To ‘love, honor, and protect’: Man seeking answers in wife's nursing home death

On March 21, 1984, Robert Horozy took a vow.

The longtime bachelor, then 39, had reunited with Patricia Misenti, then 40, a fellow member of the Francis T. Maloney High School Class of 1962 in Meriden. Bob and Pat rekindled their attraction to one another, dated for two years, and decided to get married. It was on that first day of spring in 1984 that Bob pledged to “love, honor, and protect” his wife.

Eight years later, Bob would have to make another vow to his wife.

In 1992, after experiencing episodes of fatigue, imbalance, and inexplicably dropping things, Pat was diagnosed with multiple sclerosis. For the couple, who hadn’t planned on having kids but did plan on growing old together, it changed things dramatically. After receiving the diagnosis, they drove to Hammonasset Beach State Park, where they walked out onto the jetty and exchanged promises to one another.

Bob told Pat they were dealing with an “unknown,” but going forward Pat would “never face MS alone on any given day.” However, Pat also had to promise that she would tell Bob when she’d had enough, because it wouldn’t be fair to either of them for him to continue fighting for someone who no longer wanted to live. According to Bob, Pat saw it as an “even exchange.”

“That was the foundation — I wouldn’t let her face anything by herself in the future, but when it came time that she had had enough because we don’t know what we’re facing, she had to tell me, ‘This is it, Bob, I’ve had enough,’” he said.

By 1995, Pat’s illness started affecting her work as a senior pension specialist at Aetna, but she qualified for early retirement, which included a pension and health care benefits, and she took it. Bob was downsized from Aetna the following year.

Over the next decade, Bob cared for Pat in their townhouse-style condominium in Meriden, which had been outfitted with durable medical fixtures that included a special alternating air mattress to help with bedsores. Over time, Bob learned everything he could about Pat’s illness and increasing comorbidities, becoming well acquainted with the Merck Manual Home Health Handbook, and picking the brains of Pat’s caregivers.

In March 2006, Pat started having severe seizures, launching them on what Bob calls the “institutionalization voyage.” Though the goal was always to bring Pat back home, where Bob could care for her with the help of a home health care aide, her stints in acute care, acute rehabilitation, and skilled nursing facilities became more frequent.

In 2007, while Pat was recovering from a seizure at Yale-New Haven Hospital, a group of caregivers, struck by the couple’s devotion to one another, presented them with paperwork that would designate Bob as Pat’s power of attorney.

They were told it was the “gold standard” in health care protection, and, when it was explained to Pat that she would giving him the  right to make decisions in her stead, she said something to the effect of “Well, I signed the marriage certificate, so why not sign this?” Bob recalls.

The power of attorney became increasingly important as the years passed, and Pat’s medical troubles compounded to the point of leaving her bed-bound, quadriplegic, and fitted with a feeding tube. Though her speech was affected, making it harder for her to talk with people unfamiliar to her, she and Bob continued to communicate on levels spoken and unspoken.

Hawkish oversight

As Pat’s condition deteriorated, Bob’s hawkish oversight of Pat’s care grew. Having observed varying degrees of quality, attentiveness, and understanding of his wife’s medical history in certain caregivers, he started keeping a list of hospitals and nursing facilities that he wouldn’t permit Pat to be transported to, leading to long stand-offs with hospital administrators.

In August 2017, an administrator from the Hospital of Central Connecticut in New Britain petitioned the Berlin Probate Court to have a conservator of the person appointed for Pat, saying she had been eligible for discharge since April, but her discharge couldn’t be completed due to a “lack of cooperation” from Bob.

Though Judge Walter A. Clebowicz ruled that Bob was the most appropriate person to be Pat’s conservator and appointed him as such, he ordered Bob to cooperate with the hospital on a safe discharge, be it home, to a skilled nursing facility, or to a skilled nursing facility and then home.

Bob was unable to take Pat home because her alternating air mattress, which promoted blood flow to minimize the bedsores she was prone to, was broken. So the court eventually ordered Pat’s release to Fresh River Healthcare in East Windsor, one of the few skilled nursing facilities that offered to take her.

Bob protested Pat’s discharge to Fresh River on the grounds that the facility wasn’t equipped to accommodate her needs, but the judge overruled him and Pat was sent there in February 2018.

Through the spring and summer, Pat was between Fresh River and St. Francis Hospital and Medical Center in Hartford for treatment.

During this time, Bob didn’t visit Pat at Fresh River. They’d agreed he should focus on getting her out of there, and Bob also didn’t want to be pressured to sign Pat’s admission documents to Fresh River, which, according to him, contained a paragraph that would exculpate Fresh River from being sued if anything were to happen to Pat.

In July 2018, Pat was at St. Francis, and Bob was blocking her discharge back to Fresh River. Jurisdiction at this point had shifted to the Greater Windsor Probate Court, and on July 19, Judge Marianne Lassman Fisher suspended the power of attorney that gave Bob power over Pat’s health care decisions, appointing New Hartford lawyer David C. Shepard conservator of the person for Pat. Shepard allowed Pat’s release back to Fresh River.

On Nov. 12, Bob got a call from Shepard saying that Pat had been admitted to St. Francis for what they’d later find out were fractures in each of her thighbones. In a Nov. 16 email to Judge Lassman Fisher, Shepard described the injuries as “unexplained” bilateral femur fractures that were causing “significant bleeding into her pelvis, dropping blood pressure, infection, and significant pain.”

Alhough Pat had osteoporosis, Bob was baffled as to how she could break both thighbones. When he saw her in the hospital, he asked her if she knew why she was there. She said she didn’t know. He told her about her legs, and she was beside herself. Then he asked her about the level of care she was receiving at Fresh River.

“All she kept saying was, ‘They don’t listen to me, and they’re too rough with me,’” he said.

Judge allowed code status change

Though her condition was serious, Bob believed Pat would bounce back, as she always had. But the doctors believed she was at the end of her life.

In court documents, Shepard reported that the complexity of Pat’s medical problems prohibited surgery to mend the fractures, and that doctors were recommending only pain relief and comfort care be administered.

However Pat was listed as “full code status,” which meant she wanted all life-saving measures to be applied, and Shepard’s limited conservatorship didn’t give him the authority to change it.

In his Nov. 16 email to Lassman Fisher, Shepard requested an emergency hearing to consider the request, as well as to consider whether decision-making authority should be returned to Bob.

The emergency hearing was held in the St. Francis intensive care unit on Nov. 17, and Lassman Fisher ruled that Shepard could change Pat’s code status from full code to comfort measures only.

Once the judge issued the decree, Bob was crushed.

“I knew it was a death sentence,” he said.

Bob said Pat understood what the full code was, and that’s what she wanted. Over the years, they had established code words and phrases to help him determine whether she’d had enough, and there was one that she had yet to say.

“If she told me she couldn’t pull another rabbit out of the hat, I’d know that was enough,” he said, “and she never said that.”

Seven days after the emergency hearing, Pat died at 74. Her official cause of death is listed as hypertension and hypoglycemia.

David Skoczulek, a spokesman for the Manchester-based iCare Health Network, which owns and operates Fresh River, said the company is bound by privacy laws from commenting on the care of specific residents. He also said he couldn’t confirm that Pat was even a resident of Fresh River.

Skoczulek went on to say that it is Fresh River’s policy to “immediately and thoroughly” investigate any reports or findings related to an accident or injury suffered by a resident in its care, including findings related to “underlying and pre-existing conditions.”

“We do so whether an injury is reported by a resident, staff member, family member, or guest, or if a finding is discovered during care that merits further investigation,” he said.

Skoczulek added that Fresh River “stands by the quality of care it delivers,” and, like other nursing homes in the state, is subject to regular survey and inspection by the state Department of Public Health.

DPH wouldn’t answer specific questions about Pat Horozy. The Journal Inquirer also submitted a freedom-of-information request seeking access to documents related to any DPH investigation into injuries or suspicious deaths of patients at Fresh River in the pertinent time period.

An official with the department’s Facility and Licensing Investigations section responded to the request saying there was one such case, but it was still under investigation and therefore no information would be released.

The only call the East Windsor Police Department received from Fresh River during the time in which Pat’s legs would have been broken and she would have been hospitalized was a medical aid call on Nov. 11 requesting assistance with an “unruly patient.” The call log says that one person was transported to the hospital, though it is unclear whether it was Pat.

Since Pat’s death, Bob, now 74, has hired Cheshire lawyer Robert Santoro to help investigate “any possible claims.” They declined to speculate what they think may or may not have happened to Pat, acknowledging that they have yet to see any record of how she suffered her injuries. Bob said Fresh River had sent him a registered letter, but he declined to sign for it.

In the meantime, Bob visits Pat every day at Sacred Heart Cemetery in Meriden, except when the weather makes driving hazardous. He still refers to her in the present tense, not only for the recency of her death but also because he remains driven by the same vow he took almost 35 years ago.

“My holy mission is to bring dignity and justice to my wife,” he said.

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To ‘love, honor, and protect’: Man seeking answers in wife's nursing home death