1 1 IN THE CIRCUIT COURT OF THE NINTH JUDICIAL CIRCUIT IN AND 2 FOR ORANGE COUNTY, FLORIDA 3 LAWRENCE M. DESTEFANO, 4 Plaintiffs, CASE NO: CI-00-7265 5 VS. 6 ADVENTIST HEALTH SYSTEM 7 SUNBELT HEALTHCARE CORPORATION, et al, 8 Defendants. 9 ------------------------------------------------------------ 10 The videotaped deposition of SHERRY FUCHS taken 11 pursuant to notice on behalf of the Defendant on Monday 12 October 3, 2005, beginning at 8:30 a.m., at 301 E. Pine 13 Street, Suite 1400, Orlando, Florida, before Rita G. Meyer, 14 RDR, CRR, CBC and Notary Public, State of Florida at Large. 15 16 A P P E A R A N C E S: 17 WILLIAM OSBORNE, ESQUIRE 18 538 E. Washington Street Orlando, Florida 32801 19 For the Plaintiff 20 DYANA L. PETRO, ESQUIRE 21 Gray Robinson, P.A. 301 E. Pine Street, Suite 1400 22 Orlando, FL 32802 23 For the Defendant Adventist Health System 24 25 CENTRAL FLORIDA REPORTERS, INC. 2 1 APPEARANCES, CON'T 2 DAVID EVANS, ESQUIRE 3 Mateer & Harbert P.O. Box 2854 4 Orlando, FL 32802 5 For the Defendant Orlando Regional Healthcare 6 ALSO PRESENT: Lawrence M. Destefano 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CENTRAL FLORIDA REPORTERS, INC. 3 1 I N D E X 2 DIRECT CROSS REDIRECT 3 Shelly Fuchs ................. 4 19 4 Shelly Fuchs ....................... 50 51 5 Certificate of Oath ................ 54 6 Certificate of Reporter ............ 55 7 8 E X H I B I T S 9 Defendant's Composite 1 ............. 9 10 Plaintiff's Exhibit 1 ............. 32 Plaintiff's Exhibit 2 ............. 37 11 Plaintiff's Exhibit 3 ............. 43 12 13 14 - - - - - 15 S T I P U L A T I O N S 16 It is hereby stipulated and agreed between counsel for 17 the respective parties and the witness that the reading and 18 signing of the deposition be waived. 19 20 21 22 23 24 25 CENTRAL FLORIDA REPORTERS, INC. 4 1 THE VIDEOGRAPHER: The date is October 3rd, 2005. 2 This is the deposition of Shelly Fuchs being taken in 3 the matter Destafano versus Adventist Health Systems, 4 et al. Time is now 8:31 a.m. 5 Counsel, please identify yourselves for the 6 Record. 7 MR. OSBORNE: William Osborne for the Plaintiff. 8 MS. PETRO: Dyana Petro for the Defendant 9 Adventist Health System, Sunbelt Healthcare, Rollins 10 Bedford and SHCC Services. 11 MR. EVANS: David Evans for Orlando Regional 12 Healthcare System. 13 THE VIDEOGRAPHER: And will the court reporter 14 please swear in the witness. 15 SHELLY FUCHS, 16 who was by me first duly sworn, was examined and testified 17 as follows: 18 DIRECT EXAMINATION 19 BY MS. PETRO: 20 Q. Good morning. Could you please state your name 21 for the Record? 22 A. Yes. Shelly Fuchs. 23 Q. Miss Fuchs, we understand you've been called to 24 active duty with the Florida National Guard for the next 25 several months. For the Record, can you please just CENTRAL FLORIDA REPORTERS, INC. 5 1 describe the terms of your deployment and the reason you're 2 unable to appear in person at trial? 3 A. Yes. I'm getting ready to assist with the 4 preparation of my battalion and companies to deploy to 5 Kuwait. I'll be up in Jacksonville area for approximately 6 eight months. Then head to Motes (ph) station for 7 approximately three months and then head to either Kuwait or 8 Iraq for the year. 9 Q. Thank you. 10 A. At least. At a minimum. 11 Q. And Miss Fuchs, what is your occupation when you 12 are not with the National Guard? 13 A. I'm a physical therapist assistant. 14 Q. And are you required to have a license as a 15 physical therapist assistant? 16 A. Yes, I am. 17 Q. What other training do you have for that field? 18 A. Well, we have, besides the graduation from a 19 physical, approved physical therapy assistance course, I 20 also have continuing education classes that I have to do 21 every so often to keep my license current. 22 Q. And is your license current at this time? 23 A. Yes, it is. 24 Q. Can you please briefly describe your work history 25 for the jury? CENTRAL FLORIDA REPORTERS, INC. 6 1 A. Yes. Since graduation from PTA school, I worked 2 at the -- well, initially, I started out as a physical 3 therapy technician while I was going through school. And 4 then I continued on, once I graduated, to -- worked in 5 County Hospital in the outpatient burn unit out in Arizona 6 for about a year. 7 Then I moved to Florida. I worked in an assisted 8 living facility. And then I moved on with Nova Care, where 9 I started employment at Sunbelt. Then once Nova Care 10 changed out, Sunbelt kept me on as restorative coordinator. 11 And then from there, I went to Avante of Mount 12 Dora. I had a brief break there, going to the military, 13 back with the military for a little bit. And then I started 14 back with up with Avante Mount Dora, where I've been since. 15 Q. And that is where you are currently employed? 16 A. Yes. 17 Q. And have you served in any branch of the Armed 18 Services? 19 A. Yes. I've served in both active duty Air Force, 20 and the Army National Guard both in Arizona and in Florida. 21 Q. And what do you do in the National Guard? 22 A. Um, my first 23, 24 years, I was military bomb 23 squad. And the last two years I've just been command 24 sergeant major. I'm a senior, senior management of enlisted 25 soldiers. CENTRAL FLORIDA REPORTERS, INC. 7 1 Q. Let's go back to when you were an employee of 2 Sunbelt Healthcare and subacute center. Do you remember 3 what year you began your employment there through Nova Care? 4 A. I want to say it was, I could be off, but I want 5 to say it was 1997 to '99 with Nova Care and then '99 to 6 2001 with Sunbelt, if I remember right. I could be off. I 7 don't remember the exact dates. 8 Q. And what was your position when you were an 9 actual Sunbelt employee? 10 A. Restorative coordinator. 11 Q. And can you please generally describe your duties 12 as a restorative coordinator? 13 A. Right. Um, I managed a restorative team who did 14 -- typically, when a patient comes off skilled therapy, 15 okay, they are no longer skilled, on skilled therapy, we 16 want to make sure that they keep their, their highest 17 functional level possible. And what we tend to do is we 18 continue with some type of an exercise programs or feeding 19 programs or whatever. That's my staff managing that. Keeps 20 the people functional. And I also was part of different 21 teams in the facility, such as the restraint team, the fall 22 team, the wound care team; that type of aspect. 23 Q. You've mentioned the wound care team. As the 24 restorative coordinator, did you personal assess the status 25 of patients' wounds? CENTRAL FLORIDA REPORTERS, INC. 8 1 A. With, with a team, yes. 2 Q. And when you say a team, who are you referring to 3 in addition to yourself? 4 A. Typically, the team, it could consist of a 5 multitude of different people at any different time, but the 6 team consists of a nutritionist, a nurse, a PTOT. You could 7 have the doctor in there. It just depends on when you're 8 doing our rounds who's there. But almost always it will be, 9 um, well, me, it will be usually the nurse manager, and 10 sometimes other members of the rehab team will be there. 11 Q. Okay. And what did your wound assessment consist 12 of? What did you do? 13 A. We would typically go in, do a chart audit 14 initially to find out the basis of, of the patients. 15 Anything that might assist with the assessment, itself. 16 Then we would go actually observe the skin integrity of the 17 patient; look at the wound, itself. I would do, like, a 18 trace of the wound where I put, like, plastic over plastic 19 and do an outline so I could have a visual representation. 20 There's a checklist that we filled out. And then there's a, 21 another form that we would typically fill out that kind of 22 consolidates it all together. 23 Q. And based on that assessment, would you then make 24 recommendations for treatment? 25 A. Yes. CENTRAL FLORIDA REPORTERS, INC. 9 1 Q. And during this process, did you take notes? 2 A. Yes. 3 Q. Miss Fuchs, I'd like to show you what has been 4 previously marked for identification as Defendant's 5 Composite Exhibit Number 1. It's actually in front of you. 6 Do you recognize this document? 7 (Received and so Marked) 8 A. Yes. This appears to be the form that we used 9 and I filled out back in September 21st, 1999. 10 Q. And that was during the time period you were 11 employed by Sunbelt? 12 A. Yes, it is. 13 Q. This document consists of several pages of notes. 14 Did you make these notes while you were in the room with the 15 patient? 16 A. Well, not all of them while I'm in the room. 17 The, for example, like the trace, like I said, I use clear 18 plastic to trace over it. And what I do is I, the, the two 19 layers, the second, the top layer doesn't have contact with 20 skin, so I put that on a copier and I make a regular sheet 21 and then I'll trace over it on to the actual form. 22 The checklist page, most of it I do in the room at 23 the time, but not all of it because I need some of the 24 information off of the, the trace when I'm doing it. 25 And then the notes page, the additional wound care CENTRAL FLORIDA REPORTERS, INC. 10 1 progress notes page, part of that's done when I'm doing the 2 chart audit. And then the rest of it's like a finalized, 3 usually it's, it will be within, it will be usually within a 4 couple hours of when I was with the patient. 5 Q. So for the notes that you don't make when you're 6 actually in the room, do you make those notes while your 7 assessment is still fresh in your mind? 8 A. Oh, absolutely. I always do documentation on the 9 same day. 10 Q. And was the creation of the medical notes that 11 have been shown to you in Composite Exhibit 1, part of your 12 routine business practice while you were the restorative 13 coordinator at Sunbelt? 14 A. Yes. 15 Q. And is the documentation or the writing on these 16 pages, is that your handwriting? 17 A. Yes, it is. 18 Q. And on the bottom of page two, is that your 19 signature? 20 A. Yes, it is. 21 Q. Is that also your signature on the bottom of page 22 four? 23 A. Yes, it is. 24 Q. And is that also your signature on the bottom of 25 page five? CENTRAL FLORIDA REPORTERS, INC. 11 1 A. Yes, it is. 2 Q. Can you tell me generally what this document that 3 I've shown you consists of? 4 A. What it consists of? 5 Q. Yes, ma'am. 6 A. Um, the first page is a, basically a visual 7 description of what the wound looks like and tells you where 8 it's located on the body. 9 The second page describes the wound on the first 10 page in more detail. And it also has a recommendation for 11 the dressing and treatment. And the fifth page in here, 12 which is the additional wound care progress note, that's a 13 consolidation of what I saw on the chart, plus anything else 14 I observed while we're doing the assessment. And any 15 additional information that I felt was pertinent. 16 Q. Can you read for us the name of the patient 17 that's at the top of this assessment? 18 A. Yes. It's Caroline Destefano. 19 Q. And do you recall doing this particular 20 assessment of Mrs. Destefano? 21 A. No. 22 Q. Even though you don't specifically remember 23 performing Mrs. Destefano's assessment, do you believe this 24 document reflects a written recollection of your personal 25 observations on September 21st, 1999? CENTRAL FLORIDA REPORTERS, INC. 12 1 A. Yes, I do. 2 Q. Miss Fuchs, at this time, I would like you to 3 read into the Record the last page of this document which is 4 entitled "additional wound care progress notes." 5 A. Okay. Just a second. September 21st, 1999. 6 Patient admitted on 9/19/99 with the diagnosis of decreased 7 level of consciousness, urosepsis, Alzheimer's, chronic 8 constipation, impaired swallowing. Abnormal labs on 9 9/16/99. With sodium 134. BUN 26. Red blood count 3.36. 10 HGN 9.8. HCT, 29.3. Band neutrophytes is 19.5. Lyphocytes 11 17.7. ASB band neutrophy 2.0. Myelocytes 2.7. I can't 12 read that. Uro -- can't read my writing. It's urine dyphus 13 -- sorry, urinalysis, sorry, 9/15/99. Clarity is hazy. 14 Color is yellow. Bacteria is 4 plus. Hyaline cast, 5. 15 Course span cast, 3. 16 Nursing admission skin assessment on 9/19/99 noted 17 the following: Right heel stage three with yellow slough 18 and bloody drainage. Two open areas on coccyx sacrum with 19 additional healing sites with pink scar tissue. Also with 20 stage two intact blister on left shoulder. See graphic 21 wound assessment for dressing recommendations and wound 22 status. 23 When assessed, patient found to have bright red 24 blood on incontinence pad from unknown origin. Nursing 25 notified and aware of blood. Per nursing, MD to examine CENTRAL FLORIDA REPORTERS, INC. 13 1 patient. Patient to be transferred to ORMC for evaluation. 2 And then signatures. 3 Q. And whose signature is that next to yours? 4 A. That's Mary Thornton. 5 Q. And who is Mary Thornton? 6 A. She was the nurse manager. 7 Q. Do you recall Miss Thornton being present with 8 you when you did this assessment? 9 A. Do I recall? 10 Q. Yes, ma'am. 11 A. No, I don't recall, but it's typical practice 12 that the nurse managers would be on whichever floor I'm at, 13 the nurse managers would be with us when, with me when I did 14 the assessment. 15 Q. What I'd like to do next is take you through some 16 of the information you've provided in this wound care 17 progress note. 18 Where does the initial information about Miss 19 Destefano's vital signs and lab work come from? 20 A. It would come out of the chart. 21 Q. And is that what you referred to earlier as a 22 chart audit? 23 A. Yes. I look at that, I look at the labs, most of 24 the information the beginning of this was right out of the 25 chart. CENTRAL FLORIDA REPORTERS, INC. 14 1 Q. Now, can you explain to us the actual wound 2 assessments that you noted during your examination? What 3 was the condition of Miss Destefano's right heel? 4 A. She had a full thickness 3.2 by 1.5 wound on her 5 right heel that had, that was covered with necrotic tissue. 6 And it had moderate serous sanguineous drainage and the 7 surrounding area was reddened. 8 Q. What does a stage three determination mean as was 9 noted by the nurses? 10 A. They're talking about the, the depth of the 11 wound. 12 Q. And is this graphic on the first page of this 13 document, intended to reflect your visual assessment of the 14 wound? 15 A. Yes, it is. 16 Q. And you mentioned serous sanguineous drainage. 17 What does that mean? 18 A. That means there's blood particles in the 19 drainage of the wound. 20 Q. Is that reflective of the bloody drainage noted 21 by the nurses in their assessment on the 19th? 22 A. Could you repeat the question. 23 Q. Is that serous sanguineous drainage that you 24 mentioned also comparable to the bloody drainage that was 25 noted in your progress note -- CENTRAL FLORIDA REPORTERS, INC. 15 1 A. Yes. 2 Q. -- that the nurses saw? 3 A. Yes, it is. 4 Q. Was there anything additional that you noticed in 5 relation to this wound? 6 A. Well, the only additional thing might be that the 7 wound had previously been opened before. There had been a 8 previous wound there before. 9 Q. Did you suggest a wound care plan for the right 10 heel of Mrs. Destefano? 11 A. Yes, I did. 12 Q. And what did that plan consist of? 13 A. The recommendation was to clean the wound with 14 normal saline. Apply Accuzyme to necrotic tissue. Dress 15 with four by four gauze and wrap with Kerlix and change 16 q.d., which is every day and as needed. 17 Q. In addition to the wound on her right heel, did 18 you note any other wounds on Mrs. Destefano's body? 19 A. Right. She also had a sacrum wound. 20 Q. And what is the sacrum? 21 A. It's basically the bottom where the tail bone, 22 around the tail bone area. 23 Q. And -- 24 A. On the bottom. 25 Q. -- and what was the condition -- I'm sorry, had CENTRAL FLORIDA REPORTERS, INC. 16 1 you completed your answer? 2 A. Yes. Yeah, it's by the buttocks. 3 Q. What was the condition of Mrs. Destefano's sacrum 4 when you did your assessment? 5 A. Okay. This one has had been a previous open 6 area; was healing. It was a 2.0 centimeter by .7 centimeter 7 partial thickness. It was in the healing process. And it 8 had scant serous drainage. And the area was reddened around 9 it. 10 Q. And is the graphic on page three intended to 11 represent your visual assessment of that wound? 12 A. Yes, it is. 13 Q. Was there anything additional you noted about the 14 wound? 15 A. No. 16 Q. Did you suggest a wound care plan for the sacrum 17 of Mrs. Destefano? 18 A. Yes, I did. 19 Q. What did that plan consist of? 20 A. Recommended that the wound be cleaned with normal 21 saline. Apply to skin prep periwound. Dress with 22 signadress steriderm and for dressing to be changed every 23 five days or as needed. 24 Q. Did you notice any other wounds on 25 Mrs. Destefano's body besides the two that you did the CENTRAL FLORIDA REPORTERS, INC. 17 1 assessments on? 2 A. She had a -- she also had a stage two intact 3 blister on her left shoulder. 4 Q. And did that wound require or did that wound get 5 an individual assessment? 6 A. No, it didn't. 7 Q. Going back to the additional wound care progress 8 notes, the last page of the exhibit? 9 A. Mm-hmm. 10 Q. After you described the wounds, what is the next 11 item that you have written on the wound care notes? 12 A. After I said see the graphics? 13 Q. Yes, ma'am. 14 A. It said when assessed, patient found to have 15 bright red blood on incontinence pad from unknown origin. 16 Nursing notified. Aware of blood. Per nursing, MD to 17 examine patient. Patient to be transferred to ORMC for 18 evaluation. 19 Q. Now, can you please tell us what an incontinence 20 pad is? 21 A. An incontinence pad is a pad that is typically 22 used under a patient who had incontinence issues and it's 23 used in the bed to protect the, the bed. It absorbs it away 24 from the patient, typically. 25 Q. Would you normally find an incontinence pad under CENTRAL FLORIDA REPORTERS, INC. 18 1 a patient who had had difficulty controlling her bladder and 2 her and/or her bowels? 3 A. Yes. 4 Q. What is meant by bright red blood? 5 A. Bright red blood would mean, like, fresh blood 6 like if you just cut yourself, it's typically red. Fresh 7 blood. 8 Q. And did you personally see the blood on the bed 9 pad? 10 MR. OSBORNE: Object, no predicate. 11 MS. PETRO: She's placed it in the notes. 12 MR. OSBORNE: You asked her if she personally did 13 it and not whether her notes reflect that and she has 14 no personal recollection of what occurred on that date. 15 No predicate. 16 MS. PETRO: I'll rephrase the question. 17 Q. Miss Fuchs, do your notes reflect that you saw 18 blood on that bed pad? 19 A. Yes, it does. 20 Q. Do you recall personally, do you personally 21 recall seeing the blood on the bed pad? 22 A. No. No. But if I wrote it, it did. 23 Q. And do your notes reflect that you notified the 24 nursing staff about the blood on the bed pad? 25 A. Yes. CENTRAL FLORIDA REPORTERS, INC. 19 1 Q. Do you recall personally notifying the nursing 2 staff about the blood on the bed pad? 3 A. No. But again, I wrote it, so obviously, I did. 4 MS. PETRO: No further questions for the witness. 5 CROSS-EXAMINATION 6 BY MR. OSBORNE: 7 Q. Morning, Miss -- is it Fuchs? 8 A. Fuchs, yes. 9 Q. I was saying Fukes (ph). 10 A. That's all right. 11 Q. I bet a lot of people make that mistake, don't 12 they? 13 A. Yes, they do. 14 Q. Miss Fuchs, your license is in physical therapy 15 assisting, correct? 16 A. Yes, it is. 17 Q. You hold no other licenses? 18 A. That's correct. 19 Q. You have two Associate degrees. One in physical 20 therapy assistant and one in, the other in resource 21 management? 22 A. Yes. 23 Q. You're licensed by the State of Florida as a 24 physical therapist assistant, correct? 25 A. Yes. CENTRAL FLORIDA REPORTERS, INC. 20 1 Q. And you note that that is governed by Florida 2 Statute Section 486. 3 A. I don't remember the exact statute. 4 Q. I'd like to publish for you how the Florida 5 Statutes describe your license under Chapter 486.021 and see 6 if that, if you agree that's what you do. This is under 7 486.021(6). 8 Physical therapist assistant means a person who is 9 licensed in accordance with the provisions of this Chapter 10 to perform patient-related activities, including the use of 11 physical agents, whose license is in good standing and whose 12 activities are performed under the direction of a physical 13 therapist as set forth in rules adopted pursuant to this 14 Chapter. 15 Do you agree generally that that is an accurate 16 assessment of -- 17 A. Yes. 18 Q. -- what a physical therapist assistant is? 19 A. Yes. 20 Q. Okay. And in direct supervision under Chapter 21 486.021 means supervision by a physical therapist who is 22 licensed pursuant to this Chapter, correct? Under the, the 23 Florida law as you understand how you practice? 24 A. Correct. 25 Q. Let me talk to you about what the Statute defines CENTRAL FLORIDA REPORTERS, INC. 21 1 what the practice of physical therapy is and I'm going to 2 ask you the same question about whether that's what you did 3 as a physical therapist assistant. This is under Chapter 4 486.021(11). 5 Practice of physical therapy means the performance 6 of physical therapy assessments and the treatment of any 7 disability, injury, disease, or other health condition of 8 human beings, or the prevention of such disability, injury, 9 disease, or other condition of health and rehabilitation, as 10 related thereto by the use of physical, chemical and other 11 properties of air, electricity, exercise, massage, the 12 performance of acupuncture, only upon compliance with the 13 criteria set forth by the Board of Medicine, when no 14 penetration of the skin occurs; the use of radiant energy, 15 including ultraviolet, visible and infrared rays, 16 ultrasound, water, the use of apparatus and equipment, and 17 the application of the foregoing or related thereto, the 18 performance of tests of neuromuscular functions as an aid to 19 the diagnosis or treatment of any human condition, or the 20 performance of eletromyography as an aid to the diagnosis of 21 any human condition, only upon compliance with the criteria 22 set forth by the Board of Medicine. 23 Does that comport with your understanding of what 24 the practice of physical therapy is? 25 A. Yes. CENTRAL FLORIDA REPORTERS, INC. 22 1 Q. Okay. There's no mention in the Florida Statutes 2 of wound care assessment being a part of the practice of 3 physical therapy or being a physical therapist assistant, is 4 there? 5 A. The actual term wound care? No, it didn't. 6 Q. Not only the actual term, a wound care assessment 7 does not even fall within the parameters of that definition, 8 does it, in terms of what a physical therapist does? 9 A. Are you asking me do physical therapists normally 10 do wounds? 11 Q. I'm asking you if, as defined by the Florida 12 Statutes, whether or not wound care assessment is 13 contemplated within that definition I just read to you. 14 A. I can't answer that question. I'd have to be 15 able to read the whole thing. 16 Q. Well, take a look at it. 17 A. But you didn't mention the words wound assessment 18 or wound anything in here, so I would say, no, it's not in 19 here. 20 Q. Okay. I didn't, it's not me that mentioned it. 21 It's the Florida statutes I was reading to you. 22 A. Okay. 23 Q. And your position I think is, you weren't acting 24 as a physical therapist assistant at the time you performed 25 this wound care assessment, correct? CENTRAL FLORIDA REPORTERS, INC. 23 1 A. No. No, no, no. I'm a physical therapist 2 assistant. And my position, even though the title was 3 restorative, okay, I did work under the, a physical 4 therapist at all times. I didn't do anything that wasn't 5 approved by a physical therapist. 6 Q. I think I must have given you a poor question. 7 My question really is, at the time you did this wound care 8 assessment, you weren't acting in your role as a physical 9 therapist assistant, were you? In other words, you weren't 10 performing physical therapy when you did the wound care 11 assessment. 12 A. Part of physical therapy is doing wounds, yes. 13 Q. Well, we talked about what the Florida Statutes 14 defined as physical therapy and there's no mention of any 15 wound care assessment in this statutory definition, is 16 there? 17 A. No, but physical therapy does wounds. 18 Q. So, so is this Florida Statute wrong? It should 19 also say in here wound care assessment as being a part of 20 what the duties are in the practice of physical therapy? 21 A. I'm not here to tell you what the statutes should 22 say. I would just tell you that it is common practice for 23 physical therapy to do wounds. 24 Q. You're not sure if you were working on September 25 21st as a physical therapy assistant or as a restorative CENTRAL FLORIDA REPORTERS, INC. 24 1 coordinator. 2 A. I'm always a physical therapist assistant. My 3 title is restorative coordinator. 4 Q. Do you recall when your deposition was taken, 5 Miss Fuchs, on August 27, 2004? 6 A. No. 7 Q. Do you recall when your deposition was taken, you 8 were placed under oath? 9 A. Yes, I recall that I did two depositions. 10 Q. This is your second deposition, I will assert to 11 you, at page 14, line 24. I'm going to publish a part of 12 this and ask you about it. 13 "Okay. Now as a physical therapist assistant, 14 would you normally chart in the medical records, other than 15 an additional wound care progress note, in reference to 16 wounds? And question, well, in reference to anything 17 actually. 18 Answer: Under the physical therapy section, or 19 and again, I'm not sure what my job title was at that 20 moment. If I was a restorative coordinator, or if I was 21 working in physical therapy". 22 Do you recall that testimony? 23 A. Do I recall the testimony? 24 Q. Yes. 25 A. No, but I -- CENTRAL FLORIDA REPORTERS, INC. 25 1 Q. Is it still your position you weren't sure 2 whether you were acting as a restorative coordinator or if 3 you were working in physical therapy? 4 A. I think the, the confusion here is, if my job 5 title might have been restorative coordinator, but I'm 6 always a physical therapist assistant. 7 Q. If you were acting as a physical therapist, that 8 note would've been, would have been signed off by the 9 physical therapist, not an LPN, correct? 10 A. This note you're referring to? 11 Q. Correct. 12 A. No. 13 Q. Let me rephrase. 14 A. Remember, this is a team function. This isn't 15 just one person. If I'm writing a note dealing with, with a 16 patient's exercise -- 17 Q. If you were writing -- 18 A. -- or such like that, then that would be signed, 19 if it needed to be signed off at all, it would've been 20 signed off by a physical therapist. But this is a team 21 note, not a physical therapy note. Does that answer your 22 question? 23 Q. No. Let me rephrase it. We just established 24 under the Florida Statutes, that if you're acting as a, a 25 physician therapist assistant, that you have to act under CENTRAL FLORIDA REPORTERS, INC. 26 1 the supervision of a physical therapist who is licensed 2 under this Chapter. Remember that? 3 A. Sure. 4 Q. And if you were acting as a physical therapist 5 assistant when you did this wound progress note, you 6 would've had to have been acting under the direct 7 supervision of a physical therapist, wouldn't you? 8 A. I always work under the direct supervision of a 9 physical therapist. If there is ever any question -- I 10 mean, the physical therapy was part of the team. 11 Q. But if you were, if this wound care assessment 12 was a physical therapy report, then the physical therapist 13 would've been required to sign off on this note, correct? 14 A. Correct. This is not a physical therapy note. 15 This is a wound assessment note. 16 Q. Thank you. A restorative coordinator is when a 17 person comes off skilled therapy and goes to the unskilled 18 portion, correct? 19 A. Correct. 20 Q. You did assessments in the building and continued 21 with exercise, ambulation, anything to keep the patients as 22 highly functional as possible. 23 A. Correct. 24 Q. Your testimony is that you were not hired in, in 25 the position that you were working at Sunbelt as a physical CENTRAL FLORIDA REPORTERS, INC. 27 1 therapist, correct? 2 A. Correct. Different capacity. 3 Q. And your job as a restorative coordinator, that 4 was to initially assess the patient to see if they're 5 appropriate for a bowel and bladder program. That was your 6 initial assessment, wasn't it? 7 A. I don't recall. 8 Q. Okay. Let me ask you again, this is your first 9 deposition, at May 15th, 2000. I know you said you recalled 10 you were deposed twice, correct? 11 A. Yes. 12 Q. And you were under oath on both occasions. 13 A. Absolutely. 14 Q. This is at page 5, line 9: 15 "Question: So if you could give me a real quick 16 description about your job for any individual patient. A 17 patient comes in, what do you do for that patient? 18 Answer: Okay. I will initially assess the 19 patient to see if they're appropriate for the bowel and 20 bladder program". 21 A. Correct. 22 Q. Okay. You did not do an assessment of 23 Mrs. Destefano for a bowel and bladder program, did you? 24 A. I don't know. 25 Q. It's not reflected in the, in the document before CENTRAL FLORIDA REPORTERS, INC. 28 1 you, is it? 2 A. Oh, no. That would be a different document. 3 Q. Going to your position as a restorative 4 coordinator in terms of your duties, if the patient was not 5 automatically picked up on skilled therapy, you would assess 6 the patient to see if some kind of exercise program or 7 ambulation program or activities of daily living, which 8 include grooming, hygiene, feeding themselves, that they 9 would need a little bit of additional help with which to 10 make sure they could stay as functionally independent as 11 possible. 12 A. Correct. 13 Q. Then you'd set up a program through the nursing 14 staff and/or through therapy and your staff would carry that 15 out, correct? 16 A. Correct. 17 Q. Okay. Wound assessment was not a function of 18 your job as a restorative coordinator, was it? 19 A. That was what, like, an additional duty. 20 Q. Do you recall when your deposition was taken 21 again on May the 15th of 2000? Do you recall that? 22 A. Okay. 23 Q. Okay. And I'd like you to look at pages -- I've 24 got a copy for you here. Look at pages, starting at page 4, 25 at line 21. And read through from that forward, all the way CENTRAL FLORIDA REPORTERS, INC. 29 1 through the end of page 5, line 25, when you're describing 2 what your position as restorative coordinator involved. 3 A. Through how far do you want me to read to? 4 Q. To the last line of page 5, please. 5 A. Okay. 6 Q. Have you done so? 7 A. I have. 8 Q. Did you make any mention in this deposition that 9 your duties as restorative coordinator included wound care 10 assessment? 11 A. No. 12 Q. Okay. Thank you. I'll take that from you. 13 Would you agree with me that wound care assessment has 14 nothing to do with an exercise program? 15 A. Yes. 16 Q. Has nothing to do with an ambulation program? 17 A. Correct. 18 Q. Has nothing to do with activities of daily 19 living? 20 A. Correct. 21 Q. Has nothing to do with grooming? 22 A. Correct. 23 Q. Has nothing to do with hygiene? 24 A. Correct. 25 Q. Has nothing to do with patients feeding CENTRAL FLORIDA REPORTERS, INC. 30 1 themselves? 2 A. Correct. 3 Q. Has nothing to do with patients being 4 functionally independent? 5 A. Correct. 6 Q. In fact, Carolina Destefano was not a candidate 7 who needed restorative coordination, did she? 8 A. I don't know. 9 Q. Do you recall anything Carolina Destafano? 10 A. No, I don't. 11 Q. Do you know that she was end stages Alzheimer's? 12 A. I would have to refer back to my only note that I 13 have in front of me, which says Alzheimer's. It doesn't say 14 end stage. 15 Q. The only place your handwriting appears anywhere 16 in Carolina Destefano's medical records is on the additional 17 wound and care progress notes, correct? 18 A. I don't know. I'd have to go page through page 19 through the chart to see if there's any other documentation. 20 Like I said, I don't recall this patient. 21 Q. Let me refresh your memory back to your 22 deposition of August the 27th of 2004. Starting at line 16, 23 page 34: 24 "Question: Okay. All right. Let's keep going 25 on. Let's thumb through the rest of the records and tell me CENTRAL FLORIDA REPORTERS, INC. 31 1 if you see your handwriting anywhere else. 2 Answer: On the additional wound care progress 3 note, which you already have a copy of. 4 Right. Looking at Exhibit 1. Under Exhibit 1, 5 what, that was it? Or excuse me, under Exhibit 1, that was 6 it. 7 Okay. So it appears that you only saw 8 Mrs. Destefano on this one occasion; is that correct? 9 Answer: Yes". 10 Do you recall that you reviewed the chart, the 11 medical records and at that time, at your second deposition, 12 and determined that the only place your handwriting appears 13 anywhere in the chart, is on the additional wound care 14 progress notes? 15 A. Okay. 16 Q. Okay. Isn't it true, if you looked to the 17 document in front of you there -- 18 A. Mm-hmm. 19 Q. -- isn't it true that the chart or the medical 20 notations in terms of things you copied from other sources, 21 end at "additional healed sites with pink scar tissue." Do 22 you follow me where that is, right? 23 A. Yes, I see that. Um, without having the chart in 24 front of me, the next line might also be part of, out of the 25 chart, but I don't recall. CENTRAL FLORIDA REPORTERS, INC. 32 1 Q. Okay. 2 A. I would have to see the nursing admission skin 3 assessment. 4 Q. I'm going to show you what I'm marking as 5 Plaintiff's Exhibit Number 1. The comprehensive initial 6 nursing assessment is what I've given you, correct? 7 (Received and so Marked) 8 A. Yes, it is. 9 Q. And you recognize that to be a part of the 10 charting that you customarily were used to seeing at 11 Sunbelt? 12 A. Yes, I do. 13 Q. This was done by a registered nurse or an RN? 14 A. I would assume, yes. Yes, it was. 15 Q. You would agree with me that an RN is far more 16 qualified than you to do a wound care assessment, would you 17 not? 18 A. Excuse me? 19 Q. You would agree with me that an RN was far more 20 qualified than you to do a wound care assessment. 21 A. I can't testify on someone else's abilities. 22 Q. Well, I'm talking not about individual people. 23 I'm talking about someone who has the qualifications of a 24 registered nurse, versus someone who is a licensed physical 25 therapist assistant. CENTRAL FLORIDA REPORTERS, INC. 33 1 A. I would hope so. 2 Q. You would agree from your knowledge being in the 3 medical business, that an RN has far more training than you 4 do as a licensed physical therapist assistant, would you 5 not? 6 A. I don't know what the, what the requirements are 7 for an RN. 8 Q. All right. But you do see on here in terms, on 9 the admitting nursing skin assessment, that the RN did also 10 give you the information about stage two intact blister on 11 right -- on left shoulder? 12 A. Yes. 13 Q. So the first information that was original to 14 you, was see graphic wound assessment for dressing 15 recommendations and wound status, correct? 16 A. Correct. 17 Q. And you got your information from this very sheet 18 because you say nursing admission skin assessment, that's 19 the document we're talking about where you got your 20 information about the, about the wounds, correct? As noted 21 in your charting. 22 A. Say that question again, please. 23 Q. Right. I've just shown you the admission nursing 24 skin assessment and I'm just asking you to confirm that when 25 you say nursing admission skin assessment and note -- CENTRAL FLORIDA REPORTERS, INC. 34 1 A. Yes. 2 Q. -- these three wounds, it came from this sheet, 3 did it not? 4 A. I believe it did. I'm not sure if there's an 5 additional skin assessment form that specifically goes with 6 skin assessment, but I would believe that without -- you 7 know, I mean this is a long time ago. Let me see. I would 8 -- yes. I would probably say I got it right off of this. 9 Q. Appears to be verbatim, doesn't it? 10 A. Yes, it does. 11 Q. Okay. What is a dressing recommendation? 12 A. Make a recommendation for the dressing to cover 13 the wound. 14 Q. How is that different than a wound documentation? 15 A. Excuse me? 16 Q. Do you know what wound documentation is versus 17 wound recommendation? 18 A. A recommendation is a recommendation to the 19 doctor of, this is what we recommend for a dressing or 20 procedures to happen. A documentation is where we're 21 actually writing this is what we saw. 22 Q. Okay. Let go to the, let me get the document 23 that was put in front of you. Let's go to page two of the 24 first exhibit you had there. And I think if you look down 25 to pain at site or pain frequency, you noted pain with CENTRAL FLORIDA REPORTERS, INC. 35 1 dressing change, correct? 2 A. Correct. 3 Q. Now, your testimony is that the source of this 4 information that you got was probably verbalization from 5 Mrs. Destefano, correct? 6 A. I never said that's from verbalization from 7 Mrs. Destefano. 8 Q. Yes. You never said that? 9 A. I never said verbalization. 10 Q. That's my question. My question was -- 11 A. I don't recall that, but, but, no. Typically, 12 it's, if I'm doing a assessment, I'm actually looking at the 13 wound and assessing it. I'm not -- 14 Q. Let me refresh your memory back to your August 15 27, 2004 deposition. Page 32, line 3: 16 "Question: The question's going to be, the 17 question is, do you recall how you determined she had pain 18 at the site? 19 Answer: Probably verbalization. But I, without 20 being there, I can't give you an accurate answer -- 21 Okay. 22 Answer: -- on that. It could've been if I was 23 taking the dressing off and she said something or she, her 24 facial expression. I can't tell you without, and I don't 25 remember". CENTRAL FLORIDA REPORTERS, INC. 36 1 So you'd agree with me at the time of your 2 deposition in August of 2004, you said it was probably 3 verbalization, didn't you? 4 A. Right. 5 Q. Okay. 6 A. And that was a good example, yes. 7 Q. Okay. Go back to Plaintiff's Exhibit 1, and I'd 8 like you to start at the second page of the eight pages 9 there. The second page. 10 A. Second page? Okay. 11 Q. Yeah. You follow me where it says cognitive 12 loss, dementia. Answers questions appropriately, no. 13 Follows verbal commands, no. Cooperative, no. 14 A. Okay. 15 Q. And turn to the second to the last page, language 16 spoken, Spanish. 17 A. Okay. 18 Q. Do you speak Spanish? 19 A. Very little. 20 Q. And it says, making self understood, rarely/never 21 understood. 22 A. Okay. 23 Q. Can communicate needs, no. Unclear speech. 24 Follow all that? 25 A. Sure. CENTRAL FLORIDA REPORTERS, INC. 37 1 Q. So would you agree with me that it's very 2 unlikely that you learned that there was pain with dressing 3 change from a verbalization by this particular patient? 4 A. By verbalization? 5 Q. Correct. 6 A. Okay. Like I said, in the rest of my initial 7 testimony, okay, could be by other things as well. And if 8 you look on the front page here, it says that she also opens 9 her eyes to pain, so -- 10 Q. My question was, would you agree with me that it 11 was probably not verbalization that led you to conclude it 12 was, there was pain with dressing change? 13 A. No, it was probably gesture then. Gesture or 14 response to stimuli, whatever. 15 Q. Let me show you another document. Plaintiff's 16 Exhibit 2. Exhibit 2 is a documentation record and profile. 17 Do you recognize this as another charting document 18 at Sunbelt, do you not? 19 (Received and so Marked) 20 A. I believe so. 21 Q. This is the nursing record to note when dressing 22 changes occurs on a particular patient, isn't it? 23 A. It appears to be. 24 Q. And we note here, that there's an initial entry 25 of 9/19/99 regarding the right heel, do you see that? CENTRAL FLORIDA REPORTERS, INC. 38 1 A. Yes. 2 Q. And it says 7 to 3. You note that to be the 7 to 3 3 shift, don't you? 4 A. Correct. 5 Q. And if you go over to the 20th, you'll see a 6 notation in regard to the, what, the right heel by a CB. Do 7 you see that? 8 A. Yes. 9 Q. And do you know that to be Carol Boze? 10 A. Her signature's down below, so I assume, yes. 11 Q. Then there's another initial on the 21st for 12 dressing change on the right heel. I'll represent to you 13 that it's Deborah Gerald. Do you remember a Deborah Gerald? 14 A. No, I don't. 15 Q. You'd agree with me this is the appropriate place 16 where you would chart a dressing change for Carolina 17 Destefano, do you not? 18 A. I believe so. 19 Q. And there's no indication or notation that you 20 changed the dressing on the 21st of, regarding Carolina 21 Destefano, is there? 22 A. No, I wouldn't. This isn't a document I would be 23 filling out. 24 Q. Because you're not qualified to change dressings? 25 A. No. CENTRAL FLORIDA REPORTERS, INC. 39 1 MS. PETRO: Objection, argumentative. 2 Q. You can answer the question. Are you qualified 3 to make, do dressing changes? 4 A. Yes, I am qualified to do dressing changes. 5 Q. Is it your testimony that you did a dressing 6 change on, on the 21st of September for Carolina Destefano? 7 A. I would say that I made a recommendation for what 8 the dressing changes were. Did I actually change the 9 dressing? I don't recall. I don't recall. 10 Q. All right. 11 A. But I, obviously, had access to the wound and I 12 looked at the wound. 13 Q. If you had changed dressings, would you agree 14 with me that you would have had to chart that event? 15 A. No, I don't. 16 Q. So this Exhibit Number 2, which is a document 17 that indicates any change in dressings, you would not have 18 had to note a dressing change on this document? 19 A. No. 20 Q. So the nurses or the LPNs who change the 21 dressings are required to use this documentation -- 22 A. Yes. 23 Q. -- record. But you're not required to as 24 restorative coordinator? 25 A. No. As a member of the wound care team, I do not CENTRAL FLORIDA REPORTERS, INC. 40 1 fill out that document. 2 Q. Now, you told me, you told on direct, you 3 mentioned that the, you recommended that the right heel be 4 changed every day and as needed, correct? 5 A. Yes. Change daily and as needed. 6 Q. And you told me, I think you, well, I haven't 7 established this yet, your work hours probably would've been 8 either 7:00 to 5:00, or 8:00 to 5:00 on the 21st of 9 September of 1999, correct? 10 MS. PETRO: Objection, predicate. 11 Q. You can still answer. 12 A. I don't recall, but that's -- I work days. So 13 probably 8 to 5, 7 to 4. Somewhere in there. When I get 14 done. 15 Q. That overlapped with the 7 to 3 nursing shift, 16 didn't it? Your work schedule overlapped with the 7 to 3 17 nursing shift. 18 A. Yes. 19 Q. And if you look at this, the Exhibit Number 2 I 20 gave you for the 21st, you'll see that Deborah Gerald did a 21 nursing, excuse me, did a wound change on the 21st, some 22 time in the 7 to 3 shift, correct? 23 A. Correct. 24 Q. And it also appears that a wound change was, on 25 the right heel was done once on the 19th, correct? CENTRAL FLORIDA REPORTERS, INC. 41 1 A. No. 2 Q. Well, take a look on the left side. It says, 3 cleanse right heel, talks about saline, apply Accuzyme, 4 covered with gauze, wrap, and it says 9/19/99. 5 A. Okay. 6 Q. That would appear to be a, a change of dressing 7 to the right heel wound, would it not, on the 19th? 8 A. No. 9 MS. PETRO: Objection, speculation. 10 A. That would appear to be what the doctors' orders 11 date was. 12 Q. Would you agree with me there was a wound change 13 on the 20th? 14 A. Yes, I would. 15 Q. One time? 16 A. Yes. 17 Q. Which is in keeping with your recommendation that 18 the right heel wound be changed daily -- 19 A. Yes. 20 Q. -- Correct? And it appears that Deborah Gerald 21 also complied with your recommendation because she changed 22 the dressing on the 21st one time, correct? 23 A. Correct. 24 Q. So if Deborah Gerald changed the dressing before 25 you, it would not have needed to be changed again for a CENTRAL FLORIDA REPORTERS, INC. 42 1 second time when you came on the scene, correct? 2 A. Would have been needed? 3 Q. Would not have been needed. 4 A. No, it wouldn't have been needed, but that wasn't 5 the, the point. The point was that we were doing a wound 6 assessment, which means you had access to the wound. 7 Whether the dressing was changed in the morning or not, it 8 doesn't, doesn't have any bearing on it. You still do the, 9 the wound assessment. You just don't not look at it. 10 Q. And you would agree with me that -- well, when 11 you, when you take the -- you have to take the wound 12 dressing off to do an assessment. 13 A. Yes. 14 Q. Which means you change the dressing when you put 15 it back on, correct? 16 A. Yes. 17 Q. And that's -- and you'd agree with me that if the 18 dressing by Deborah Gerald that occurred on the 21st had 19 occurred before you got there, you wouldn't have needed to 20 change the dressing, would you? 21 A. I wouldn't have needed to change the dressing, 22 but I would've, if I hadn't done the assessment yet, and 23 they changed the dressing before, I still would've done the 24 assessment and then put a dressing on afterwards. 25 Q. Why was a second assessment done within 48 hours CENTRAL FLORIDA REPORTERS, INC. 43 1 from the time that the RN did the, what's called the -- 2 A. Comprehensive. 3 Q. -- admission nursing skin assessment as a part of 4 the comprehensive admission nursing assessment? 5 A. Okay. That's an easy one. This was done by the 6 admitting nurse, okay? This was done by the wound care 7 team, okay? Which is more than one person. It's common 8 practice that the facility had wound care team on specific 9 days of the week, go through each floor and look at all the 10 wounds in the building to make sure that all the needs are 11 being met for the wounds. 12 Q. Why did your graphics not include a right 13 shoulder area graphic? 14 A. Um, I would guess because the wound was not 15 opened, but I'd be speculating. I don't recall why. It was 16 a blister. It's not, it was not an open wound. But I can't 17 really give you a good answer on that. But that would be my 18 guess. 19 Q. I'm going to show you what I'm marking as Exhibit 20 3 to your deposition. Do you recognize -- there's four 21 different pages in here. Do you recognize what types of 22 documents these are? 23 (Received and so Marked) 24 A. Yes, I do. 25 Q. What are these documents? CENTRAL FLORIDA REPORTERS, INC. 44 1 A. The first page is the speech therapist's 2 evaluation. The second page is the occupational therapy 3 evaluation. The third page is the same thing -- no, it's 4 different. It's occupational therapy. 5 Q. Would you agree with me that if there was a 6 physical therapy evaluation done, there would've been a 7 document in the Carolina Destefano charting? 8 A. Yes. 9 Q. I would represent to you that there is no 10 physical therapy document. Do you have any recollection 11 other than that? 12 A. No. 13 Q. Okay. Would you agree with me that going back to 14 the Defendant's Exhibit 1 that you've got in front of you 15 there, that in terms of your narrative, that the only new 16 charted item that is indicated on here, is that patient 17 found to have bright red blood on incontinence pad? 18 A. The only new information from the chart? 19 Q. The only new information from the chart, correct. 20 A. Okay. Other than seeing the graphic pages, okay. 21 Q. Well, the graphic pages weren't new. That was 22 already talked about in the initial nursing assessment, 23 describing those particular wounds, correct? 24 A. Well, very limited, but, yes. 25 Q. But in terms of there's something new to the CENTRAL FLORIDA REPORTERS, INC. 45 1 chart from any source, the only new item charted is patient 2 found to have bright red blood. 3 A. Okay. 4 Q. Is that a yes? 5 A. Yes. 6 Q. Okay. Do you have any idea why Sunbelt would say 7 in a sworn interrogatory answer, this note was made by Lily 8 McBride, RN? 9 A. Say that again. 10 Q. Do you have any idea why Sunbelt would say in a 11 sworn interrogatory answer, that this note was made by Lily 12 McBride, RN? 13 A. What note? 14 Q. This narrative note of 9/21/99 contained in 15 Exhibit, Defense Exhibit 1. 16 A. No. Because I don't even know who that is. 17 Q. But you have testified -- 18 A. That's my writing, too. 19 Q. You have testified that Mary Thornton was there 20 during the wound assessment, correct? 21 A. Yes. It's common practice that the nurse manager 22 be part of the wound team and assist with the assessments. 23 Q. And because all of your assessments are co-signed 24 by a nurse, correct? 25 A. Correct. CENTRAL FLORIDA REPORTERS, INC. 46 1 Q. Isn't it really true, Miss Fuchs, that you never 2 did any work with or for Carolina Destefano during the time 3 of 9/21/99? 4 A. Are you asking me whether I did this wound 5 assessment or not? 6 Q. My question is, isn't it true that you never did 7 any work with or for Carolina Destefano? 8 A. Okay. I'm not exactly sure what you're referring 9 to, but if you're asking me whether I did this assessment or 10 not, the answer is, yes, I did the assessment. Okay. If 11 you're asking me whether I did any additional restorative 12 items, then the answer is no. 13 Q. My question is more basic than that. Including 14 this additional wound care assessment you've been talking 15 about. Isn't it true that this really didn't happen; that 16 you never did any work with or for Carolina Destefano? 17 MS. PETRO: Objection, asked and answered. 18 Q. At any time? 19 A. I'm not really sure what you're asking me. If 20 you're asking me did I do this assessment, my answer is yes, 21 I did this assessment. 22 Q. All right. Let me ask you -- 23 A. If you ask me did I look at this patient's bottom 24 and look at her heel, the answer is, yes, I did this 25 assessment. It's written right here. CENTRAL FLORIDA REPORTERS, INC. 47 1 Q. Let me ask it this way: Do you recall when your 2 deposition was taken on May 15 of 2000 when you were under 3 oath at that time? 4 A. Okay. 5 Q. And that was within eight months or so of 6 September 21st of 1999? 7 A. Okay. 8 Q. Correct? 9 A. Sure. 10 Q. And would you agree with me that your 11 recollection back on May 15th of 2000 as to the events of 12 September 21st of 1999, would be fresher than they are 13 today? 14 A. Absolutely. 15 Q. I'd like you to like to read the following 16 questions and answers to you at page 6, line 5: 17 "Question, did you ever work with Carolina 18 Destefano? 19 Answer: No. 20 Do you know who that is? 21 Answer: Only by name. No, I do not otherwise. 22 Question: But you never did any work with 23 Carolina, with Carolina or for Carolina Destefano? 24 Answer: No". 25 A. Okay. CENTRAL FLORIDA REPORTERS, INC. 48 1 Q. Do you recall those questions and answers? 2 A. All right. 3 Q. Would you agree with me that this testimony again 4 is fresher to your memories of September 21st than what 5 you're saying today? 6 A. Sure. 7 Q. And you knew -- 8 A. Let me -- can I ask you something? 9 Q. Let me ask you something. 10 A. Okay. 11 Q. You knew back in May of 2000, that Larry 12 Destefano had been picketing at Sunbelt, correct? 13 A. Do I know that he was picketing? Yes. Do I 14 remember the exact dates? No. 15 Q. I didn't ask you the exact dates, but you knew he 16 was picketing? 17 A. Yes. 18 Q. In fact, your deposition on May 15 of 2000 was 19 for a criminal action because he was arrested for being out 20 there picketing, correct? 21 A. Correct. 22 Q. So you certainly knew who Larry Destefano was 23 back in May of 2000, correct? 24 A. Okay. Yes. 25 Q. And you certainly, in terms of your care and CENTRAL FLORIDA REPORTERS, INC. 49 1 treatment of Carolina Destefano, you would agree with me 2 that Larry Destefano had been picketing virtually from 3 September of 1999, certainly up to the date of your 4 deposition on May 15 of 2000, correct? 5 A. Like I said, I don't recall the dates, but I know 6 he was out there for a long time. 7 Q. He was out there every day, correct? Yes? 8 A. Yes. 9 Q. So you, in terms of these events as they were 10 unfolding from September to May of 2000, they were kept 11 fresh in your mind because Mr. Destefano was out there as a 12 reminder because he was picketing in front of your place of 13 employment literally every day, correct? 14 MS. PETRO: Objection, lack of predicate. 15 Q. Do you remember the question? 16 A. No. 17 MR. OSBORNE: Would you read the question back, 18 please, Madame Court Reporter? 19 (Reporter complied with above) 20 A. With the events, the events of myself, yes. 21 MR. OSBORNE: If we could take just a break, I 22 think I might be finished. Let's go off camera. 23 THE VIDEOGRAPHER: Time is 9:28 a.m. Off the 24 Record. 25 (Short Recess) CENTRAL FLORIDA REPORTERS, INC. 50 1 THE VIDEOGRAPHER: Time is 9:34 a.m. On the 2 Record. 3 MR. OSBORNE: Plaintiff has no further questions. 4 CROSS-EXAMINATION 5 BY MR. EVANS: 6 Q. Good morning, Miss Fuchs. My name is David Evans 7 and I represent Orlando Regional Healthcare and I just have 8 a very small list of questions for you this morning. 9 My first one is, have you ever been employed by 10 Orlando Regional Healthcare? 11 A. No, I haven't. 12 Q. Did you have any contact with Orlando Regional 13 Healthcare in connection with Carolina Destefano in regard 14 to her transfer to Orlando Regional Healthcare? 15 A. No, I didn't. 16 Q. Now, in the record, it says ORMC. You take that 17 to mean Orlando Regional Medical Center? 18 A. Yes. I was told by nursing that the patient was 19 going to be transferred. 20 Q. And Orlando Regional Medical Center is part of 21 Orlando Regional Healthcare, did you know that? 22 A. No, I didn't, but okay. 23 Q. Did you have any contact with Orlando Regional 24 Healthcare in connection with Miss Destefano in any respect 25 at all? CENTRAL FLORIDA REPORTERS, INC. 51 1 A. No. No, I did not. 2 MR. EVANS: Those are all my questions. 3 REDIRECT EXAMINATION 4 BY MS. PETRO: 5 Q. Miss Fuchs, I'm going to have some brief redirect 6 examination for you. 7 Mr. Osborne showed you your deposition testimony 8 from May 15th, 2000 wherein you went through your job 9 description as restorative coordinator. Do you recall that? 10 A. Yes. 11 Q. And he pointed out to you that you did not 12 mention wound care as part of that job description. Would 13 it be your practice, being asked what you did for a living, 14 would you describe every detail and every function of your 15 job in that instance? 16 A. No, I wouldn't. 17 Q. Mr. Osborne also asked you a question regarding 18 Mrs. Destefano's verbalization of her pain. Is it your 19 previous testimony that you do not recall this patient? 20 A. Correct. 21 Q. Do you have any recollection of how you 22 determined Mrs. Destefano had pain? 23 A. No, I don't. 24 Q. Could it have been determined in a manner other 25 than through verbalization? CENTRAL FLORIDA REPORTERS, INC. 52 1 A. Yes, it could have. 2 Q. Miss Fuchs, approximately how many patients have 3 you seen in your career as a physical therapist assistant? 4 A. Hundreds. 5 Q. Do you recall all of them? 6 A. No, I don't. 7 Q. Do you recall them specifically by name? 8 A. No, I don't. 9 Q. Would you remember a patient by name six to eight 10 months after doing a wound assessment on a patient? 11 A. No, I wouldn't. 12 Q. So if asked specifically by name if you recalled 13 a specific person, what do you believe your answer would be? 14 MR. OSBORNE: Object, calls for speculation. You 15 can answer the question. 16 Q. You can answer the question. 17 A. What was the question again? 18 Q. If you were asked specifically and only by name 19 if you recalled a particular person, do you believe it is 20 more likely or less likely that you would recall the person 21 by name? 22 MR. OSBORNE: Same objection. 23 A. I still wouldn't recall. 24 Q. Do you recall at your deposition on May 15th, 25 2000, if you were provided with any documentation to allow CENTRAL FLORIDA REPORTERS, INC. 53 1 you to refresh your recollection as to who Mrs. Destefano 2 might have been? 3 A. I don't recall. 4 MS. PETRO: No further questions. 5 MR. OSBORNE: Nothing further. 6 MR. EVANS: Nothing further. 7 THE VIDEOGRAPHER: Time is 9:38 a.m. Off the 8 Record. 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CENTRAL FLORIDA REPORTERS, INC. 54 1 CERTIFICATE OF OATH 2 STATE OF FLORIDA: COUNTY OF ORANGE: 3 I, RITA G. MEYER, RDR, CRR, CBC, certify that SHELLY 4 FUCHS personally appeared before me and was duly sworn. 5 WITNESS my hand and official seal this 5th day of October, 2005. 6 ____________________________ 7 RITA G. MEYER, RDR, CRR, CBC 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CENTRAL FLORIDA REPORTERS, INC. 55 1 CERTIFICATE OF REPORTER 2 STATE OF FLORIDA: 3 COUNTY OF ORANGE: 4 I, RITA G. MEYER, RDR, CRR, CBC, do hereby certify that I was authorized to and did stenographically report the 5 deposition of SHELLY FUCHS; that the review of the transcript WAS NOT requested and that the foregoing 6 transcript, pages 1 through 54, inclusive, are a true and complete record of my stenographic notes. 7 I further certify that I am not a relative, employee, 8 attorney or counsel of any of the parties, nor am I a relative or employee connected of any of the parties' 9 attorneys or counsel connected with the action, nor am I financially interested in the outcome of the action. 10 DATED this 5th day of October, 2005. 11 12 __________________________________ 13 RITA G. MEYER, RDR, CRR, CBC 14 15 16 17 18 19 20 21 22 23 24 25 CENTRAL FLORIDA REPORTERS, INC.