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Death raises questions after Ill. hospital closure

Friday, September 30, 2011

CHICAGO (AP) ó A bedridden patient who predicted he wouldn't survive a move from a now-closed Illinois charity hospital has died three weeks after his transfer to a nursing home, family and friends said Thursday.

The death of Michael Yanul, 58, who had muscular dystrophy and breathed with a ventilator, raises questions about how Cook County managed patient transfers while closing the hospital in Chicago's south suburbs.

Facing a multimillion-dollar budget deficit, Cook County convertedOak Forest Hospital to an outpatient center in August to save money. Earlier this year, protesters opposed to closing the hospital carried Yanul's photo, enlarged to poster size, to several public hearings. They said they wanted officials to see the faces of patients who could be harmed if the hospital closed.

The last nine patients, including Yanul, were moved into private homes and other health care facilities by the end of August.

Yanul resided at Oak Forest where he received continuous care for 17 years, long enough to have others decorate his room with Beatles posters and glow-in-the-dark stars. He moved into a nursing home chosen by his family Aug. 31. Yanul's brother, Tom Yanul, said he died Sept. 20 of pneumonia and a blood infection after a series of problems with his care.

Cook County Health spokeswoman Marisa Kollias said the county has "an elite team" that makes sure transfers go smoothly. Following standard practice in the health care system, the county is not officially tracking the hospital's former patients after the transfers, Kollias said.

"Cook County Health and Hospitals System is extremely saddened by the death of Mr. Yanul," she said. "He was a member of Oak Forest Hospital community for several years."

Tom Yanul has filed a complaint against the nursing home with theIllinois Department of Public Health. He said Oak Lawn Respiratory and Rehab broke promises for how Michael Yanul would be cared for, lacked needed equipment such as a heated humidifier for Yanul's ventilator and didn't educate staff about Yanul's needs.

When Yanul first arrived at the nursing home, his brother said, his room didn't have a call button he could operate. The room's call button worked with a cord, which Yanul didn't have the strength to pull.

"He had very limited use of one hand and no strength," Tom Yanul said. Days went by before the nursing home installed a doorbell-type call button Yanul could use, Tom Yanul said.

Phone messages left for the Oak Lawn nursing home's administrator weren't immediately returned.

Oak Lawn Respiratory and Rehab is in the same building as a nursing home that lost its state license after repeated problems. New owners took over the facility in September of last year.

Transferring ventilator patients requires detailed planning, including making sure the new facility has similar equipment, said Steven Sittig, a respiratory therapist and pediatric transport clinical specialist at Mayo Clinic in Rochester, Minn. Sittig chairs the transport specialty section of the American Association for Respiratory Care.

"The logistics of it are very complex. It goes beyond the normal discharge planning," Sittig said. "As the sending facility, you make sure all the fine points of the patient's care are relayed on, such as the need for active humidification, the time and involvement for (tracheostomy tube) care, ventilator settings and that the staff is knowledgeable of the ventilator and how to troubleshoot it."

Deborah Kennedy of Chicago-based advocacy group Equip for Equality said the group intends to investigate Yanul's death pending the outcome of a possible state investigation. An Illinois Department of Public Health spokeswoman could not confirm whether a complaint had been received or if an investigation would be conducted.

"I am very troubled by this patient's death," Kennedy said. An investigation by Equip for Equality, she said, would focus on the transfer process. "Was it rushed? Were his needs fully articulated? Did someone look carefully at whether the facility they sent him to could satisfy his needs? Given that this patient died, where was the breakdown?"

Juanita Gibbs, a friend of Yanul's, was highly involved in his care for many years. She said Yanul loved the care he received at the now-closed hospital and predicted he would die if he had to move.

"He didn't want to be moved because he knew the outcome," Gibbs said. "He said he was signing his death warrant."

Yanul told The Associated Press in April that he was "devastated" to think Oak Forest might close: "The doctors and nurses here have kept me alive. I can't breathe on my own."

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