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Thursday, October 19, 2000

Medical experts to
testify in care-home death

By Suzanne Tswei

The state and the defense plan to call medical experts to testify in the manslaughter trial of a care-home operator who is charged with the death of a 79-year-old patient.

Both sides said they have the medical proof to support their cases in the trial of Raquel Bermisa that began yesterday. Bermisa is believed to be the first care-home operator in the nation to face manslaughter prosecution in the death of a patient who died of complications from pressure sores or bed sores.

Bermisa had pleaded no contest in March to manslaughter by omission for failing to provide proper medical attention for Chiyeko Tanouye, who died in August last year. Bermisa was allowed to withdraw her plea after claiming she did not know expert testimony by an infectious-disease doctor was available.

The state will call on forensic experts and Tanouye's doctors to show that Bermisa failed her "legal duty" to care for her patient, deputy attorney general Michael Parrish said.

Bermisa's failure to follow doctors' orders to return Tanouye for treatments led to an infection that caused fatal heart failure, he said.

Defense attorney William Harrison said he will call on a Hawaii doctor who is an expert in treating pressure sores to show that a sore on Tanouye's back did not cause her death. Tanouye simply died of cardiac arrest, he said.

"She was an independent and feisty woman (who) ... had a number of medical problems," including small strokes that caused her to lose her balance and fall, Harrison said. Her falls and high blood pressure led to a large pressure sore on her back, he said.

Parrish said Tanouye was in "relative good health" and could care for herself when she entered Bermisa's care home, but soon developed a sore on her back the size of a fist.

Tanouye sought and received medical treatment initially, but "was withering away, and the sore was getting bigger and more unmanageable" after Bermisa failed to return her to follow-up appointments, Parrish said.

Tanouye was taken on Aug. 9, 1999 to a hospital emergency room unconscious, "basically DOA" -- dead on arrival, Parrish said.

Hospital staff revived her, but she died a day later.

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