, from this -- from this vantage 23 point, can you tell us what part of Mrs. Destefano's 24 mouth was he kissing? And by that I mean was he kissing 25 the corner of her mouth? Was he kissing dead center on CENTRAL FLORIDA REPORTERS, INC. 1188 1 her mouth or -- 2 MR. GROWER: Or what? 3 MR. GLICK: That's the end of the question. 4 A As I told you yesterday, his lips were on her 5 lips. Exactly where, who would remember that? 6 Q Okay. It's possible he was kissing her in the 7 corner of the mouth? 8 A To the best of my recollection his lips were 9 directly on her lips, yes. 10 Q Okay. Now, when you -- do you recall how far 11 away you were from Mr. Destefano when you saw what 12 you've told us about? 13 A If I can't remember entering the room, I 14 wouldn't remember how far away I was. No. 15 Q Okay. The kiss -- you, you were not able to 16 see whether the kiss was open mouth or not? 17 A Correct. 18 Q Now, you've told us yesterday the kiss lasted 19 I believe, and you can correct me if I'm wrong, between 20 ten and 15 seconds, and during that ten or 15 seconds 21 you told us you were in a state of disbelief. 22 A I said it was approximately that amount of 23 time. 24 Q Right. 25 A I couldn't be sure. And, yes, I was very CENTRAL FLORIDA REPORTERS, INC. 1189 1 shocked. 2 Q Okay. And you didn't say anything at that 3 point in time? 4 A As I explained yesterday, that Larry saw that 5 we were standing there, came over and shut the door in 6 Mary Thornton's face. 7 Q I understand -- well, what I'm asking you is 8 while he was kissing her, you didn't say anything? 9 A As a trained medical staff professional, 10 that's not something that -- you don't try to make a 11 situation -- or make somebody upset to cause a scene. 12 So absolutely not. I wouldn't address it at that time. 13 That would have been very foolish on my part. 14 Q All right. You didn't think it was 15 appropriate to say, excuse me, or something like that? 16 A Considering that he was -- that the nurse 17 manager felt threatened by him a few minutes before, 18 absolutely not, no. 19 Q Did you -- did you get any sense of why 20 Mr. Destefano was kissing his mother in this way? 21 A It's not my job to assess why people are 22 kissing other people, whether it be appropriate or 23 inappropriate. No. 24 Q Okay. Did -- have you seen in -- you know, in 25 your lifetime experiences people kissing passionately CENTRAL FLORIDA REPORTERS, INC. 1190 1 and their heads are moving back and forth? You've seen 2 that like in the movies or whatever? 3 A I'm sure, yes. 4 Q Okay. Was Mr. Destefano animated while he was 5 kissing his mother? Was his head moving back and forth? 6 Was he -- was he -- was his body moving or was he just 7 holding a kiss still on his mother's lips? 8 A He was just holding a kiss still. 9 Q All right. So then Mr. Destefano got up, and 10 you told us that he slammed the door in Mary Thornton's 11 face. Do you remember if Mary Thornton put up her arm 12 at all to block the door? 13 A Mary was behind me. I entered the room and he 14 came around me and shut the door, and I wasn't even 15 paying any attention. 16 Q All right. I want to talk to you a little bit 17 about Mr. Sherer and his involvement in all this. 18 From -- during that day on September the 21st, do you 19 recall approximately how many conversations you had with 20 Mr. Sherer? 21 A No. 22 Q Okay. You talked to him -- I believe 23 yesterday you testified you talked to him multiple 24 times. 25 A That's correct. CENTRAL FLORIDA REPORTERS, INC. 1191 1 Q And I want -- if you can, describe for me as 2 best you can recall each time you spoke to Mr. Sherer 3 and what was said in that conversation. 4 A I can't tell you. That was three years ago. 5 We had multiple conversations about many things during 6 the course of the day. I -- 7 Q Okay. I'm -- 8 A I can't be specific. 9 Q I'm only referencing Larry Destefano. 10 A That's what I'm saying. I can't be specific 11 on what we talked about. I mean -- 12 Q Okay. 13 A -- I can't remember a conversation from three 14 years ago. 15 Q Okay. But you were talking to him -- would it 16 be fair to say that you were talking to him most of the 17 day several times about Larry Destefano and the entire 18 situation? 19 A Yes. 20 Q And one of those instances was when you told 21 him that you were going to call DCFS regarding the 22 inappropriate kiss? 23 A Yes. I told him I was going to call HRS, yes. 24 Q And he didn't object to that? 25 A No, he didn't. CENTRAL FLORIDA REPORTERS, INC. 1192 1 Q Okay. Do you remember, was Mary Thornton in 2 that meeting when, when you told that to Mr. Sherer? 3 A As I told you yesterday, I don't remember if 4 she was there or not. 5 Q Okay. Now, do you know if Mr. Sherer while, 6 while this was going on whether he was talking to 7 anybody -- any of his superiors about what was going on? 8 In other words -- 9 A Yes, he had made phone calls throughout the 10 day. 11 Q Okay. And do you know who he called? 12 A He called people at the corporate office. I'm 13 not sure who specifically. 14 Q And do you know what their response was to all 15 this? 16 A I wasn't in on the conversation. I don't 17 know. 18 Q Okay. Mr. Sherer didn't, didn't tell you? 19 A I can't remember. 20 Q Did, did -- on that day did you leave the 21 facility and go to the corporate offices to, to discuss 22 the matter? 23 A I did not go to corporate office, no. 24 Q Okay. Did Mr. Sherer go to the corporate 25 office that day to discuss the matter? CENTRAL FLORIDA REPORTERS, INC. 1193 1 A I don't know if he did or not. 2 Q At any time did you go to the corporate office 3 to discuss this matter? 4 A No, I did not. 5 Q All right. Okay. Mrs. Bean, I want to ask 6 you now about the note that was signed by Carol Boze 7 that was prepared by Larry Destefano, which we can mark 8 as Exhibit No. -- 9 COURT REPORTER: 9. 10 BY MR. GLICK: 11 Q -- to this deposition. 12 MR. GLICK: Thank you. 13 BY MR. GLICK: 14 Q Let me show that to you. Is this -- and after 15 you take a quick look at it or a long look, however you 16 prefer, can you tell me, is that the first time you've 17 ever seen that? 18 A As I stated yesterday, I can't remember if I 19 had seen it before. 20 Q Okay. Now, to the best of your recollection, 21 when was the first time that you learned that 22 Mr. Destefano had asked or persuaded, or however you 23 want to phrase it, a nurse from your facility to sign a 24 note regarding a dressing change or a note -- or a -- a 25 non-dressing change? CENTRAL FLORIDA REPORTERS, INC. 1194 1 A As I stated yesterday, I believe that he had 2 told me that in his mother's room. 3 Q All right. Is that -- you said you believe 4 and -- 5 A Uh-huh. 6 Q -- is that something that you're sure of or is 7 it possible that Mary Thornton may have mentioned it to 8 you on the way down to the room or some other way of 9 learning of that? 10 A To the best of my knowledge, I believe 11 Mr. Destefano had told me that, but I'm not 100 percent 12 sure. I mean, so many things happened in the course of 13 that day. 14 Q Okay. Now, do you recall a, a meeting -- not 15 a meeting but a con -- any conversation with Margarita 16 Walters either the night before the 21st, getting a 17 phone call from her at home or anything of that nature 18 telling you of any problems with Mr. Destefano the night 19 before? 20 A No, I do not remember that. 21 Q Do you recall any, any such conversation with 22 Carol Boze the night before? 23 A No, I do not remember that. 24 Q How about do you -- do you recall any 25 conversation with Margarita Walters that morning CENTRAL FLORIDA REPORTERS, INC. 1195 1 regarding Larry Destefano? 2 A Margarita works 3:00 to 11:00 -- 3 Q Right. 4 A -- so she wouldn't be at the facility. 5 Q Okay. I mean as far as a phone call? 6 A I do not recall, no. 7 Q And how about do, do you recall speaking to 8 Carol Boze at all that morning? 9 A Yes. I, I called her to ask her to -- about 10 the documentation, that she needed to come in and do the 11 documentation, yes. 12 Q Okay. Now, at that time when you spoke to 13 Carol Boze that morning, do you recall if Dr. Black had 14 performed his examination before Carol Boze -- before 15 you spoke with Carol Boze or after? 16 A I, I don't remember. 17 Q All right. Tell me about that first 18 conversation you had with Carol Boze on the telephone. 19 A I don't remember the conversation. I just 20 know that, that I called her and that she needed to, to 21 do the documentation. 22 Q Okay. And that was the doc -- and what, what 23 documentation was that that you asked her to document? 24 A She needed to document that there wasn't a 25 dressing on the ankle and that she applied one and that CENTRAL FLORIDA REPORTERS, INC. 1196 1 the son was aware. 2 Q On her shift? That she had done that on her 3 shift, not to document that a dressing change had been 4 done on a prior shift by somebody else? 5 A No, she -- I would never ask anybody to 6 document for somebody else. 7 Q Now, dur -- when you talked to Carol Boze at 8 that time, do you recall if Carol Boze said anything to 9 you at that time about Larry Destefano being -- lying on 10 top of his mother the night before and kissing her 11 passionately or any words of that nature? 12 A I don't remember that being the conversation 13 on the phone, no. 14 Q All right. Let's -- you have the Sunbelt 15 records out so that's good. And -- so on 9/20/99 Carol 16 Boze documented the late entry. Could you read that 17 first late entry? 18 A 7:00 to 3:00 nurse passed on to 3:00 to 11:00 19 nurse end report that dressing change to wound right 20 heel had been done as ordered. Patient's son came to 21 3:00 to 11:00 nurse and stated to her that there was no 22 dressing on patient's right heel and that patient's son 23 wanted dressing change done immediately. 24 Q Okay. Does, does that note reflect that there 25 was no -- that there in fact was no dressing on the 3:00 CENTRAL FLORIDA REPORTERS, INC. 1197 1 to 11:00 shift the night before? 2 A The, the note states patient's son came to 3 3:00 to 11:00 nurse and stated to her, quotes, that 4 there was no dressing on patient's right heel and that 5 patient's son wanted dressing change done immediately, 6 quote. 7 Q Right. But it -- does Carol Boze in that 8 note -- do you take her -- do you take that note to mean 9 that she is documenting that there was in fact no 10 dressing change on Carolina -- no dressing on Carolina 11 Destefano on the 3:00 to 11:00 shift the night before? 12 A I take the note that the patient's son stated 13 to her there was no dressing change on the patient's 14 right heel. 15 Q Okay. 16 A I can't read any more into it than what's 17 there. 18 Q Okay. Fair enough. Now, the next note, if 19 you flip the page over, that note says what? 20 A 9/20/99, late entry. 3:00 to 11:00 nurse did 21 dressing change to patient's right heel as ordered with 22 Accuzyme four-by-four and cleaned. 23 Q So very clearly she is documenting that she 24 had done the dressing change to the patient's right heel 25 as ordered? CENTRAL FLORIDA REPORTERS, INC. 1198 1 A Well, I don't know -- well, that's what it 2 says. I don't know what that exact order was but, yes. 3 Q Okay. All right. Did -- obviously Carol Boze 4 made these notes at the facility. When she got to the 5 facility, do you recall what the conversation was with 6 her? 7 A No, I do not. 8 Q Do you have a -- do you remember her -- what 9 time she came in that day? 10 A No. 11 Q Do you remember what time you called her to 12 come in? 13 A No. 14 Q I think you told us yesterday that it was 15 after the police had already left. 16 A Well, of course it would be after the police 17 left, yes. That was the priority at that time. Yes. 18 Q Okay. Deborah -- do you remember seeing 19 Deborah Jarrell at the facility that morning? 20 A I believe she was there that day. I don't 21 remember specifically seeing her that morning. 22 MR. GROWER: That morning being the 21st or 23 the 20th? 24 MR. GLICK: The 20th -- excuse me, I'm sorry. 25 The morning of the 21st? CENTRAL FLORIDA REPORTERS, INC. 1199 1 A Well, she documented in the record on the 21st 2 so she would be there. I don't remember if she was 3 there or not, but according to the documentation 4 she -- yes, she was there. 5 Q All right. Do you know what caused Deborah 6 Jarrell to make the next note, the 9/20/99 late entry? 7 It seems to say dressing change done to right heel per 8 order. Cleansed and Accuzyme applied with two-by-two 9 and cleaned. 10 A Well, according to the note that on 9/20 she 11 also did a dressing change. 12 Q Okay. Did, did you direct Deborah Jarrell to 13 make that note? 14 A If Deborah Jarrell had indeed done the 15 dressing change then, yes, I would have told her she 16 needed to put a late entry and to state that. Did I 17 direct her to write this note? No. 18 Q Okay. Did you direct her to make a note? 19 A If indeed she had done a dressing change, then 20 I would have directed her, yes, to write a late entry 21 note. 22 Q Do you remember a specific conversation with 23 Deborah Jarrell in regard to that? 24 A No. 25 Q Do you remember a specific conversation with CENTRAL FLORIDA REPORTERS, INC. 1200 1 Carol Boze with regard to the two 9/20/99 late entries 2 that we just talked about? 3 A As I told you before, no, I don't remember the 4 exact conversation. 5 Q But you were talking to her on the phone and 6 telling her to, to document this? 7 A I didn't tell her what to document. 8 Q Uh-huh. 9 A People need to document whatever they've done 10 or whatever they've seen. I mean, that's clearly 11 subjective. I did not tell her what to write. 12 Q Okay. What, what did you -- what did you tell 13 her then? 14 A I told her that if, if she -- whatever had 15 happened the evening before, she needed to write a 16 nurse's note -- 17 Q Okay. 18 A -- as a late entry. 19 Q All right. Then we see Mary Thornton's note. 20 And then -- now we go -- you see at the end of Mary 21 Thornton's note there is another 9/20/99 -- actually two 22 more late entries on that page. Do you see those? 23 A Yes, I do. 24 Q Okay. Could you read the first one to me? 25 A 9/20/99, late entry. Nurse went into CENTRAL FLORIDA REPORTERS, INC. 1201 1 patient's room to deliver meal to patient and found 2 patient's son lying on top of patient and kissing her 3 repeatedly on patient's mouth. Patient's son stopped 4 kissing her when he saw nurse entering the room. 5 Q Okay. Do you recall Carol Boze telling you 6 about this incident that she documented here? 7 A I remember her telling me that this incident 8 happened. And I told her then if it indeed happened, 9 then she needed to also make a late entry and document 10 it in the record. 11 Q Okay. And did you in fact dictate this, this 12 note and tell her exactly what to write? 13 MR. GROWER: Form, previously asked and 14 answered. 15 A Absolutely not. 16 Q Okay. Do you know why Carol Boze would say 17 that, that you did dictate it to her and tell her what 18 to write? 19 A I have no idea why she would say that. 20 Q How would you describe Carol Boze's competence 21 as a nurse? 22 A We had issues with Carol Boze as far as 23 attendance. She called out of work a lot. She was put 24 on a -- from what I remember, she was put on a 30-day 25 probationary period where she could not call out of CENTRAL FLORIDA REPORTERS, INC. 1202 1 work. I've seen a lot of nurses, worked in a lot of 2 places, and I wouldn't find her to be the most competent 3 nurse that I've worked with. 4 Q Okay. How about Margarita Walter's 5 competence? How would you describe Margarita Walter's 6 competent as a nurse? 7 A Margarita functioned in the role of a 8 supervisor. As far as her skills, I wouldn't know. 9 Q Okay. How about as a supervisory -- in her 10 supervisory position? What type of job did she do? 11 A Margarita would complain a lot about things 12 that were happening in the building, but she didn't take 13 it upon herself as being the supervisor to correct -- to 14 correct the problems. 15 Q Okay. What was your reaction when Carol Boze 16 told you that she went into the patient's room to 17 deliver a meal to the patient and found the patient's 18 son lying on top of the patient and kissing her 19 repeatedly on the patient's mouth? 20 A I was once again shocked and said that if this 21 indeed had happened, then she needed to document that. 22 Q Did -- do you remember if you told her at that 23 time what you had -- you and Mary Thornton had 24 witnessed? 25 A I'm not sure. CENTRAL FLORIDA REPORTERS, INC. 1203 1 Q Okay. Do you remember if you ever did tell 2 her what -- 3 A I'm not sure. I don't remember. 4 Q All right. Now, at -- would you please read 5 the next note, 9/20/99 late entry? 6 A Sure. 9/20/99 late entry. This nurse was 7 approached by son of resident wanting nurse to sign a 8 paper of his stating dressing change not done. This 9 nurse refused to sign paper. Mr. Destefano at that time 10 put paper in nurse's face and stated that he was not 11 leaving until she signed his paper. Nurse went to 12 evening supervisor and explained situation to her. 13 Evening supervisor gave this nurse approval to sign 14 paper. 15 Q Okay. Do you recall Carol Boze telling you of 16 that situation? 17 A Yes, we had a conversation about that. I 18 don't remember the exact wording, but I know we had a 19 conversation about that. 20 Q Was that at the same time as the conversation 21 about the incident where she saw Mr. Destefano allegedly 22 lying on top of his mother and kissing her? 23 A I don't remember. 24 Q What was your response when Carol Boze told 25 you about the note incident? CENTRAL FLORIDA REPORTERS, INC. 1204 1 A That I told her if this indeed had happened, 2 then she needed to document that also as a late entry. 3 Q All right. Do you know if -- strike that. 4 Did you in fact dictate this second -- well, 5 actually the -- it's the fourth 9/20/99 late entry that 6 Carol Boze wrote, the one -- the one at the bottom of 7 the page there. It says this nurse was approached by 8 son of the resident. Did you in fact dictate that note 9 word for word to Carol Boze and tell her what to write? 10 A Absolutely not. 11 Q Did Carol Boze ever tell you which of these 12 two incidents occurred first, the, the incident with the 13 signing of the paper or the incident where she witnessed 14 the -- Mr. Destefano lying on top of his mother and 15 kissing her? 16 A I don't remember. 17 Q Do you recall if you were present when Carol 18 Boze made any of her late entries? I mean, physically 19 there watching her write any of the late entries? 20 A I don't believe that I was, no. 21 Q Do you recall if -- when you called Carol Boze 22 on the telephone if you asked her any questions about 23 the note? 24 A Like I told you before, I don't remember the 25 conversation. CENTRAL FLORIDA REPORTERS, INC. 1205 1 MR. GROWER: The note being Exhibit -- 2 MR. GLICK: Exhibit 9. 3 BY MR. GLICK: 4 Q Now, do you recall a conversation where Carol 5 Boze told you -- and assuming this in fact -- strike 6 that. Let me ask it another way. 7 Do, do you remember there being a conversation 8 where Carol Boze told you that Margarita Walters told 9 her not to document what she saw, meaning the incident 10 with Larry Destefano lying on top of his mother, and 11 that she would take care of it, meaning Margarita 12 Walters? 13 A I don't remember that conversation. 14 Q Now, let me show you one more note here that 15 is, is Exhibit 1 to a prior deposition dated 9/22/99. 16 MR. GLICK: We can mark it as Exhibit 10 to 17 this deposition. 18 BY MR. GLICK: 19 Q Okay. Have you ever seen that particular note 20 before? 21 A I'm not sure. 22 Q Okay. Can you check your records to see if 23 that note is contained within your records? 24 A This may be a statement for HRS because 25 everybody was asked to provide statements regarding what CENTRAL FLORIDA REPORTERS, INC. 1206 1 they had seen. 2 Q Okay. Do you see that note in your records? 3 A It wouldn't be in the record because the 4 record would be a closed record. At that time the 5 patient was no longer in the building. 6 Q Okay. 7 MR. GROWER: What's the date on that record? 8 THE WITNESS: 9/22/99. 9 MR. GROWER: All right. That's Exhibit 10? 10 MR. GLICK: Yes. 11 BY MR. GLICK: 12 Q All right. Did -- now, correct me if I'm 13 wrong. Did you just say that -- it's your understanding 14 that this note was, was written for, for the purpose of 15 the HRS investigation? 16 A I would believe that that's what it's for, 17 yes. 18 Q Okay. Do you know of any other reason 19 Mrs. Boze -- or Ms. Boze would have written what is 20 largely, largely the same as what she already wrote in 21 the record? 22 A No. 23 Q Did you direct her to write this 9/22/99 note? 24 A She may have been asked to provide 25 documentation for HRS. CENTRAL FLORIDA REPORTERS, INC. 1207 1 Q Okay. Did you in fact dictate this -- these 2 9/22/99 notes to Carol Boze word for word? 3 A Absolutely not. 4 Q If you told her anything, it was just to go 5 ahead and fill out another statement similar to what she 6 had already written? 7 A I had many staff members come to me with -- 8 saying that they had seen things. And basically, like I 9 said yesterday, I told the staff members if indeed this 10 had happened, then you need to document it. Otherwise I 11 don't want to hear about it. 12 Q Okay. You're talking about seeing things. 13 You're not talking about only Mr. Destefano's matter. 14 You're talking about just everything -- 15 A No. 16 Q -- that went on at the facility? 17 A No. To do with Mr. Destefano. 18 Q Oh. You had other people come and tell you 19 that they had seen things regarding Mr. Destefano? 20 A Nurse's aides, yes. 21 Q Okay. All right. Let's, let's talk about 22 that. Tell me, first of all, what it is that you had -- 23 what are these other things that you're talking about 24 that nurse's aides or other personnel at Sunbelt had 25 come to you and told you about Mr. Destefano? CENTRAL FLORIDA REPORTERS, INC. 1208 1 A I can't remember exactly what the things were, 2 but basically it was inappropriate behavior. And what I 3 told the staff, that if you're not willing to put it on 4 a piece of paper and document it, then I don't want to 5 hear it because the nursing home can become a real 6 Peyton Place where people can gossip and things can get 7 blown up and made into a big story. And if somebody 8 wasn't willing to put it on a piece of paper, then to me 9 it didn't happen. 10 Q Okay. Now, do you recall the names, first of 11 all, of any of those nurses that told you of 12 inappropriate behavior? 13 A They were nurse's aids and, no. 14 Q Do you recall any of the dates that any of 15 these people came to you and told you of inappropriate 16 behavior? 17 A It was on the same day. 18 Q 9/21/99? 19 A Correct. 20 Q And do you recall approximately how many 21 nurses came to you or other personnel? 22 A It may have been two aides. I can't remember 23 exactly. 24 Q Do you -- can you give me any more details 25 other than they said there was inappropriate behavior? CENTRAL FLORIDA REPORTERS, INC. 1209 1 A I can't remember what they had said. Like I 2 said, if they weren't willing to put it on a piece of 3 paper, then to me it's just -- it's just hearsay. If 4 somebody is not willing to back it up with their 5 signature, then it doesn't carry a lot of weight. 6 Q Did these statements by the nurses contribute 7 at all to you calling HRS? 8 A No. I had already called HRS. 9 Q Did these statements at all contribute to any 10 comments you may have made to Orlando Regional Medical 11 Center? 12 A Comments being as what? 13 Q Anything that you told them. In other words, 14 when you -- if you mentioned inappropriate kissing or if 15 you mentioned that there was blood on the pad or 16 anything of that nature, any, any, any of the problems 17 with Mr. Destefano or Carolina Destefano that you talked 18 to ORMC about, we -- did you take into consideration any 19 of these statements made by these unnamed nurses? 20 A Absolutely not. 21 Q Okay. Now, do you remember if the -- if the 22 behavior that these possibly two aides or whoever they 23 were that they told you about, do you remember where in 24 the facility they told you about them? 25 A We were in my office. CENTRAL FLORIDA REPORTERS, INC. 1210 1 Q And do you remember, did they -- did two -- 2 were they all there together, these two aids or more? 3 A I don't remember. I don't remember. 4 Q And the inappropriate behavior, did they give 5 you any more details, such as was it of a sexual nature 6 or a physically abusive nature or unruliness or, or 7 what? 8 A There was never any talk of any kind of sexual 9 behavior. 10 Q Okay. How about -- how about physical abuse 11 of, of Mrs. Destefano? 12 A I don't believe so. 13 Q It was more that he was being -- 14 A I believe it was more along the lines of the 15 kissing. 16 Q Okay. Do, do you remember any of the details 17 of the kissing? 18 A No. Like I said, I told them if they weren't 19 willing to put it on a piece of paper, then basically I 20 didn't want to hear it. 21 Q Okay. Was -- now, when, when Carol 22 Boze -- the two -- the unnamed nurses that we're talking 23 about, the nurse's aides, you did not instruct them to, 24 to document what they saw? 25 A Absolutely not. I told them if they saw CENTRAL FLORIDA REPORTERS, INC. 1211 1 something and that they wanted somebody to believe that 2 or whatever -- I mean, anybody can say, oh, I saw this, 3 I saw that. But if you're not willing to put it on a 4 piece of paper and sign your name, then it didn't 5 happen. 6 Q Okay. All right. How, how is it that you 7 know that this -- that this document, Exhibit No. 10, 8 was prepared for HRS purposes? 9 A I remember that after the incident anybody who 10 saw something needed to document that so it could go to 11 HRS. 12 Q All right. Did you ever have a discussion 13 with Margarita Walters about her alleged approval -- her 14 allegedly giving Carol Boze approval to sign that note 15 which is labeled Exhibit 9? 16 A I don't remember. 17 Q Okay. Do -- would that have been the 18 appropriate thing for Margarita Walters to do, to give 19 Carol Boze approval to do that? 20 A No. 21 Q Would, would it have been appropriate for 22 Carol Boze to ask Margarita Walters if she could go 23 ahead and sign that note? 24 A Yes. 25 Q Okay. Now, the, the -- do you know why CENTRAL FLORIDA REPORTERS, INC. 1212 1 the -- what Carol Boze had put in the records was not 2 enough for HRS? Why did they need this second note 3 dated 9/22/99? 4 A That's the same thing with my nurses' note. 5 It wasn't enough. They needed me to write an addendum 6 on the bottom that that was my statement. They wanted a 7 specific statement. 8 Q As you wrote -- you put that attestation 9 clause at the bottom? 10 A Yes. 11 Q Okay. Now, you did not document in your note 12 what Carol Boze had told you that she had seen, correct? 13 A No. 14 Q What -- why is that? 15 A I would only document what I saw and, and what 16 happened during the course of the day that I was 17 involved in. I wouldn't document what somebody told me. 18 Q By the way, did you believe Carol Boze that 19 she had actually seen Mr. Destefano lying on top of his 20 mother kissing her? 21 A When she was willing to write it down on a 22 piece of paper and sign her name, yes. 23 Q All right. I, I don't think -- if I -- you 24 know, it's been a long two days already. I don't 25 remember if I asked you this question or not. Do you CENTRAL FLORIDA REPORTERS, INC. 1213 1 remember the specific conversation -- not the exact 2 words, but can you picture the conversation with Carol 3 Boze telling you that? 4 A No. 5 Q Okay. Now, as far as the, the transfer of 6 Carolina Destefano, when you called Larry Destefano to 7 tell him that Carolina had been transferred to ORMC, do 8 you recall him asking you why was she transferred to 9 ORMC? 10 A I don't remember the conversation. 11 Q Okay. Do -- let me ask you, do you remember 12 telling Larry Destefano that the reason that she was 13 being transferred to ORMC was to get you -- I mean Larry 14 and his mother the hell away -- the far -- as far the 15 hell away as we possibly could from us? 16 A I definitely wouldn't use that word in talking 17 to a family member or anybody else in the workplace so 18 absolutely not, no. 19 Q Okay. Now, take a look at page three of your 20 note -- your four-page note. And in there it talks 21 about -- and I've got to find it, also, but somewhere it 22 says that you wrote that he, Larry Destefano, was 23 threatening you. 24 I think it's about three-quarters of the way 25 down. It says the son proceeded to call me in the early CENTRAL FLORIDA REPORTERS, INC. 1214 1 afternoon and was threatening me, and I told him I was 2 not going to listen to this and said good-bye. 3 Do you recall what the words were of the, the 4 threats that he made? 5 A I think we discussed this yesterday and, no, I 6 don't. 7 Q Now, the next -- right after the -- right 8 after that -- or shortly after that, it says I received 9 a call from Dr. Black at approximately 1:00 p.m. in re 10 inappropriate behavior at the hospital from the son. Do 11 you see that? 12 A Yes. 13 Q Now, was this -- in this phone call -- was 14 this phone call the same conversation that you had with 15 Dr. Black regarding his examination of Carolina 16 Destefano? 17 A I don't remember if we talked about the 18 examination at that time. 19 Q Okay. You told us earlier that you had a 20 conversation with Dr. Black regarding the examination of 21 Carolina Destefano where he told you that there was a 22 possibility of internal hemorrhoids? 23 A Uh-huh. 24 Q Now, do you -- 25 MR. GROWER: I'm sorry, you have to say -- CENTRAL FLORIDA REPORTERS, INC. 1215 1 A Yes. I'm sorry. 2 Q Now, do you remember if that was the same 3 conversation as this phone call that you received from 4 Dr. Black at approximately 1:00 p.m.? 5 A You just asked me that same question and, no, 6 I don't remember. 7 Q Okay. All right. All right. So you say here 8 that Dr. Black called you at approximately 1:00 p.m. 9 regarding inappropriate behavior at the hospital from 10 the son. Is Dr. -- did you know Dr. Black before this? 11 A No. 12 Q And -- I mean, all of this is going on, and 13 then at 1:00 o'clock the phone rings and Dr. Black calls 14 and -- to tell you that Larry Destefano was misbehaving 15 at the hospital? 16 MR. GROWER: Is that -- 17 A Yes. 18 MR. GROWER: Form. 19 BY MR. GLICK: 20 Q Okay. Did you -- did you -- was that a 21 surprise to you that here is somebody that would call 22 out of the blue like that? 23 A Well, he had already come to the facility and 24 examined her. 25 Q Okay. CENTRAL FLORIDA REPORTERS, INC. 1216 1 A So he probably went back to the hospital and 2 was talking about it with other residents, and then he 3 received this information and then he called me with 4 that information. 5 Q Was Dr. Steely a resident, do you know? 6 A I, I don't know. 7 Q Did you know Dr. Steely? 8 A No. 9 Q Okay. Did Dr. Black -- strike that. 10 Now, did Dr. Black in that telephone 11 conversation tell you what the inappropriate behavior 12 was except for -- I guess -- I guess it's further 13 documented here in this note. Is that accurate? 14 A Yes. 15 Q Okay. Let me just take a look at this. Was 16 he basically relating what Dr. Steely had told him? 17 A Yes, he was. 18 Q Did -- was there anything more that Dr. Black 19 told you in that conversation other than what's stated 20 at the bottom of page three of your note that you can 21 recall? 22 A Not that I can recall because if he had told 23 me, I would have put it in the nurse's note. 24 Q Do you recall -- there was two telephone calls 25 at least made by you to HRS. Do you recall if there was CENTRAL FLORIDA REPORTERS, INC. 1217 1 any more than that? 2 A As I stated yesterday, I'm not sure. 3 Q All right. You -- in your -- on page -- is 4 that three -- or two of your -- of your note it says I 5 did look into the chart and the 3:00 to 11:00 nurse had 6 not documented in the chart. I told him there was not a 7 note for last evening, that the nurse may have been 8 under the impression that she signed his paper so a note 9 was not needed. 10 You, you recall telling that to Mr. Destefano? 11 A That's what I documented. 12 Q Okay. Thinking back -- now that there's been 13 plenty of time to reflect on that, do you think that is 14 still a valid reason as to why Carol Boze did not 15 document that there was not a dressing at -- in the 16 record at the time? 17 A In thinking back, I had a very angry, irate 18 man pounding his fist on a chart where there wasn't 19 documentation, and I was trying to diffuse the 20 situation. 21 Q Okay. Do you know now why Carol Boze didn't 22 document that? 23 A No. 24 Q To the best of your recollection, can you 25 describe as best you can in whatever words you want to CENTRAL FLORIDA REPORTERS, INC. 1218 1 use how Mr. Destefano was pounding on the chart? 2 A He had his fist and he was banging on the 3 chart. 4 Q All right. Was he yelling at this time? 5 A Yes, he was. 6 Q Was it -- where was this at? 7 A This was at the nurse's station. 8 Q And who else was at the nurse's station at 9 that time, if you recall? 10 A As I said yesterday, I don't remember who was 11 there. 12 Q Okay. Did anybody come over to, to see what 13 was going on? 14 A People did. Residents came out of their 15 rooms. Staff members came out, and there was a -- Val 16 Tomlin was there. 17 Q Now, during this time period 9/21/99 and the 18 few days or weeks afterwards, was there any conversation 19 about Mr. Destefano around the nursing home? 20 A I'm sure there was. 21 Q Okay. Do you recall what any of the 22 conversation was? 23 A No. 24 Q Do you recall if anybody had told you during 25 the next few weeks whether or not Mr. Destefano had CENTRAL FLORIDA REPORTERS, INC. 1219 1 committed any other -- or any sexual acts upon his 2 mother? 3 A There was never any talk of any type of sexual 4 act at any time. 5 Q Okay. Now, at any time after this was there 6 an investigation done other than by DCFS? In other 7 words, did Sunbelt or Florida Hospital or the Adventist 8 group, did they do their own investigation to try to 9 find out exactly what happened with regard to Larry 10 Destefano and his mother? 11 A I don't believe so. 12 Q Okay. We don't have too much more, Mrs. Bean. 13 Let me ask you, the -- we talked yesterday 14 about you resigning from Sunbelt, and this was in the 15 midst or shortly thereafter there was a -- allegations 16 of missing drugs. Do you recall that? 17 A Yes. 18 Q Were you -- have you ever been rehired by 19 Florida Hospital? 20 A No. I didn't work for Florida Hospital. 21 Q Okay. Have you ever been rehired by the 22 Adventist group? 23 A No. 24 Q The -- you, you said you worked at Winter 25 Park? CENTRAL FLORIDA REPORTERS, INC. 1220 1 A I didn't work at -- I worked in the Winter 2 Park building, but Vitas leased the space in the Winter 3 Park building. 4 Q Okay. That's not a Florida -- connected to 5 Florida Hospital -- 6 A Uh-uh. 7 Q -- or anything like that? Okay. How would 8 you describe your demeanor at -- when you worked at 9 Sunbelt as far as on a daily -- day-to-day basis? 10 A Professional. 11 Q All right. Did you lose your temper a lot 12 when you were there? 13 A No. 14 Q All right. Did you tend to blow things out of 15 proportion? 16 A No. 17 Q Do -- I think you were asked this yesterday, 18 but as far as your con -- any of your conversations with 19 Carol Boze on 9/21/99, do you recall yelling and 20 screaming at her at all? 21 A As I stated yesterday, no, I did not yell or 22 scream at her. 23 Q As far as any type of inappropriate conduct by 24 anybody in that facility, if a nurse witnessed that -- 25 and, and it is with regard to a patient, optimally CENTRAL FLORIDA REPORTERS, INC. 1221 1 should she document that immediately? 2 A As I discussed yesterday, it depends on the 3 situation, what the situation is and what the priority 4 is. 5 Q Okay. Did -- what Carol Boze witnessed, is 6 that something she should have documented immediately? 7 A She should have documented it during her 8 shift, yes. 9 Q Would there have been anything inappropriate 10 of you informing the police at the time of the trespass 11 warning about what you saw with regard to Larry 12 Destefano kissing his mother? Would there be anything 13 wrong with that? 14 A No. 15 Q Is that the kind of thing that you're only 16 allowed to tell DCFS but not the police to the best of 17 your knowledge? 18 A Not that I'm aware of, no. 19 Q Last question Ms. Bean. Have you ever lied 20 before? 21 A I'm sure I've told white lies, yes. 22 - - - - - 23 CROSS EXAMINATION 24 BY MR. GROWER: 25 Q Mrs. Bean, the morning -- or this morning, CENTRAL FLORIDA REPORTERS, INC. 1222 1 excuse me, counsel for the Plaintiff suggested through a 2 line of questions that either you or someone at Florida 3 Hospital or presumably someone who was conspiring with 4 Florida Hospital at, at Orlando Regional Medical Center 5 placed Mrs. Destefano's blood on the pad in an attempt 6 to do something illegal or improper. 7 Now, I'd like you to assume for the moment 8 that the spot that you saw on the pad earlier this 9 morning has been demonstrated by the Plaintiff's own 10 experts to be blood. And I'd like for you to further 11 assume that that blood has been further demonstrated by 12 99 point percent of something certainty to be 13 Mrs. Destefano's blood. All right? 14 Now, with those two assumptions in mind, let 15 me ask you, was there any vial or bag or bowl or any 16 container at anywhere in the facility at any time 17 containing Mrs. Destefano's blood? 18 A Not that I'm aware of, no. 19 Q Was there any -- did you ever have any 20 occasion to withdraw or take blood from Mrs. Destefano? 21 A No, I did not. 22 Q Do you ever take blood from any patient? 23 A I have -- I have drawn blood in the past, but 24 at Sunbelt I never drew blood from anybody. 25 Q How was blood drawn at the Sunbelt facility CENTRAL FLORIDA REPORTERS, INC. 1223 1 while you were there? Who, who actually did that? 2 A To the best of my knowledge, Florida Hospital 3 came in and drew all our -- all of our blood. 4 Q You mean people would come over from 5 pathology? 6 A From the lab, yes. 7 Q Okay. What are they called? What are those 8 people called? There's a name for that. 9 A A phlebotomist. 10 Q All right. And were there any orders in the 11 chart for a phlebotomist to come draw blood from 12 Mrs. Destefano on the 21st? 13 A No, not that I'm aware of. 14 Q Was there a transfusion bag standing by of 15 blood that Ms. Destefano had perhaps contributed herself 16 anywhere in the facility? 17 A We do not do blood transfusions at the 18 facility. 19 Q Did you at any time place any blood on that 20 pad from Mrs. Destefano for any reason? 21 A Absolutely not. 22 Q Do you have any knowledge that anyone at 23 Florida Hospital did that? 24 A Absolutely not. 25 Q Did you ever ask anyone at Orlando Regional CENTRAL FLORIDA REPORTERS, INC. 1224 1 Medical Center to do that? 2 A Absolutely not. 3 Q Do you have any knowledge that anyone at 4 Orlando Regional Medical Center did that? 5 A No. 6 (Whereupon the videotaped deposition was 7 concluded, after which the following proceedings 8 were had.) 9 THE COURT: Is that the conclusion? Stand up 10 and stretch. 11 MR. OSBORNE: Judge, can we have a five-minute 12 comfort break in between? 13 THE COURT: Yes, we'll take five minutes. 14 (Whereupon, there was had a recess from 4:30 15 o'clock p.m., to reconvene at 4:35 o'clock p.m., in 16 the presence of the Jury.) 17 * * * * * 18 Continued to Volume X 19 20 21 22 23 24 25 CENTRAL FLORIDA REPORTERS, INC. 1225 1 C E R T I F I C A T E 2 STATE OF FLORIDA) 3 COUNTY OF ORANGE) 4 I, SHARON L. TRAMONTE, R.M.R., certify that I was 5 authorized to and did stenographically report the 6 foregoing proceedings and that the transcript is a true 7 and accurate record. 8 Dated this 23rd day of May, 2006. 9 10 11 ___________________________________ 12 SHARON L. TRAMONTE, R.M.R. 13 14 15 16 17 18 19 20 21 22 23 24 25 CENTRAL FLORIDA REPORTERS, INC.