National Association to Stop Guardian Abuse: Orlando guardian’s client wanted to live, but she overruled him, hospital staff testify

Thursday, September 15, 2022

Orlando guardian’s client wanted to live, but she overruled him, hospital staff testify

By Monivette Cordeiro

Rebecca Fierle, sits in a Tampa courtroom on trial having been charged with aggravated abuse and neglect of an elderly or disabled adult in Tampa, Fla., Wednesday, Sept. 14, 2022. Fierle is charged in the case of Steven Stryker, a 75-year-old man whose death sparked a statewide scandal in Florida’s guardianship system. (Willie J. Allen Jr./Orlando Sentinel)

TAMPA — When psychiatrist Dr. Kirtikumar Pandya examined Steven Stryker at Tampa’s St. Joseph’s Hospital in 2019, the 75-year-old man showed cognitive problems with memory and judgment but was clear on his desire to continue treatment, Pandya testified in court Wednesday.

“Did you indicate ... that he was able to determine that he wanted to live?” Assistant Statewide Prosecutor Cass Castillo asked.

“Yes,” Pandya answered.

“Was that your opinion — that he was able to make that decision?” Castillo asked.

“Yes,” the psychiatrist said.

Prosecutors say that went contrary to the desires of his court-appointed caretaker, former Orlando guardian Rebecca Fierle, who signed a “do not resuscitate” order on Stryker’s behalf against his wishes and ordered medical staff at a Tampa hospital to cap his feeding tube, despite warnings that he could choke and die.

Stryker aspirated and died five days after the tube was capped.

Fierle, 53, is charged with aggravated abuse and neglect of an elderly or disabled adult in the case of Stryker, whose death sparked a statewide scandal in Florida’s guardianship system. Fierle, who pleaded not guilty, has denied wrongdoing in the past.

Prosecutors are expected to rest their case against Fierle early Thursday. On Wednesday, jurors heard from an array of hospital staff members who said she went against Stryker’s wishes, favoring choices she claimed would prioritize the “quality” of his life over its length.

A Florida Department of Law Enforcement investigation found Fierle left St. Joseph’s staffers unable to take lifesaving measures because of the DNR order. Jurors, though, did not hear about the order after a judge ruled to exclude it from the trial.

Fierle’s attorneys argued the DNR “never came into play” in Stryker’s death because Stryker was found deceased in his hospital room and no care or treatment was ever withheld from him because of the order.

“Any discussion of the DNR has the risk of inflaming the jury and improperly appealing to their emotions,” Circuit Judge Robin Fuson wrote in a June 13 order.

Stryker was a patient at AdventHealth Orlando in 2018 when the hospital asked a judge to declare him incapacitated and appoint Fierle to make all his decisions. Stryker had a history of dementia and suffered from multiple conditions, including esophageal strictures, which made swallowing difficult and required him to use a feeding tube, medical staff testified.

While under Fierle’s care, Stryker was in different hospitals and assisted living facilities, staff said. It was difficult to place Stryker in an assisted living facility because of his feeding tube and his registration as a sex offender for lewd exhibition, according to staff.

While Stryker was at St. Joseph’s Hospital starting in April 2019, nurse practitioner Julie Thomas said Stryker told her he wanted to continue aggressive medical measures to prolong his life. She told jurors she takes what dementia patients say with “a grain of salt” because they’re not consistent.

Pandya told jurors Stryker did not have the capacity to make quality-of-life decisions or understand the full scope of his medical issues, so he asked for a consultation between the hospital ethics committee and Fierle.

Nelson Lezcano, a doctor at St. Joseph’s Hospital who treated Stryker, said Fierle told medical staff at the meeting that she wanted Stryker’s feeding tube capped so he would be accepted into an assisted living facility despite their warnings of the risk.

“Why did you cap the feeding tube if it didn’t have a medical benefit?” Castillo asked.

“It was a request from [Fierle],” Lezcano said. “... At some point, specifically, she said she preferred the patient to have quality over quantity of life.” (Click to continue reading)

Full Article & Source:

Orlando guardian’s client wanted to live, but she overruled him, hospital staff testify

Ex-guardian Rebecca Fierle may not stand trial in ward’s death until 2021, attorney says