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When Dr. Yoshio Hosobuchi of the University of California at San Francisco performed an experimental procedure in December, 1990, to implant platinum electrodes into the brain of Terri Schiavo as a "brain stimulator", he was a licensed physician.
However, according to records obtained by The North Country Gazette, since that time Hosobuchi has been the subject of several public reprimands for professional misconduct including a recent suspension of his medical license for 90 days for performing "unnecessary surgery".
His assistant, CD Yingling who traveled to Florida in April, 1991, four months after the implant surgery, is reportedly not licensed to practice medicine and according to public records, carries only a doctor of philosophy or PhD.
Terri Schindler-Schiavo, 41, suffered serious brain damage as the result of a mysterious incident on Feb. 25, 1990, at her Florida home when she was 26 years old. She died March 31 of starvation and dehydration after her feeding tube was removed by her husband on the order of Florida's Sixth Judicial Circuit Court judge George W. Greer. Schiavo and his lawyer, George Felos, claimed that Terri was in a persistent vegetative state with no hope for recovery and would not want to be kept alive by assisted feeding. They petitioned Greer to remove the feeding tube. She left no living will or advanced directive but Schiavo claimed she had told him that she would not want to be kept alive by artificial means although at the time he says she made the statement, feeding tubes were not considered a means of artificial life support.
Under Florida law, PVS is defined as a permanent irreversible condition of unconsciousness in which there is the absence of voluntary action or cognitive behavior of ANY kind and an inability to community or interact purposefully with the environment. (See Medical Chart Below)
Terri's parents, Mary and Robert Schindler Sr., disputed Greer's PVS finding and said that their daughter responded to them, was alert and aware and would want to live.
In November, 1990, Dr. David Baras, medical director of Bayfront Rehabilitation Center in St. Petersburg where Terri was being treated, said that her "last hope" would be to undergo experimental surgery to be performed by Hosobuchi in California.
Fund raisers were conducted by her parents, Mary and Robert Schindler Sr. as well as her husband, Michael Schiavo during the fall of 1990 after Prudential Insurance Company of America refused to cover the cost of the surgery, estimated to be $100,000, because it was experimental. Terri had worked for Prudential prior to her injury and was insured by the company. As of 1990, prior to the medical malpractice lawsuits brought by Michael Schiavo against Prudential Insurance Company and prior to the settlements, Schiavo and the Schindlers were still speaking.
In December, 1990, Michael Schiavo accompanied his wife to California where the surgery was performed to implant platinum electrodes into Terri's brain, electrodes which were reportedly never removed and remained in Terri's brain for 15 years. According to medical experts, leaving the electrodes in her brain could have caused infection and medical complications. http://www.fda.gov/cdrh/safety/neurostim.html
See also http://www.northcountrygazette.org/articles/102705SchiavoImplant.html
"The FDA has received several reports of serious injury, including coma and permanent neurological impairment, in patients with implanted neurological stimulators who underwent magnetic resonance imaging (MRI) procedures. The mechanism for these adverse events is likely to inovle heating of the electrodes at the end of the leadwires, resulting in injury to the surrounding tissue. Although these reports involved deep brain stimulators and vagus nerve stimulators, similar injuries could be caused by any type of implanted neurological stimulator, such as spinal cord stimulators, peripheral nerve stimulators and neuromuscular stimulators" stimulators, and neuromuscular stimulators". http://www.fda.gov/cdrh/safety/neurostim.html
Schiavo testified that "The protocol for the stimulator was three months" but he kept it on Terri for a year, even though he knew that leaving the stimulator on longer than three months could harm or even kill Terri.
According to the California Medical Board, Hosobuchi who lives in Riverdale, NY, is currently licensed as a physician and surgeon in that state but recently had his medical license suspended for 90 days with terms and conditions. Records indicate that disciplinary action against Hosobuchi's medical license was imposed by the Hawaii Board of Medical Examiners in a decision effective Feb. 11, 2004, with a public reprimand issued Sept. 14, 2004. In addition to his medical license being suspended, he was also assessed administrative costs of $2,000. http://www2.dca.ca.gov/pls/wllpub/WLLQRYNA$LCEV2.QueryView?P_LICENSE_NUMBER=17232&P_LTE_ID=790
According to the January, 2005, Action Report of the Medical Board of California, Hosobuchi was disciplined by Hawaii for performing unnecessary survey on a patient. He reportedly completed an educational course.
Records also indicate that he received an earlier public reprimand for alleged professional misconduct in 2003.
Records indicate that Hosobuchi graduated from Loyala University of Chicago's Stritch School of Medicine in 1964 and joined the University of California at San Francisco faculty in 1969. He was listed as a board certified neurosurgeon in 1994, after the surgery on Terri.
At the time of the proposed surgery on Terri in 1990, Dr. Raj Narayan, associate professor of neurosurgery at Baylor College of Medicine, said that he was familiar with Hosobuchi's work and said that the proposed procedure was experimental. He said little had been done with in the United States and that the procedure had only been performed on 120 patients worldwide, most of it in Japan and Europe. At that time, Narayan said that the operation was considered risky with only 30% of the patients showing improvement.
However, according to the medical observations of Terri recorded after the surgery, she was showing improvement. But less than four months after the surgery, in which many experts say was inadequate time, Hosobuchi's assistant, Yingling who had no medical license but whose field of expertise was allegedly interpreting EEG's, traveled to Florida. Thereafter, the sensory stimuli treatment was ceased and her therapy was reduced to once a week although he admitted probably six months or more would be needed to see improvement and he failed to obtain a machine needed for testing of Terri.
In a November, 1993, in a deposition before the unrelated medical malpractice trial, Michael Schiavo said under oath that Yingling failed to obtain equipment that he needed to conduct testing of Terri, had "loads of wine" at dinner and spilled it all over the couch at Schiavo's home.
Thereafter, despite the medical reports of marked cognitive awareness by Terri Schiavo, George Felos, Michael Schiavo's attorney, reported misled both the public and the court by stating that "tests show that she is in a vegetative condition and has no consciousness". He claimed that "there has been nothing new brought up in this case for years now" and that her condition has been "essentially the same as it has been the past 13 years". Although brain scans were later introduced and said to be Terri's, they failed to show the platinum electrodes which were still implanted in her brain, raising question if the scans produced were those of Terri Schiavo or some other individual.
Felos had claimed that "Terri's cerebral cortex has atrophied. It's gone. She had no consciousness", Felos told the public on Fox TV.
But the medical reports contradicted Felos and raise serious questions as to the level of awareness that Terri Schiavo may have reached had her therapy not been discontinued for over 10 years following a determination by non-physician Yingling and a refusal by Michael Schiavo to allow Terri to be given therapy and rehabilitation after he received the $750,000 which had been awarded by the jury in the medical malpractice trial, earmarked for Terri's rehabilitation.
In his pre-trial deposition in November, 1993, Michael Schiavo's testimony was as follows with attorney James Sheehan of St. Petersburg conducting the deposition and Steven Nilsson representing Schiavo.
SHEEHAN: Tell me about Doctor Hosobuch and his treatment of Terri.
SCHIAVO: Well, the basic thing was we took her to California. He had some experimental stimulators that he was placing in peoples' heads. There were some people that work up. It's a whole protocol on it. I don't have it with me. But it would be very experimental. He put it in. He did some testing. There was no evidence of it working with Terri. The only thing it would do, when he turned it up passed a certain point Terri would just sit up, which was just motor response. She would just get real bright-eyed because things were being stimulated. He wasn't thrilled about it because he didn't see any positive signs.
SHEEHAN: Was---did he implant anything into her? Did he put anything in her head that remained?
SCHIAVO: Yes
SHEEHAN: Are they still?
SCHIAVO: Yes.
SHEEHAN. What are they?
SCHIAVO: Electrodes. They're platinum electrodes.
SHEEHAN: Did he suggest any future treatment that was experimental-----
SCHIAVO: Treatment for what?
SHEEHAN: --in California. Diagnostic testing, anything of that nature?
SCHIAVO: No. When Doctor Yingling was here, he came out and basically, if it didn't work within-
NILSSON: The question is with whoever the doctor was in California.
SHEEHAN: Is there an objection? He's answering the question.
NILSSON: I'm going to ask the witness to be responsive. You're asking about a different doctor than Yingling. Your question was about the doctor in California.
SHEEHAN: I think his answer is responsive to my question. Just the fact that there is another doctor involved, let him answer.
NILSSON: I want the witness to be responsive to the question. If you're asking about the doctor in California, that's what I want the witness to tell you about the extent he has knowledge.
SHEEHAN: If he's not responding to my question, I think that's my objection.
NILSSON: Well, it's my objection.
SHEEHAN: We can do this all day. You started to-----
SCHIAVO: Repeat your question.
SHEEHAN: My question was; Was there a suggestion of further diagnostic testing or procedures after the treatment by Doctor Hosobuchi in California?
NILSSON: Objection. Overly broad. Vague and ambiguous.
SCHIAVO: As far as I can remember----
NILSSON: Are you talking about a suggestion by that doctor in California. Jim, I don't mean to be funny with you but there's lots of doctors. Are you asking about all the doctors, any treatment after that?
SHEEHAN: I'll tell you what----I will tell you what, if you want to play this game, I'm going to ask him about Doctor Hosobuchi and then my next question is going to be about Doctor Yingling. Eventually, we're going to get it.
NILSSON: Okay. That's fine. But for you to ask any suggestion of further analysis after some event in California when that could have happened a dozen times, to me, it's overly broad, vague and ambiguous. Now, if you got the doctor in California and want to know what the doctor said, ask him that question and if you don't, I'm going to object.
SHEEHAN: Did Doctor Hosobuchi, after he saw Terri, recommend any further diagnostic procedures?
SCHIAVO: He recommended that Doctor Yingling would be doing it.
SHEEHAN: So did she see Doctor Yingling?
SCHIAVO: She---Doctor Yingling came out here, I believe, a year later.
SHEEHAN: And that was at the suggestion of Doctor Hosobuchi?
SCHIAVO: That, I have no idea.
SHEEHAN: Okay. What did Doctor Yingling say or do, to your knowledge?
SCHIAVO: He came out---Terri was at Mediplex-he came out and did some testing, and he needed a CP-900 machine or something from Shands, and it wasn't available, and he said it wasn't no big deal. He told me he had---he didn't see any evident sign that the stimulator was working, did some tests with Terri. Nothing was new with her from the time he had last seen her. And that was basically it. We took him out to dinner and he had loads of wine and that was it. He spilled it all over our couch.
SHEEHAN: Other than Doctor Hosobuchi and Doctor Yingling----was Doctor Yingling also from California?
SCHIAVO: Yes.
SHEEHAN: And he was somebody that Doctor Hosobuchi suggested see Terri?
SCHIAVO: He was Hosobuchi's assistant.
SHEEHAN: Has she seen any other experts such that time?
NILSSON: Objection. Overly broad and ambiguous.
SCHIAVO: What type of experts?
SHEEHAN: Since Doctor Yinglin saw her, what physicians have seen her?
SCHIAVO: She's seen Doctor Lyles?
SHEEHAN: And who is Doctor Lyles?
SCHIAVO: He's a physiatrist (sic)---I don't know how to say that----
SHEEHAN: Physiatrist?
SCHIAVO: Yeah-at Health South. She has seen Doctor Becker for gastrostomy problems. Doctor Mina Chang for gynecology. Doctor Porter for her teeth. Doctor Harrison for neurology. Doctor Mulroy.
SHEEHAN: What is Mulroy's specialty?
SCHIAVO: He's an internist. Doctor Joan Brown, podiatrist. Um, there is a GI doctor and I can't remember his name. I'm sure there is a couple of other doctors she's seen, I just can't remember their names.
SHEEHAN: Okay. How often does Doctor Harrison see her, do you know.
SCHIAVO: He's seen her---
NILSSON: You're talking right now, as we sit?
SHEEHAN: Yeah. I mean does he see her on a regular basis now?
SCHIAVO: No.
SHEEHAN: When was the last time he saw her?
SCHIAVO: Yesterday.
SHEEHAN: When was the last time before that?
SCHIAVO: She didn't.
SHEEHAN: So Doctor Harrison saw her for the first time yesterday?
SCHIAVO: Yes, on the advice of Doctor Lyles to go see her or him.
SHEEHAN: Okay. When was the last time Terri had seen a neurologist?
SCHIAVO: I'd have to look up some records. I don't remember.
SHEEHAN: Has it been years?
SCHIAVO: No, I don't think it's been years.
SHEEHAN: Has a neurologist seen her since Doctor Yingling saw her?
SCHIAVO: I don't recall.
SHEEHAN: Have any diagnostic tests been performed since Doctor Yingling saw Terri?
NILSSON: Objection. Overly broad, ambiguous. You mean of the neurology strain?
SHEEHAN: Okay, of a neurology strain.
SCHIAVO: I don't recall. There could have been. I don't recall.
SHEEHAN: Now, you said Doctor Lyles had referred Terri to Doctor Harrison?
SCHIAVO: Uh-huh.
SHEEHAN: And when did Doctor Lyles suggest that Terri see Doctor Harrison?
SCHIAVO: We had Terri over there last week, I believe and he suggested it then.
SHEEHAN: What was the purpose of bringing Terri to see Doctor Lyles last week?
SCHIAVO: We---to get Theresa off medication called Tegratol, which is for seizures.
SHEEHAN: Who put her on Tegratol?
SCHIAVO: Doctor Hosobuchi.
SHEEHAN: So she had been on Tegratol for quite awhile?
SCHIAVO: Uh-huh, yes.
SHEEHAN: And it was your decision you wanted to have her taken off the medication?
SCHIAVO: It was my and Doctor Lyle's decision.
SHEEHAN: Well, you indicated that the purpose of taking her to Doctor Lyles was to have her taken off Tegratol?
SCHIAVO: No, I didn't say that.
SHEEHAN: What was the purpose of taking her to Doctor Lyles?
SCHIAVO: 'Cause he was looking at her hip.
SHEEHAN: Uh-huh. What happened to her hip?
SCHIAVO: It was starting to turn out and turned out it was just tone, they were trying to correct the problem.
SHEEHAN: So the purpose of taking her to see Doctor Lyles was really for treatment of her hip?
SCHIAVO: Uh-huh.
SHEEHAN: And at that time----
SCHIAVO: He---go ahead.
SHEEHAN:----he suggest that you take her off Tegratol?
SCHIAVO: The Tegratol subject came up.
SHEEHAN: How did it come up?
SCHIAVO: He had seen her before and Terri's Tegratol level had been real high and he was kind of concerned because she was lethargic. And I mentioned about the Tegratol and she's still real lethargic. He told me the best thing for us to do was take her ovoer to Doctor Harrison.
SHEEHAN: What did Doctor Harrison say?
SCHIAVO: That there is no seizure activity and probably wouldn't present a problem taking her off that.
NILSSON: Are you asking for everything Doctor Harrison said to him?
SHEEHAN: Yeah.
SCHIAVO: Doctor Harrison sent (sic) to me, when the EEG was done, sat me down in the office and he says that her EEG is so depressed and why do you let her live. And he said to me that this woman died four years ago, and it's such a tragic thing. And he said to me, I noticed you've taken her to Largo Medical Center for some treatments and he says that the next time she gets an infection, not to treat it. And then we started talking about---he said, remove the feeding tube. And I told him I couldn't do that to Terri. And then he says---then he said to me, well---
SHEEHAN: Go ahead.
SCHIAVO: There is no seizure activity, so it wouldn't present a problem of taking her off the Tegratol.
SHEEHAN: Was it Doctor Harrison's suggestion the feeding tube be removed?
SCHIAVO: It wasn't a suggestion, it was just talk. He just mentioned it.
SHEEHAN: How did he mention it? What did he say?
SCHIAVO: He was talking about removing the feeding tubes, and I said I couldn't do that to Terri.
SHEEHAN: Was this the first---this was the first time she had seen Doctor Harrison?
SCHIAVO: Yes, it was.
SHEEHAN: Do you know Doctor Harrison at all?
SCHIAVO: No, I do not.
SHEEHAN: Other than a referral from Doctor Lyles?
SCHIAVO: Just a referral from Doctor Lyles.
SHEEHAN: The things that Doctor Harrison said to you yesterday, have they ever been said to you by another physician?
NILSSON: Objection. Overly broad and vague. Compound. Ambiguous. Is there any aspect of what was said of the many things that you are curious about?
SHEEHAN: He just testified that the doctor said her EEG is so depressed, why do you let her live. This woman died four years ago. Next time she has an infection, don't treat it. There is no seizure activity. Those were the things he testified to. I asked him the things that the doctor told you, has any other physician ever told you that.
NILSSON: Jim, let me make my objection to you. There are a whole lot of things that Harrison said, not just the things you just stated, those were stated, but many other things too. If you have a particular point of interest, such as taking the feeding tube or lack of EEG response, or any of those things, why don't you just ask him that specifically. And ask him if any of the other doctors have discussed those points with him as opposed to giving him ten unknown things to try---given by all the doctors, you know.
Below is a medical chart of notes regarding the progress of Terri Schiavo. The chart clearly contradicts Michael Schiavo's statement under oath that Yingling saw Terri a YEAR after the experimental surgery. The notes indicate that she was exhibiting increased alertness and awareness in response to stimuli a month after the surgery. In April, 1991, about four months after the surgery, Yingling who is not a licensed medical professional, does his "DBS investigation" and the formal sensory stimulus program is ceased and therapy reduced to once a week, later discontinued totally after Schiavo received the insurance settlement.
| 1/29/1991 |
Progress Note Dr. Alcazaran Meadowbrook, California facility |
Meadowbrook, California facility 11/29/90 admitted, seen by Dr. Hosobuchi for DBS placement. Done 12/12/90. Stimulator started 12/17/90. Awakening threshold of 2.7 volts, 50 hz - with eye opening and blinking. 12/19/90 back to Meadowbrook from acute care. Noted to have severe agitated response and fever. Stimulator placed on hold. UTI? 1/9/91 brain stimulator resumed with gradual response. Weaned off Dantrim 1/13/91. by 1/17/91 stimulating up to 12 hrs w/ amperage 1.3 Noted increased alertness, turns head toward voice, turns head from tactile stimulation. Sucking and rooting response to olfactory stimulation. Spontaneously vocalized. Good cough. Head midline X 15 sec. Some visual tracking. Upper extremity - ATNR Discharged 1/20/90 Has been home x 1 wk. |
| 1/29/1991 |
Nursing Note O'Connell, LPN |
Pt awake in bed, examined by Dr. Alcazaren - eyes open - some tracking noted X1 when spoken to. No commands followed. |
| 1/29/1991 |
Case Management Notes T. Hughes |
Open eyes to voice and tactile stimulation, appears to track periodically, especially to right. |
| 1/30/1991 |
Psychosocial History |
Opens eyes to voice, has limited tracking ability. Appears to focus upon objects placed within her environment for short periods of times. Able to turn head towards sounds. |
| 2/1/1991 |
Therapeutic Recreation Notes Sherri Lage |
Pt. appeared to focus on several pictures of family for about 10 seconds, appeared to slightly track to left each session, but inconsistent. Quick startle response to all auditory stimuli, occasionally moved head away from tactile stimuli. No response to olfactory. |
| 2/1/1991 |
Physical Therapy Notes |
Alert throughout treatment session, responds to pain, moaning, turns head from noxious stimulii |
| 2/4/1991 |
Progress Notes Dr. Carnahan |
Both knees increased warmth, start Keflex, question H.O. of knees, repeat alkalyn phosphotase. ? Bone Scan |
| 2/5/1991 |
Progress Notes Dr. Carnahan |
Both knees very warm, probable arthritis / H.O. |
| 2/5/1991 |
X-Ray Report Dr. Ricciardello |
2 views each, right knee, left knee. No fracture or subluxation. There is severe osteopenia and degenerative change. |
| 2/6/1991 |
Progress Notes Dr. Alcazaran |
Both knees very warm, monitor for H.O., blinks eyes to loud noise |
| 2/6/1991 |
Speech-Language Notes |
Commands to voice - moves tongue, (slight elevation noted), blinks eyes. Movements not developed to the point that a yes/no response could be initiated. Visual tracking to left is inconsistent. Oral motor stimulation results in increased reflexive chew / swallow |
| 2/8/1991 |
Therapeutic Recreation Notes Sherri Lage |
Seen 5X last week. Had eyes open each session, appeared to focus on family pictures but only slight tracking to left noted X1. Consistent startle response to auditory stimuli |
| 2/11/1991 |
Summary of all Departments |
Swallowing improving, some possible following commands to voice |
| 2/12/1991 |
Progress Notes Dr. Carnahan |
Labs consistent w/ H.O., plan trial Didronal |
| 2/13/1991 |
Progress Notes Dr. Alcazaren |
Arouses easily |
| 2/13/1991 |
Speech Language Notes |
Minimal visual focusing and tracking were observed. She responded briefly to family photos. Responses to commands is inconsistent. Movements noted include - voicing, onset, tongue protrusion, swallows, right foot and head nodding |
| 2/15/1991 |
Progress Notes Dr. Alcazaren |
Knees swelling, left greater than right. H.O. vs. breaking of adhesions, treat locally w/ heat |
| 2/15/1991 |
Therapeutic Recreation Notes Sherri Lage |
30 day summary |
| 2/15/1991 |
Psychology Notes Patti Shook |
Terri's eye opening responses were her strongest. Terri's tactile responses were her best, with the other four modalities only 1 to 2 points behind. This level of functioning is appropriate for a sensory stimulation program. |
| 2/18/1991 |
Progress Notes Dr. Carnahan |
Knees both tender to touch, right lower thigh indurated, probably H.O. |
| 2/19/1991 |
Progress Notes Dr. Alcazaren |
Opens eyes to auditory stimulation |
| 2/19/1991 |
Speech Language Notes |
Responds briefly to family photos |
| 2/19/1991 |
Physical Therapy Monthly Summary |
Terri came to Mediplex in a completely inadequate chair for her seating needs, as it allows no head support, facilitates her lower extremity abnormal extensor pattern, and her upper extremity flexor pattern. It gives her no trunk support and she literally falls out of the chair, even when positioned to the optimum. She was seen in wheelchair clinic on 2/8. Funding authorization currently being sought. |
| 2/20/1991 |
Physical Therapy Notes |
Pt has made significant gains since admission in all areas of range of motion. Have on one occasion when pt reclined, on command pt extended right knee, 4 X / 6 at random request. Appeared to follow command to turn her head while I had her on the mat the other day, but not (yet) consistent. |
| 2/21/1991 |
Progress Notes Dr. Carnahan |
Plan Bone Scan |
| 2/20/1991 |
Progress Notes Dr. Alcazaren |
Brief tracking of family pictures |
| 2/22/1991 |
Therapeutic Recreation Notes Sherri Lage |
Seen 5X/wk. Decrease in arousal in the past week, did not keep her eyes open for more than 30 sec at a time. Marked decrease in responses last week |
| 2/25/1991 |
Progress Notes Dr. Alcazaran |
Random voicing. Responsiveness - no change. Auditory and tactile stimulation. Step down therapies to appropriate levels. |
| 3/1/1991 |
Therapeutic Recreation Notes |
Pt seen 4X past wk. Continues to respond to auditory stimulus to the point of being auditorily defensive. |
| 3/5/1991 |
Bone Scan Report Dr. Walker |
Evaluate for Trauma Multiple hot spots |
| 3/6/1991 |
Nursing Note DeRosa, RN |
Pt lifted head off pillow straining neck, look at something to her right. Pt making humming sounds for about 5 min. |
| 3/8/1991 |
Progress Notes Dr. Carnahan |
Bone Scan reveals subperiosteal area of right thigh - most likely reflects H.O. Other areas not explained by disease ? Infection. Neoplastic is rare probability. |
| 3/11/1991 |
Summary of All Departments |
2 point increases in vocalization and eye-opening, motor response. Tactile increased 3 points. Overall her general responsiveness score increased slightly from 19 to 23. Remains at a Rancho level 2. |
| 3/12/1991 |
Progress Notes Dr. Carnahan |
Question if arthritis or bone involvement was related to Dilantin (?) |
| 3/12/1991 |
Progress Notes Dr. Alcazaren |
Knees with almost no swelling, d/c warm compresses |
| 3/13/1991 |
Sensory Stimulation Assessment |
Blinked constantly while purpose of test explained, eyes widened in response to heat (tactile test); turned slightly toward stimulus, moaned, turned away from cold |
| 3/15/1991 |
Therapeutic Recreation Notes Laura Mizell |
Therapeutic Recreation T.R. 5X/wk for 1/2 hr. Pt has displayed an increase in eye opening since last 30 day summary. Pts responses to auditory stimulation are at the point that they are almost auditorily defensive. During recent outings, rugby game kept eyes closed to, from and during game, beach visit more aroused. |
| 3/15/1991 |
Case Management Notes T. Hughes |
Family visits continue on a frequent basis |
| 3/18/1991 |
Monthly Physical Therapy Summary |
On one occasion Terri did appear to attend and follow two one-step commands, and another time she turned her head to right on command, but this has not recurred during P.T. sessions. Little progress has been made in obtaining the necessary modifications for Terri's personal chair. She continues to be seated in a Mediplex loaner chair, which has been modified to accommodate her seating positioning. |
| 3/19/1991 |
Speech Language Notes |
Occasionally responds to requests to verbalize, swallow and move arms |
| 3/22/1991 |
Therapeutic Recreation Notes Laura Mizell |
Seen 5 X this week |
| 3/26/1991 |
Nurses Notes |
Terri's side-rail on her bed found down after Michael left. When told about it, he replied that "that was their job." |
| 3/29/1991 |
Therapeutic Recreation Notes Laura Mizell |
Seen 5X this week. Peppermint olfactory resulted in increased respiration, tone, movement of head. Pt now consistently keeping eyes open during therapy. Responded to touch of face, moved away from touch |
| 4/2/1991 |
Physical Therapy Interim Evaluation |
Occasionally appears to track visually |
| 4/5/1991 |
Therapeutic Recreation Notes Laura Mizell |
Pt seen 5X this week. Pt appears to blink eyes to sounds. Turned away from blow drier, increase in tone. Turned head when therapist used her name. |
| 4/12/1991 |
Therapeutic Recreation Notes Laura Mizell |
Seen 5X/wk. Increase in tone and heavy breathing noted in response to auditory threat. |
| 4/16/1991 |
MS Journal |
Became very excited, cried, facial expressions, tears, whining |
| 4/16/1991 |
Physical Therapy Notes |
Goals for next month are to maintain or improve range of motion and achieve maximum level of function. Will also be seeking authorization for wheelchair. |
| 4/17/1991 |
MS Journal |
Sitting in chair, holding her legs together, holding her own head up, response to every noise she hears, tasted (extracts), swallowed. Mixed up days and nights |
| 4/17/1991 |
Progress Note Dr. Alcazaran |
Dr. Yingling, DBS investigator conjectures lack of progress to original severity of injury, possibly needs more time for DBS - 6 months or more, possibly needs higher electrical stim current. In any case, the factor that would promote any more progress, if at all, would be the DBS - and not further intensive acute rehab intervention, i.e, daily O.T., P.T. S.L.P., T.R. |
| 4/17/1991 |
Case Management Notes |
Lengthy Meeting w/ docs & Michael- Dr. A says due to no functional improvement 3 hrs. of therapy is not appropriate. Some mention of Shands - machine for P900 brain mapping procedure may be available there. Funding not in place. Occasionally voicing to touch, taste and occasionally with visual / scanning. Scanning is perseverative with commands. Auditorily defensive, i.e, increased eye blinks to noise increase. Pet therapy has shown little if any response. Response greatest to auditory and tactile. |
| 4/18/1991 |
Speech Language Notes |
Family care conference completed on 4/17. Pt status reported to husband and mother. Therapy decreased to 1 X per week. Formal sensory stim program discontinued |
10-29-05 NCG
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