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After paying $2,500 a month to a Pearl City care-home operator, the family of 79-year-old Chiyeko Tanouye thought she would be taken care of. Family still agonizes
Patients' ordeals described
over care-home deathBy Debra Barayuga
Star-Bulletin"I never expected this to happen," said Wayne Morikawa of his aunt, who apparently collapsed during a care-home outing in August 1999. She died the next day. She had been living at the care home for about four months.
"I thought it was going great and she was providing necessary care," Morikawa said yesterday of Raquel Bermisa, the care-home operator convicted for failing to provide proper care to Tanouye. Bermisa was sentenced yesterday to 20 years in prison, with a mandatory minimum of six years and eight months.
She is believed to be the first care-home operator in the nation to be prosecuted for causing the death of a patient through neglect, or manslaughter by omission.
State attorneys said they are not trying to make an example of Bermisa, but they will not hesitate to vigorously prosecute cases where there is evidence to support it.
"We were simply carrying out our duty as a law enforcement entity in enforcing the law," said deputy attorney general Michael Parrish, in response to defense charges that the state was trying to make an example of Bermisa.
Morikawa said he believes Bermisa's conviction puts other care givers on notice that they can't get paid and provide improper care to their patients without suffering the consequences.
According to state experts, untreated decubitus ulcers, or bed sores, became infected and led to complications that resulted in Tanouye's death. The defense had argued and their expert testified that Tanouye died of cardiac arrest, and not as a result of the ulcers.
"It's a sad case," Morikawa said. "We all felt my aunt didn't have to die if proper medical treatment was given."
He had been taking Tanouye to the doctor but Bermisa had offered to schedule appointments for his aunt at the nearby Kapiolani Medical Center at Pali Momi, so he left it up to her, he said.
While he was aware of the small bed sores his aunt had developed before she went into the care home, "Bermisa never told me about the blisters becoming that big."
When his aunt died, the ulcers were so large "you could stick a fist right through (them) ," he said.
According to a doctor, when Bermisa saw the sores getting worse, she should have brought it to the attention of doctors, he said. "The sad part is she had a couple more good years to live."
Tanouye had lost her husband about 1 1/2 years earlier, "but she had strong heart," said her younger sister, Kazue Kondo, 77.
"She didn't have to die ... she still can live some more," she said of Tanouye, her elder by four years.
Kondo couldn't help but feel sorry for Bermisa being sentenced to prison.
"I hate to see anybody go jail, especially so young," Kondo said. "But no matter how much I despise her, my sister not coming back."
Granddaughter Melissa Kondo, 23, said her father is angry because Bermisa hasn't apologized or admitted any responsibility. Bermisa didn't make any statements in court but her attorney, William Harrison said she never intended for Tanouye to die and feels remorse.
Kondo was appalled that Bermisa had even requested delaying serving her prison sentence to next Tuesday so she could visit a niece who had been hospitalized.
The family was just as upset that sentencing was continued from December because Bermisa wanted to shield her college-age daughter from the adverse publicity while she was home for Christmas break.
"My aunt didn't get to spend Christmas with her family, or see New Year's," Kondo said.
Kondo said when her grandmother gets too old to live on her own, she would gladly take care of her rather than sending her to a care home. "I can't see her ending up like my auntie."
Morikawa advised other families looking for a care home for elderly family members to take a careful look at the facility and talk to patients and their family members to get a better sense of the operator.
"I think my sister is satisfied," said the elderly Kondo as she left the Circuit Court building yesterday. "I think now she can rest in peace."
Family members of former patients and friends have commented on Raquel Bermisa's compassion and the quality of care she provided. Letter, state report
describe ordeals
of Bermisa patientsBy Debra Barayuga
Star-BulletinBut family members of other patients and the Department of Health have documented instances where the care Bermisa's patients received has been less than adequate and not in compliance with state regulations.
According to a sentencing statement filed by Bermisa, she was an adult residential care-home operator since August 1995 until the state revoked her license in February -- six months after the death of patient Chiyeko Tanouye in August 1999.
In one of numerous letters submitted to the court supporting Bermisa, Michael and Iris Pacheco called her "caring, meticulous" and a "professional."
They commented on the communication Bermisa had with them that helped alleviate the stress they and their mother endured.
They noted how Bermisa's "prompt and precise evaluation" of their mother's health resulted in her having to drive her to the emergency room on two separate occasions where Bermisa "waited with the love of concern, the love a mother has for her child."
But evidence the state couldn't introduce at trial because it was too prejudicial shows a less rosy picture.
In a November 1997 report by the Department of Human Services stemming from complaints about the care Bermisa provided, investigators confirmed "residents are not provided adequate food and psychological care."
The report recommended Bermisa "not take in any new residents until she complies with all regs and deficiencies."
An investigator noted he found one resident tied to a chair without doctor's orders. Bermisa had said she restrained the patient because the patient wanted to follow her to a doctor's appointment and her husband was outside hanging laundry.
Arlene Tanaka wrote a 10-page letter describing her two-year experience with Bermisa and how her mother's physical and mental condition deteriorated under Bermisa's care.
Within a year after entering Bermisa's care home, her elderly mother's weight went on a downward spiral. She began to grab at food family members brought and would stuff her mouth "like a starved animal," Tanaka wrote.
When Tanaka took her mother out to eat, she tried to eat paper napkins even after eating a complete meal and became agitated and refused to leave until she had eaten another meal.
Despite the weight loss, Bermisa insisted Tanaka's mother ate well.