On May 15, 2024 a
Motion-Secondary
was filed
involving a dispute between
In The Matter Of The Application Of Montefiore Medical Center, Petitioner,
For An Order Authorizing The Physicians And Staff Of Montefiore Medical Center, To Perform Such Medical Procedures Upon Anonymous As May Be Necessary To Preserve Her Life And Health. Respondent,
and
for Other Matters - Emergency Medical Treatment
in the District Court of Bronx County.
Preview
FILED: BRONX COUNTY CLERK 05/15/2024 04:10 PM INDEX NO. 807982/2024E
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 05/15/2024
SUPREME COURT OF THE STATE OF NE\V YORK
BRONX COUNTY
·-· ---- ·- ·-: ------· --- ·---- ·.----------· ----··-----· --- ·------ . ----. ---X
In the l\fatter ofthe Applicatioi1 of
MONTEFIORE MEDICAL CENTER,
P�titioner, AFFIRMATION
For uh Order Authorizing the Physicians and Staff
of!vfontefiore Medical Center. to Perform Such
•
Iv!edirnl Procedures·upollthe Pel'son .• of
asJday be Necessary to
Pteserve hei'Life..and Health.
Respondent.
· ------. ---------- ·-------- ·----------------------.. -. ----------- . -. - ·x
STATE OF NE\\! YORK )
: ss.:
BRONX COUNTY )
CANDACE HATTEN-PQ\\/ELL, t\l.D .. affirms this 10th day ofMay,2024, 1in:der the
penalties of perjury miderthe laws ofNe,\.' \; ork, ,vhich may include a fine or impri:sonment. that
the follmving is true, and I understand that this dotmnent may be filed inan action or ptoceedi11g
in a court of law.
L lam an Attending Physician in the Department of Psychiatry, Consultation Liaison
Sexvice a Uv1ontefiose I'v1edical Center, ("I\-1cmtefiore").
2. 1 ah1Jicensed to practice medicine in theState ofN ew Y otk and am Board-Ce1iified
i
in the f eld of Psychiatry.
3. 1s a. fifty-two (52) year�old female with a. history of
hYl"iertel'1sion, hyperlipideri1iiL. 111ultinodulat goiter. and stati.1spostkid11eftransplan:t with progressive
allograJtfailul'e. She Was ad1rtit'ted t(J M<))1tefrcire. on Febrtmrj' 15, 2024,.due to her suffering from
r�spiratory distress; causing EMS to initiate hei· mi 15 liters: ofOxygen via non-rebreather riasal.
1 of 3
FILED: BRONX COUNTY CLERK 05/15/2024 04:10 PM INDEX NO. 807982/2024E
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 05/15/2024
canula. While in the emergency department, she was placed on bilevel positive airway pressure and
required emergent intubation due to hypoxie respiratory failure secondary to renal failtire.
4. Pauline Smith is the healthcare agent for It is the unified
opinion of the treatment team that Pauline Smith is currently unable or unwilling tomake decisions
in the best interests of Pauline Sniith has consistently interfered with the care
of on occasions has instructed to pull tubes and to
convey misleading and at fimes incorrect information to treatment providers. Pauline Smitlfs
visitations had to be suspended due to her aggressive and chnically inappropriate interactions with
and care providers.
5. I have examined or attempted to examin on several occasions.
Additionally, 1 have discussed her coni·se of care and treatment with her treatment team, and
thoroughly reviewed her medical record. currently suffers from psychological
factors affecting other niedical conditions, severe and is currently unable to consent tatheproposed
treatment. has been ttnable to demonstrate capacity to consent to theproposed
treatment. While she has been able to consistently state a choice to decline a tracheostomy and
permanent dialysis catheter. she struggles to appreciate the riska and.alternutives to refusing all
medical procedures that would essentially preserve her life and health. Due to ongoing
psychological factors, she does not appreciate that she may die if she continues to refuse appropriate
medical intervention.
6. ismot able to communicate verbally. hut is able to consistently
conununicate via neat. coherent. and clear handwriting- which dentonstrates a linear thought
process. She clearly states that she is currently intubated, and that she will need to have a safe and
clear airway in order to be discharged from .the hospital She also shöws an understanding that
2 of 3
FILED: BRONX COUNTY CLERK 05/15/2024 04:10 PM INDEX NO. 807982/2024E
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 05/15/2024
dialysis has been a necessary part of her care ‰owever, has consistently refused
plac.ement of a tracheostomy and permanent dialysis catheter. though she is.unable to articulate
alternatives to the proposed treatnient as well as a rationale for the refusal. She often defers to her
healthcare agent for direction.
7. It is my opinion that as a result of the aforeinentioned diagnosis and re.1ated
symptoms. lacks the capaelty to make a reasoned decision with regard to the
proposed treatment as she is unable to coniprehend in a meanitigful way information presetited to
her. She is tinable to weigh the risks and benefits of refusiiig t1 e proposed treatme14 or that inaction
may lead to her death.
REQUESTFORA VIRTUALHEARING:
8. is in a medically compromised condition and coupled with her
comprised mental status. leaves her at risk of further physical and co.gnitive decline if she were to be
transported to the Bronx Supreme Court.
Dated: Bronx NewYork
May 10 . 2024 CANDACE
HATTEN-POWEll. M.D.
-3-
.. ............................................................ .................. . .
3 of 3
Document Filed Date
May 15, 2024
Case Filing Date
May 15, 2024
Category
Other Matters - Emergency Medical Treatment
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Preview
FILED: BRONX COUNTY CLERK 05/15/2024 04:10 PM INDEX NO. 807982/2024E NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 05/15/2024 SUPREME COURT OF THE STATE OF NE\V YORK BRONX COUNTY ·-· ---- ·- ·-: ------· --- ·---- ·.----------· ----··-----· --- ·------ . ----. ---X In the l\fatter ofthe Applicatioi1 of MONTEFIORE MEDICAL CENTER, P�titioner, AFFIRMATION For uh Order Authorizing the Physicians and Staff of!vfontefiore Medical Center. to Perform Such • Iv!edirnl Procedures·upollthe Pel'son .• of asJday be Necessary to Pteserve hei'Life..and Health. Respondent. · ------. ---------- ·-------- ·----------------------.. -. ----------- . -. - ·x STATE OF NE\\! YORK ) : ss.: BRONX COUNTY ) CANDACE HATTEN-PQ\\/ELL, t\l.D .. affirms this 10th day ofMay,2024, 1in:der the penalties of perjury miderthe laws ofNe,\.' \; ork, ,vhich may include a fine or impri:sonment. that the follmving is true, and I understand that this dotmnent may be filed inan action or ptoceedi11g in a court of law. L lam an Attending Physician in the Department of Psychiatry, Consultation Liaison Sexvice a Uv1ontefiose I'v1edical Center, ("I\-1cmtefiore"). 2. 1 ah1Jicensed to practice medicine in theState ofN ew Y otk and am Board-Ce1iified i in the f eld of Psychiatry. 3. 1s a. fifty-two (52) year�old female with a. history of hYl"iertel'1sion, hyperlipideri1iiL. 111ultinodulat goiter. and stati.1spostkid11eftransplan:t with progressive allograJtfailul'e. She Was ad1rtit'ted t(J M<))1tefrcire. on Febrtmrj' 15, 2024,.due to her suffering from r�spiratory distress; causing EMS to initiate hei· mi 15 liters: ofOxygen via non-rebreather riasal. 1 of 3 FILED: BRONX COUNTY CLERK 05/15/2024 04:10 PM INDEX NO. 807982/2024E NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 05/15/2024 canula. While in the emergency department, she was placed on bilevel positive airway pressure and required emergent intubation due to hypoxie respiratory failure secondary to renal failtire. 4. Pauline Smith is the healthcare agent for It is the unified opinion of the treatment team that Pauline Smith is currently unable or unwilling tomake decisions in the best interests of Pauline Sniith has consistently interfered with the care of on occasions has instructed to pull tubes and to convey misleading and at fimes incorrect information to treatment providers. Pauline Smitlfs visitations had to be suspended due to her aggressive and chnically inappropriate interactions with and care providers. 5. I have examined or attempted to examin on several occasions. Additionally, 1 have discussed her coni·se of care and treatment with her treatment team, and thoroughly reviewed her medical record. currently suffers from psychological factors affecting other niedical conditions, severe and is currently unable to consent tatheproposed treatment. has been ttnable to demonstrate capacity to consent to theproposed treatment. While she has been able to consistently state a choice to decline a tracheostomy and permanent dialysis catheter. she struggles to appreciate the riska and.alternutives to refusing all medical procedures that would essentially preserve her life and health. Due to ongoing psychological factors, she does not appreciate that she may die if she continues to refuse appropriate medical intervention. 6. ismot able to communicate verbally. hut is able to consistently conununicate via neat. coherent. and clear handwriting- which dentonstrates a linear thought process. She clearly states that she is currently intubated, and that she will need to have a safe and clear airway in order to be discharged from .the hospital She also shöws an understanding that 2 of 3 FILED: BRONX COUNTY CLERK 05/15/2024 04:10 PM INDEX NO. 807982/2024E NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 05/15/2024 dialysis has been a necessary part of her care ‰owever, has consistently refused plac.ement of a tracheostomy and permanent dialysis catheter. though she is.unable to articulate alternatives to the proposed treatnient as well as a rationale for the refusal. She often defers to her healthcare agent for direction. 7. It is my opinion that as a result of the aforeinentioned diagnosis and re.1ated symptoms. lacks the capaelty to make a reasoned decision with regard to the proposed treatment as she is unable to coniprehend in a meanitigful way information presetited to her. She is tinable to weigh the risks and benefits of refusiiig t1 e proposed treatme14 or that inaction may lead to her death. REQUESTFORA VIRTUALHEARING: 8. is in a medically compromised condition and coupled with her comprised mental status. leaves her at risk of further physical and co.gnitive decline if she were to be transported to the Bronx Supreme Court. Dated: Bronx NewYork May 10 . 2024 CANDACE HATTEN-POWEll. M.D. -3- .. ............................................................ .................. . . 3 of 3