'Client H' investigation raises more troubling questions for DSN

By Charles Sowell  

APRIL 19, 2012 10:42 a.m. (2)

Greenville County Disabilities and Special Needs has been cited by state officials for violating the standard of care in the Feb. 11 death of Heather Dawn Worchester Lemon, 36, a resident at one of the agency’s group homes.

The citation came in a recertification review of the Civitan Community Residence and is detailed in a state Department of Health and Environmental Control report dated March 8. The report was made available to the Journal by sources close to the situation.

A Greenville County Coroner’s report says Lemon died of cardiac arrest and septic cardiogenic shock following the extraction of six abscessed teeth. Lemon died about 24 hours after the extractions.

The same DHEC report on Civitan cites an instance of client abuse by staff when a staff member reportedly stomped on the client’s foot. Subsequent investigations by the State Law Enforcement Division uncovered another incidence of abuse by staff, and a staff member was arrested, according to the DHEC report.

Patrick Haddon, interim director of GCDSN, said Wednesday he was unfamiliar with the substance of the DHEC reports, which are required before any group home facility can be recertified by the state, and needed more time to respond to the issues raised in the reports. He was told about the reports by the Journal on Monday.

Lois Park Mole, director of communications for the state Department of Disabilities and Special Needs, told the Journal that state DDSN staff had been dispatched to Greenville to help the local DSN deal with the issues raised in the DHEC reports.

“The numbers of instances in Greenville are not unusual,” Mole said. “You have to remember these folks (the clients) are not in the best of health to begin with.”

She had no comment on other instances where state staff had been dispatched to help local agencies deal with issues like the ones raised in the DHEC reports.

In Lemon’s death, the DHEC report said, “Review of a Death Report dated 02/11/12 revealed Client H (Lemon) went to the dentist on 02/10/12. Once sedated, the dentist was able to get a clear look into Client H’s mouth and determined she had six teeth that were abscessed and needed to be removed.”

The staff member accompanying Lemon spoke with the facility nurse, who contacted Lemon’s mother and got verbal consent for the extractions. After the extractions, Lemon returned to the group home, where staff reported significant bleeding.

Lemon was taken out of the group home at 4:45 p.m. for a weekend visit with her mother. By 6:30 p.m., DHEC said, the mother was on the phone with staff at Civitan to tell them about significant bleeding from Lemon’s mouth. That was followed by a call to the dentist’s office at 7 p.m.

At 9:30 p.m., the mother called the group home again to tell them Lemon had suffered a grand mal seizure and was undergoing treatment at Greenville Memorial Hospital’s emergency room. “At 11 a.m. on 02/11/12, the dentist was contacted by a physician from the hospital who informed him that Client H (Lemon) was in septic shock. Client H passed away at 12:30 p.m. on 02/11/12,” the DHEC report said.

“Continued review of the staff statement dated 02/13/12 and attached death report revealed that when Client H’s mother was called to get permission to extract Client H’s teeth, she was told a ‘few’ teeth, but was not told six,” DHEC said.

“Review of Client H’s medical records revealed that on 9/18/11, Client H (Lemon) had been taken to the emergency room due to ‘continual bleeding from the mouth.’ ”

The Sept. 18, 2011, bleeding incident and other details of Lemon’s condition were not contained in the information given to the dentist on Feb. 10, DHEC said. There were also problems with getting details of Lemon’s conditions (she was under the care of a cardiologist and an oncologist) into her medical records in a timely manner.

“The cardiologist also ordered that Client H receive Amoxicillin as a prophylaxis prior to dental appointments. There was no indication that dental extractions were discussed with either Client H’s hematologist/oncologist or her cardiologist,” DHEC said. “Continued review of Client H’s record revealed no indication that her dentist had been made aware of the incident of bleeding from the mouth on 09/18/11.”

DHEC went on to say, “By failing to identify these issues, the facility failed to ensure that corrective action was specified as a part of the investigation to prevent their recurrence.”

About 50 persons turned out for Greenville County Council’s regular Tuesday meeting this week to listen as seven people spoke about ongoing issues of accountability and transparency with the Greenville DSN board of directors. Four of those speakers asked the council to request that Gov. Nikki Haley remove the board.

Council Chairman H.G. “Butch” Kirven proposed a formal meeting on May 15 during the regular council meeting to address the DSN issues.

The local DSN board will be invited along with the interim executive director. “And I want to include by special invitation the lady who is the head of the state DDSN (Beverly Buscemi), so she can be here and hear all this too,” Kirven said.

Kirven said he has formed an ad-hoc committee to meet with families, staff and others to listen, catalog and get all the perspectives to “sift out the common truth.” Committee members will be Liz Seman, Lottie Gibson and Dan Rawls.

“The people served by DSN are the most helpless of all of our citizens,” said Councilman Willis Meadows, shortly after the council’s first request to meet with the DSN board for an explanation in March.

Councilman Joe Dill said he had planned to propose a meeting with DSN on May 1, but is willing to wait until the May 15 date.

“None of us really realize what these people are going through,” Dill said, referring to parents of disabled clients who spoke during public input.

“It’s a major issue and a lot of people have been hurt and a lot have been neglected. The parents here were just a drop in the bucket,” Dill said after the meeting. So far, “all the paperwork says the board” is the source of the problems, he said.

Dill’s comments were in visible contrast to his portrayal in an email sent to the DSN board on Friday, April 6, by DSN board Chairwoman Roxie Kincannon. A copy of the email was given to the Journal by a source close to the situation.

Referencing a press release she sent out earlier that week, Kincannon wrote, “Try not to laugh too hard. Joe Dill says he is looking forward to having us come by and talk to his committee. I will let all of you know when and where. It will be nothing but positive, guaranteed. Joe couldn’t be happier about things.”

Kincannon said later in her email, “By the way, Joe Dill says he was misquoted and said that he said nothing negative about Patrick at all. He is completely on board with everything we’re doing, as is Butch (Kirven). Willis Meadows is the only one with a real issue and it’s purely a personal grudge against Patrick. … The take home message is that Greenville County Council is fine now.”

In addition, Kincannon wrote, “Also, ignore this business about Governor Haley. She won’t remove anyone from the board. Trust me on that.”

Haley spokesman Rob Godfrey said, “The governor only has the authority to remove board members for cause to include malfeasance, misfeasance, incompetency, absenteeism, conflicts of interest, misconduct, persistent neglect of duty in office, or incapacity. To date, no information has been presented to our office that would allow the governor to remove a DSN board.”

Staff writer April A. Morris contributed to this report.

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Concerned  - No justice for the underserved   |2012-04-19 13:20:33 The Board of directors,interim Executive Director and Residential Director should all be booted out immediately. The Board is self serving and could care less about the welfare of the consumers. If the parents could see how the consumers are poorly dressed, poorly fed and their health concerns go for months without proper medical treatment, Staff falsify records, the residential director Dawn Crawford should have been removed with the death of the consumer who was found in a building. The investigations into consumer abuse is a joke, if you are one of her pets, the incident gets swept under the carpet. If a consumer is from the community, they don't even use the same standards that apply to the consumers living in the residence. Program managers that fail to adhere to seizure protocols for consumers that suffered seizure for more that 5 minutes are given a pass. Patrick Haddon, hasn't a clue about this field and should have... Reply

Elizanbeth urrie  - DDSN   |2012-04-20 03:48:05 I thank you so much for continued reporting on DDSN. We, family members,friends, and other people who care about the special needs person will not stop until the problems are solved and proper care is srestored. The misappropation of funds should be a concern of evey tax payer in the state. Thank you and please continue to report the issues people need to know. Reply

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