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Trial of Winkler County Nurse Who Reported Doctor to TMB-Part II

Posted Feb 11 2010 9:09am

The Texas Nurse Association has been tracking this case closely and is in attendance at the trial. TNA has also set up a legal defense fund and provided letters in support of the nurses’ actions. Here is their account of the daily ongoings quoted from,

Andrews Courthouse – On the stand this morningthe nurse’s defense attorney Cook continued the cross-examination of Sheriff Robert Roberts of Winkler County. Defense wanted to know: what was confidential about the nurses’ complaint? That’s still unclear.

Andit seemsthere was yet a second complaint filed against the physician. The sheriff admitted that he didn’t check with the Texas Medical Boardsaid he didn’t know which complaint was the first and which was the second. The second complaint was filed by a nurse who was never indicted. Sheriff said he didn’t do any investigation of whether complaints the nurses made were true.
When the defense attorney asked if the sheriff had ever arrested someone simply because the person gave him information about a possible crimethe sheriff answered“yes.” The defense attorney rephrased the question and asked it again. Still the sheriff answered“yes.” The courtroom laughed. The judge then admonished that their laughter was inappropriate behavior and he will have them removed if the laughter continues.
Court is now recessed for lunch. When trial continues this afternoonthe next witness is the nurse who replaced Vicki Galle in the performance improvement position at Winkler County Memorial Hospital.

AndrewsTX Courthouse – State prosecutors rested their case against Anne Mitchell. The court is in a recess. When it reconvenesdefense attorney Cook is to file a motion for a directed verdict that the state failed to prove every element of its case beyond a reasonable doubt. More updates to follow.

Court has recessed after what was day 3 of the Winkler RN trial. Judge Rex denied an earlier defense attorney’s motion for a directed verdict. The defense started presenting its case this afternoon and called a number of character witnesses for Anne Mitchell. Trial resumes tomorrow morning. Closing arguments might be heard at day’s end.

ThursdayFebruary 11

The State and the Defense have put on their cases and rested. This morningAnne’s attorney has finished her defense.

The State had to prove five elements to prove Anne misused official information: 1) Anne was a public servant (all public employees are)2) she had access to information because of her employment3) that information not public4) Anne used the information with the intent to harm another5) the information was used for a nongovernmental purpose. The State’s evidence focused on the last two elements because the prosecutor told the jury that those were the two most in dispute. The State’s main evidence consisted of several witnesses who testified about two to three occasions on which they heard Anne make statements such as “Dr. Arafiles will be gone in a year” “he is not a doctor” “he is a witch doctor.” There was also testimony of an ongoing conflict between Anne and Dr. Arafiles. She had refused to sign off on his original credentialing because hospital bylaws required physicians to have unrestricted license. The State also focused on the need to follow the chain of command. In cross examinationAnne’s attorney was able to get in good information about substandard care by Dr. Arafiles on cases Anne reported to Texas Medical Board (TMB). The Defense showed that most of the witnesses who testified about Anne’s motives had only been contacted within the past couple of weeks and not before Anne was indicted.

On WednesdayAnne’s attorneys began her defense and called several witnesses to testify. The first was a nurse practitioner who had worked at the Winkler County Rural Health Clinic and left because of her concerns that issues relating to the care provided by Dr. Arafiles had not been addressed. She had also filed a complaint against Dr. Arafiles with the TMB at the same time as Anne and Vicki (all worked together). The NP testified that she has subsequently filed a second complaint. She testified that Anne was motivated only by her concern for patients. The second witness was an LVNwho testified about her concerns regarding Dr. Arafiles’ work at the clinic. She also left because of those concerns and the stress they were causing her. The Defense called the Winkler County judge (not the trial judge) testified that she knew Anne and Anne had discussed her concerns about Dr. Arafiles. The judge said Anne’s motive was patient concern. Lolly LockhartRNtestified as an expert witness on a nurse’s duty. Dr. PhamChief of Staff at Winkler County Memorial Hospitaltestified about concerns about Dr. Arafiles’ care. He also testified that Anne was concerned about patient care and that Anne is a good nurse.

Thursday morningthe defense called a medical expertwho testified that he had reviewed the five cases cited in the complaint to TMB and found substandard care. The Defense has rested. Nextthe charge will be read to the jurythe Prosecution and Defense will give their closing argumentsand the jury will begin deliberation.

The case is no less perplexing as to why Anne was indicted. All witnesses (even the State’s) have agreed nurses have a duty to report unsafe care.

Personal take: That this case has even gotten this far is unbelievable and the only hope is that the jury is fair and unbiased. It sounds like the defense teams for both nurses have been working hard in establishing that the nurses were concerned about patient care.

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