Max moved a chair closer to the bed where his 31-year-old sister, also named Marina, lay. Chernyakova sat and silently rubbed Marina’s foot beneath the bedcovers. Caring for Marina has consumed the family’s life since October 2014, when Marina suffered a cardiac event at a tanning salon in Brooklyn that led to brain damage, leaving her bedridden and dependent upon a ventilator and feeding tube.
After that, Blagodar cared for her daughter at home, with the help of home health aides. Marina was admitted to ORMC Oct. 17 with low blood pressure, and hasn’t been allowed to leave. Her mother wants to bring Marina back home, but the hospital is petitioning for guardianship: It would allow testing of Marina’s brain function to determine the best care for her, according to court papers. But Blagodar said she is afraid the hospital just wants to cut off life support and let her daughter die.
A hearing scheduled for Nov. 21 before Orange County Supreme Court Justice Robert Onofry was adjourned until Dec. 12 to allow the county Department of Social Services, which has temporary guardianship of Marina, to secure her past medical records, which Blagodar at first refused to provide.
About a year ago, the family moved to the Town of Crawford. The spacious house and yard offered fresh air and quiet that their Brooklyn apartment could not. Blagodar found a doctor to provide regular care for Marina in Monroe; Max enrolled at Pine Bush High School, made friends and played football.
As part of Marina’s care, Blagodar said, she brought her daughter to ORMC for check-ups – the last one was in early October, and the doctors and nurses there couldn’t have been kinder, Blagodar said. Two weeks later, on Oct. 17, Marina’s blood pressure became dangerously low, and she returned to the hospital, with Blagodar at her side day and night.
Her condition improved to the point where discharge papers were being prepared, and a hospital bed was ordered to be brought to Blagodar’s home, according to Blagodar. But court records related to the guardianship petition cite otherwise: Marina had pressure ulcers with bone exposure, severe sepsis with septic shock, pneumonia, a urinary-tract infection, and gastrointestinal hemorrhage. Also, Blagodar refused to release previous medical records, and interfered with nurses providing care, court papers stated.
In the preliminary court appearance on Nov. 21, Blagodar refused Onofry’s order multiple times to release Marina’s past medical records, insisting it was not in Marina’s best interest. She said she was concerned that providing that information would smooth the path for the hospital’s intention to test Marina for brain death. Onofry assured her that the hearing itself was postponed, and urged her several times to release the needed records.
“This court believes it is in your daughter’s best interest that medical providers have all past case history,” Onofry told Blagodar, who stood crying with her son at her side. “How is it in your daughter’s best interest to conceal vital information?”
Finally, Max and his mother together named three hospitals and a couple of doctors who cared for Marina over the years, and DSS representatives said they would subpoena the medical records if necessary.
Until the hearing Dec. 12, however, Onofry ruled that Marina stay at the hospital.
“Based upon preliminary reports provided to the court ... because of the serious medical condition your daughter was in when she was admitted to the hospital, it calls into question the safety and efficiency of the medical care your daughter was receiving when she was treated,” the judge said.
“That was a lie!” Blagodar responded to the judge, adding that nurses and hospital staff fabricated reports that Marina’s ulcers had bone exposure.
Blagodar and her son pleaded with the judge for Marina’s return home, saying her weak immune system makes her more prone to infections in a hospital setting.
The judge was not moved: “I am not authorizing her return home, because of the condition of your daughter when she was admitted.”
“On Oct. 23, I was told that the palliative care team – hospice, end of life – wanted to meet with me,” Blagodar said, with a thick accent that belied her Ukraine birthplace. “I said, ‘No, thank you, we don’t need it.’ But they wouldn’t let her leave.”
Blagodar points to a whiteboard in the room. “Those people” - nurse leaders and other ORMC caregivers - “they lie about her condition. All they care about is organ donation. They want my daughter’s organs.”
On Nov. 1, Onofry granted Orange Regional’s petition for temporary guardianship of Marina. The petition - for which the Dec. 12 hearing is scheduled - included authorization for the hospital to perform a CAT scan of Marina’s brain and other tests to determine if she has suffered brain death. If brain activity is discovered, ORMC requested authority to choose Marina’s place of abode, either her home or a nursing home.
The alternative, however, is what alarms Blagodar: “If the neurological findings are conclusive that (Marina) is brain dead, the Petitioner (ORMC) requests an order directing the refusal, withholding and/or withdrawing all life support and devices,” additional court papers said.
Blagodar says further testing of Marina’s brain is unnecessary, as tests have been done over the years. She insists Marina responds to stimuli, and that she is not brain-dead.
“Once their testing is over, they could take her off of life support,” Blagodar worried. “This is not in her best interest. Every second I thank God I have her here with me. You don’t have to kill people just because they’re sick.”
“Our goal as a hospital is to compassionately care for the patients we serve, follow accepted medical standards, and adhere to New York State law,” Lee said. “We are responding accordingly to the situation at hand with the utmost care and diligence, but we cannot comment on the complex specifics of this particular case out of respect for patient confidentiality.”
Arthur L. Caplan, Ph.D., is head of medical ethics for NYU Langone Health. “The question becomes, if a patient has suffered so much brain damage that she could have brain death, who has the right to take the patient off life support?” Caplan said. “But you can’t ask a doctor to treat a patient without a proper diagnosis. The hospital should have the right to determine if the patient is dead.”
He said that a hospital’s pursuit of guardianship is not a common practice: “It’s difficult to remove a competent mom. They would have to prove she is harming her daughter. If there is no evidence her daughter is suffering or dead, they could rule in favor of the mother. But if the mother is in denial, and not doing what is in her daughter’s best interest, they could remove her.”
In the meantime, Marina is still unresponsive in a bed at the hospital, her eyes closed and mouth partly open. Intravenous lines, a ventilator tube, a feeding tube and other wires snake their way from various machines until they disappear under the sheets and blankets that cover her. Her mother sleeps in a chair beside her, worried what next month will bring.
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Mother, ORMC in court dispute over care of brain-damaged daughter
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