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Zablotny v. State Board of Nursing

Supreme Court of Maine

February 14, 2017

JOHN S. ZABLOTNY
v.
STATE BOARD OF NURSING

          Argued: October 27, 2016

          Janet T. Mills, Attorney General, and Andrew L. Black, Asst. Atty. Gen. (orally), Office of the Attorney General, Augusta, for appellant State Board of Nursing

          Joseph M. Baldacci, Esq. (orally), and Eugene M. Sullivan, Jr., Esq., Law Office of Joseph M. Baldacci, Bangor, for appellee John S. Zablotny

          Panel: SAUFLEY, C.J., and ALEXANDER, MEAD, GORMAN, JABAR, and HUMPHREY, JJ.

          ALEXANDER, J.

         [¶1] The State Board of Nursing (Board) appeals from a judgment entered in the District Court (Machias, D. Mitchell, J.) concluding that John S. Zablotny had engaged in certain activities that constituted professional misconduct pursuant to 32 M.R.S. § 2105-A(2) (2016) as alleged by the Board, but also concluding that the Board had failed to prove other allegations of professional misconduct. On appeal, the Board contends that the trial court erred when it concluded that the Board had failed to prove that Zablotny committed professional misconduct as defined in 32 M.R.S. §§ 2105-A(2)(F) and (H) when he did not fully inform the on-call physician of-or immediately notify law enforcement or the patients emergency contact about-the conditions under which a patient was leaving the Down East Community Hospital against medical advice.[1] We affirm the trial courts judgment.

         I. CASE HISTORY

         [¶2] The tragic events that generated this case are before us on appeal for a second time. See Zablotny v. State Bd. of Nursing (Zablotny I), 2014 ME 46,89A.3d143.

         [¶3] This case arises out of the death of a patient on January 1, 2008, near the Down East Community Hospital in Machias. Five days earlier, the patient, who was emaciated and suffered from several ailments, was admitted to the hospital with complaints of severe abdominal pain. While in the hospital, the patient was seen by physicians and several other health professionals and was treated with large doses of narcotics.

         [¶4] On January 1, a physician checking on the patient had no concerns for his "medical stability" and found no "obvious etiology" for the patients reported pain. After seeing the patient around noon, the physician left the hospital but remained on call. Later that afternoon, a nurse called the physician to inform him that the patient was in pain and requested more medication. Suspecting that the medication could be causing the patients pain, the physician ordered a decrease in the patients medications.

         [¶5] Around 6:30 p.m., a nurse caring for the patient notified the nursing supervisor that the patient was confused and needed restraints. However, the nursing supervisor found the patient to be quiet, lucid, rational, mentally competent and in no need of restraints. The patient told the nursing supervisor that he wanted to go home, and the nursing supervisor, knowing that his family had left, told him that he would have to sign the Against Medical Advice (AMA) form. When the patient asked for the AMA form, the nursing supervisor refused based on the patients condition and the weather.

          [¶6] Zablotny arrived at work at 7:00 p.m. as the nursing supervisor for the evening shift. The day shift nursing supervisor reported to Zablotny her concerns about the patient and told Zablotny not to let him leave AMA, to which Zablotny responded that the patient could leave if he signed the form.

         [¶7] Zablotny spoke with the patient who stated that he wanted to be discharged against medical advice. While Zablotny was in the room, the patient looked out the window and could see that the weather was an "old-fashioned Nor Easter"-bitterly cold, windy, snowy, and stormy.

         [¶8] At the time, no physician was present in the unit where the patient was admitted. Zablotny retrieved the AMA form and called the on-call physician pursuant to hospital policy. Zablotny explained to the physician that the patient wanted to leave AMA and that the patient had indicated that he intended to go to a friends house, but Zablotny did not inform the physician of what the patient wore for clothing or that he intended to walk to the friends house. Based on the information relayed to him by Zablotny, the physician, who had seen the patient earlier in ...


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