Care-homeA Circuit Court jury today found Raquel Bermisa guilty of one count of manslaughter in a case that may set a nationwide precedent in prosecutions of care-home operators suspected of failing to provide proper care to patients.
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The jury began deliberating yesterday to decide if Bermisa, a Pearl City care-home operator, committed manslaughter in the August 1999 death of 79-year-old Chiyeko Tanouye.
Sentencing is scheduled for Dec. 19. Bermisa faces up to 20 years in prison. Her bail was set at $10,000.
Bermisa is believed to be the first care-home operator in the nation to face manslaughter prosecution in the death of a patient who may have died of complications from bed sores.
The jury had the option of returning a guilty or not guilty verdict, or choosing a lesser charge of second-degree assault.
In his closing argument yesterday, state Deputy Attorney General Michael Parrish said Tanouye was able to care for herself and function in her daily routines when she checked into Bermisa's care home. But Tanouye developed bed sores and did not receive prompt medical attention.
Three months and one week after she checked into the home, Tanouye was rushed to a hospital emergency room unconscious. A day later, she died of infection as a result of complications from bed sores, Parrish said.
Tanouye's death could have been prevented if Bermisa had fulfilled her "legal obligations" to provide care for Tanouye, Parrish said. Bermisa "was aware (the death) could happen and had the tools to prevent it," but consciously and recklessly ignored her duties, he said.
However, defense attorney William Harrison said his client did not intentionally or knowingly cause Tanouye's death, which he said was due to heart failure. Bermisa gave good care to Tanouye and delayed doctor's appointments because she simply did not understand the seriousness of the bed sores.
"She made a mistake," Harrison said. "She cannot be punished for making a mistake. She was not conscious that her act would cause the death." Bermisa took Tanouye to the doctors seven times in three months, but made "a mistake for not taking her to the doctor quicker" for the bed sores.
Parrish argued that the "mistake" lasted two weeks, during which Bermisa did not take Tanouye to her regular Meals on Wheels lunches. An autopsy showed Tanouye had not eaten for some time, and physical evidence showed she had been neglected.
But Harrison said witnesses testified that Tanouye always appeared well cared for, and the evidence does not support the state's contention that Tanouye died of complications from bed sores.
The state hired medical experts from the mainland and Maui to provide testimony in support of the manslaughter charge, Harrison said. But none of them was a specialist in treating bed sores.
The defense's medical expert, a Honolulu doctor who has treated 10,000 patients with bed sores, said Tanouye did not die from bed sores, Harrison said. Dr. Steven Berman testified that hospital records indicated Tanouye was not malnourished.
Bermisa did not neglect Tanouye or any of the other patients at the care home, Harrison said.
If convicted of manslaughter, Bermisa may face a 20-year prison sentence. If she is convicted of second-degree assault, she may be sentenced to prison for five years.