After twelve days in court, Lorraine Phillips-Bohn and Glenn Bohn say their son Bret Bohn is now under guardianship of the State against his will. The Bohn’s claim hospital officials, and ruling Judge Erin B. Marston, have ignored their son’s original Power of Attorney, which gave them (the parents) the right to make medical decisions on behalf of their son.

Bohn’s General Power of Attorney, and Health Care Power of Attorney were drafted in 2007, before Bohn’s current illness.

According to court documents, during the course of Bohn’s medical treatment at Providence Hospital, his parents informed the medical staff of these documents and began acting accordingly.

Shortly after the Bohn’s began acting in accordance to their son’s Power of Attorney, “a conflict soon arose between the medical staff, and Bohn’s parents, who said that Bohn was being overly medicated, and wanted their son to stop using any medications and leave the hospital immediately.

The document goes on to say that Bohn’s parents ignored medical advice from doctors at Providence that their son was gravely ill and could die if removed from the hospital.”

Case Background:

On October 16, 2013 after several nights of insomnia, Bohn’s parents brought him to the Providence Hospital Emergency Room to seek treatment. During this first emergency room visit, Bohn was given two prescriptions, one for anxiety, the other for sleep, then released to go home.

Phillips-Bohn says after taking these medications her son experienced a seizure and was brought back to the emergency room. While in the emergency room for the second time, Bohn experienced two more seizures, and was admitted into the Intensive Care Unit where he stayed for several days.

The Bohns were told their son would be released to go home with them on October 22. However, officials at Providence allegedly moved him to the fifth floor medical unit instead of the promised discharge.

According to Phillips-Bohn, her son remained on the fifth floor of the hospital for weeks, being treated by doctors with as many as twenty-two different medications at one time, without a proper diagnosis.

 

 

 

 

 

Erik Guzman, Bohn’s long-time friend, spent as much time at the hospital as he could supporting Bohn, and would often spend nights at Bohn’s bedside. Guzman said he saw a lot of changes in Bohn by the time he entered the hospital to the last time he was permitted to visit Bohn on December 24. Guzman said on some days Bohn was coherent and talkative, but began to deteriorate quickly after the many medical tests he was given.

Some of these tests included MRI’s, spinal taps, and blood transfusions, which all came back negative. According to Guzman, Bohn had needle holes up and down his spine and complained of his back hurting. Eventually he became agitated, and at one point, Bohn fought five security guards and several nurses while attempting to remove his IVs and catheter so that he could leave on his own.

Guzman reported during one of his visits, that Bohn had said, “I’m tired, I’m beat up, I just want to go home. I’m tired of being poked, my back hurts, I’m tired of getting needles in my back. I’m tired and just want to go home.”

Court documents say Phillips-Bohn began to interrupt and interfere with Mr. Bohn’s care, and that her actions included an event where she decided it was necessary to physically restrain her son in front of doctors even thought doctor’s asked her to stop.

Phillips-Bohn claims she was trying to get her son to stay at the hospital even though he wanted to leave because she wanted him to get well.

Guzman said, Bohn once tried to voluntarily leave the hospital, because Bohn had been wanting to leave since his first week there, so he decided to walk out of the hospital of his own will, “because the hospital staff was not going to let me out.”

Guzman said, “he walked halfway down the floor he was on, and that’s as far as he went.”

The court documents say after these incidents, “Providence physicians believed Ms. Phillips was jeopardizing Mr. Bohn’s medical care and ultimately his life. They instituted security measures, including limiting visitation. Providence Hospital as a mandatory reporter, notified Adult Protective Services of the threats to Mr. Bohn.”

The Bohn’s eventually asked for a transfer to a psychiatric hospital for a second opinion, but say this request was denied.

After months of tests, and while the issue of guardianship was before the court, Bohn was finally diagnosed with Autoimmune Encephalitis.

Dr. Souhel Najjar, a nationally known expert on autoimmune encephalitis explained there are several different types of the disease.

 

 

 

 

“Autoimmune encephalitis is a disorder in which a body turns against its brain.”

Dr. Najjar explained what this means, “the body produces anti-bodies that target the brain tissue, and cause inflammation in multiple areas of the brain.”

One of the systems that can be affected is the lymphatic system, which is the area of the brain that affects emotion and behavior.

Najjar said, “It is not unusual that the patients (with autoimmune encephalitis), will be mistaken for a mental disorder.”

Since Bohn is now a ward of the State, the court appointed guardian, along with the medical team, can authorize Bohn’s hospitalization and treatment plan.

In an open letter to the Legislature dated February 19, 2014, Providence Hospital outlines policies regarding patient privacy laws (HIPPA), and rules about the role of court appointed guardians and visitation. The following is an excerpt from the open letter explaining the rights of patients and the hospital.

State law requires health care provider’s to make reports of harm to Adult Protective Services whenever they have reasonable cause to believe a vulnerable adult suffered abuse or neglect.

Under state law, when a patient is not competent to make medical decisions on their own behalf, their (1) guardian, (2) health care agent, or (3) surrogate are allowed to make heath care decisions on their behalf. Health care providers are permitted under state law, and required by their standard of care, to decline to comply with the direction of a surrogate if they determine that the surrogate is not abiding by the wishes, values, and best interest of the patient. AS 13.5w.060(h). Health care providers are also permitted under state law, and required by their standard of care, to decline to comply with the direction of a guardian, agent, or surrogate if that direction requires health care that is contrary to generally accepted health care standards. AS 13.52.060(f)

When a temporary or permanent guardian is appointed by the court for a patient, that guardian will, in most cases, have the sole authority to make health care decisions on behalf of the patient, including decisions regarding medication and ho long the patient should stay in the hospital. Accordingly, when a guardian the sole authority to make health care decisions for the patient, Providence confers with the guardian regarding the treatment of the patient and obtains the necessary consent to treatment from the guardian.

Providence only restricts visitation to a patient when that patient request no visitors or when restricting visitation is medically necessary and in the

 

 

 

 

best interests of the patient. There are many different types of medical situations in which restricting visitation, including visitation by family members may be medically necessary. Providence attempts to work with the family and the patient to reinstitute visitation as soon as doing so is both in the best interest of the patient and requested by the patient. For patients that do not have capacity and have a guardian appointed, Providence also confers with the guardian in regards to any restrictions on visitation.

The last time family and friends spoke to Bohn, he told them he does not trust anyone at Providence. Bohn allegedly said, “I tell them no, but they don’t listen.”

Bohn’s parents believed their son when he said that, stating they witnessed first hand Bohn’s objections to treatment, and the medical staff ignoring his requests not to be medicated.

According to the court, in late October, the Bohn family sought advice from lawyer and family friend Rhonda Butterfield. The documents say that Ms. Butterfield met with Mr. Bohn’s parents and Providence doctors to discuss Mr. Bohn’s treatment and specifically the medications he was receiving. The papers document say, “After subsequent meetings with Ms. Phillips, Ms. Butterfield began to have “very serious concerns” for Mr. Bohn’s safety at the hands of Ms. Phillips. Ms. Phillips was quoted to have told Ms. Butterfield that “I would rather (Bret) die in my arms than have any more drugs” and added that she would “start making funeral arrangements”’ for Mr. Bohn.

Testimony by Bohn’s physician Dr. Krakker, Heather Brock ANP, and Dr. Peter Abraham along with medical records, which were provided to the court stated that due to Bohn’s symptoms of delirium, hallucinations and incontinence, Mr. Bohn was unable to testify on his behalf.

Jim Gottstein a lawyer with the law project for psychiatric rights, Psych Rights, said, “I think one of the takeaways is, this can really happen to anyone and people’s rights are regularly ignored when this sort of thing happens. It’s kind of like their rights are ignored legally like when the US stole the land from the Indians fair and square. Not always, but in this case, they violated his rights but they seem to have a court order so someone can say his rights weren’t violated, but when you look at what happened you can say that his rights were. Now one thing that’s clear is no one can really talk to Bret to see how he feels about this which I think is really important. And that’s not to doubt in any way what the parents are saying.”

Dr. Najjar said there is an 80% survival rate for patients who have been diagnosed with Autoimmune Encephalitis if the disease is caught early and treated aggressively with proper medication.

Phillips-Bohn says that she loves and misses her son, and her arms are aching to hold him and to hug him. “It’s the same feeling when I lost my first son, who was still-born. I

 

 

 

 

ached to have a baby in my arms, to love, and so you know, he’s an adult now, but he’s my son, and I love him. I just want him to know, and I feel that he knows that, (that I love him), because we are real close.”

The court documents say, “ Mr. Bohn’s parents have continued to act independently of medical opinion, and the course of treatment prescribed by Mr. Bohn’s doctors. Therefore, the Office of Public Advocacy must be appointed to meet the best interests of Mr. Bohn as to his medical decisions.”

They go on to say Bohn’s parents, family and friends do not have the ability to follow medical directives and treatment and the Bohn’s wish to stop their son’s medication and treatment.

Ms. Butterfield stated to the court, “During the course of my conversations with Lorraine, it became crystal clear that Lorraine is adamantly, absolutely without exception, opposed to Bret having any medication, tests, or medical treatment, even when his doctors deem it necessary and even when it means the difference between life and death.”

A court visitor also substantiated Ms. Butterfield’s statement about Phillips-Bohn’s beliefs about medical treatment.

Under the law, the Bohn’s are no longer a party to their son. Family and friends will continue to fight for visitation rights.