Expert: Comatose Woman May Not Have Shown Signs Of Pregnancy

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A doctor examined an Arizona woman in a vegetative state nearly nine months before she gave birth but did not find that she was pregnant, and medical experts said Thursday that it’s possible she displayed no outward signs that workers who cared for her every day would have noticed either.

Police are looking for her rapist and say it appears none of the staff members at a Phoenix long-term care facility knew about the pregnancy until the baby was born Dec. 29, a notion that has drawn skepticism. But the 29-year-old woman, who is described in a medical report as having tubes to feed her and help her breathe, may not have had a swollen belly, according to a doctor of fetal medicine.

While factors remain unknown, such as how far along she was, someone who is fed the same amount from a tube every day might not show any dramatic changes that would be noticed, especially by staffers who don’t work with pregnant patients, said Dr. C. Kevin Huls, a clinical assistant professor and maternal-fetal medicine fellowship director at the University of Arizona College of Medicine-Phoenix.

The mother could actually lose weight in other places like her face or arms if a fetus is consuming nutrients, Huls added.

“A good way to understand it is that really, the baby’s going to continue to grow even at the expense of the mom’s nutrition,” Huls said. “So, her weight may not change because she’s not taking in additional calories. There may be changes to her body that are going to go undetected in a chronic care condition or at a facility like this.”

The revelation that an incapacitated woman was sexually assaulted inside a care facility has horrified advocates for people with disabilities and the community at large. The provider’s CEO resigned this week, and the state said the center has made safety changes.

A doctor examined the woman on April 16 and found “no change” in her health, writing that the exam was external only, according to Maricopa County Superior Court documents. Her mother submitted the results of the physical as part of an annual report that state law requires of legal guardians.

Court documents indicate the woman had been living at the facility since she was 3 years old, local media outlets reported.

Phoenix police learned of the pregnancy situation when they received a call on Dec. 29 about a newborn in distress at the Hacienda HealthCare facility. Officers launched a sex crime investigation when it was determined the mother was in a vegetative state, police spokesman Tommy Thompson said.

“She was not in a position to give consent to any of this,” Thompson said.

The baby and the woman are recovering at an area hospital, and their conditions were not released.

It’s possible the woman won’t have any additional long-term complications from giving birth. Women in a vegetative state after accidents or strokes have successfully delivered babies, Huls said.

Her family, who are members of the San Carlos Apache tribe in southeastern Arizona, said in a statement through their attorney that they will care for the baby boy.

Phoenix police, meanwhile, have not ruled out any suspects in the sexual assault. They are gathering DNA samples from the facility’s male staffers and have appealed to the public for any information.

It remains unclear to investigators if the woman was raped more than once.

“I know at least once she was sexually assaulted, which is way too many times,” Thompson said.

The Hacienda intermediate care facility specializes in providing around-the-clock care for infants, children and young adults with developmental disabilities or who are “medically fragile.”

Since the birth came to light, Hacienda HealthCare has implemented increased safety measures, including more than one staff member being present during patient interactions and more scrutiny of visitors.

The company has said it welcomes DNA testing of its male staffers and is cooperating in the investigation.

Original Story:

PHOENIX, A.Z. — Police served a search warrant Tuesday to get DNA from all male employees at a long-term care facility in Phoenix where a patient who had been in a vegetative state for years gave birth, triggering reviews by state agencies and putting a spotlight on safety concerns for patients who are severely disabled or incapacitated.

Hacienda HealthCare said it welcomed the DNA testing of employees.

“We will continue to cooperate with Phoenix Police and all other investigative agencies to uncover the facts in this deeply disturbing, but unprecedented situation,” the company said in a statement.

Local news website Azfamily.com first reported the woman, who had been in a vegetative state for more than 10 years after a near-drowning, delivered a baby on Dec. 29.

San Carlos Apache officials announced Tuesday night that the 29-year-old woman was an enrolled member of the tribe, whose reservation is in southeastern Arizona about 134 miles (215 kilometers) east of Phoenix.

In a statement, tribal officials said the woman was still in a vegetative state when she gave birth.

The woman’s name was redacted from the tribal statement. It’s also unclear if staff members at the facility were aware of her pregnancy until the birth.

“On behalf of the tribe, I am deeply shocked and horrified at the treatment of one of our members,” tribal chairman Terry Rambler said. “When you have a loved one committed to palliative care, when they are most vulnerable and dependent upon others, you trust their caretakers. Sadly, one of her caretakers was not to be trusted and took advantage of her. It is my hope that justice will be served.”

A lawyer for the woman’s family released a statement Tuesday saying the family was outraged at the “neglect of their daughter” and they asked for privacy.

“The family would like me to convey that the baby boy has been born into a loving family and will be well cared for,” Phoenix attorney John Micheaels said in a statement.

San Carlos Apache Police Chief Alejandro Benally said Phoenix police “will do all they can to find the perpetrator” and his department will assist “in any way possible.”

A spokesman for Hacienda HealthCare said investigators served a search warrant Tuesday to obtain DNA samples from all male staffers.

In a statement, board member Gary Orman said the facility “will accept nothing less than a full accounting of this absolutely horrifying situation.”

“We will do everything in our power to ensure the safety of every single one of our patients and our employees,” Orman said.

Hacienda CEO Bill Timmons stepped down Monday, spokesman David Leibowitz said. The decision was unanimously accepted by the provider’s board of directors.

Gov. Doug Ducey’s office has called the situation “deeply troubling.”

Phoenix police so far have declined comment.

The Hacienda facility serves infants, children and young adults who are “medically fragile” or have developmental disabilities, according to the website. In the wake of the reports, the Arizona Department of Health Services said new safety measures have been implemented. They include increased staff presence during any patient interaction, more monitoring of patient care areas and additional security measures involving visitors.

The state’s online complaint database for care facilities shows multiple complaints about Hacienda de Los Angeles going back to 2013. Most of them involve fire drill and evacuation preparation or Medicaid eligibility. But one complaint from December 2013 outlines an allegation that a staff member made inappropriate sexual comments about four patients two months earlier. Nobody relayed the incidents to an administrator. That employee was later fired.

Martin Solomon, a personal injury attorney in Phoenix whose clients are mostly vulnerable adult victims of abuse and neglect, said a lawyer representing this woman should call for all pertinent medical records, a list of current and ex-employees and any past litigation involving Hacienda. It would be the police who would lead DNA testing to figure out who fathered the baby, Solomon said.

It would be hard for Hacienda to escape any kind of liability in court.

“There’s a lot of information we do not have. But things like this don’t happen without someone either knowing about it or should have known about it,” Solomon said. “Whether it’s an employee or someone from the outside, the facility has an obligation to protect residents.”

Advocates for the disabled say Arizona needs to find a way to monitor allegations of sexual abuse and sexual violence in group settings. Doing background checks isn’t enough, said Erica McFadden, executive director of the Arizona Developmental Disabilities Planning Council.

“I think when you’ve had somebody who’s had multiple allegations from different parties, there has to be some way to track that,” McFadden said. “If it’s the same story from different people, then there’s something wrong.”

The council recently formed a task force to look at how to improve training for health care workers when it comes to identifying and reporting sexual abuse.

“We don’t have a systematic way to train people what’s a good touch or a bad touch. We also don’t have required training for providers,” McFadden said. “We really need a lot of work in this area.”

Jon Meyers, executive director of The Arc of Arizona, an advocacy group for people with intellectual and developmental disabilities, called the allegations “disturbing, to put it mildly.”

“I wasn’t there. I clearly don’t have firsthand knowledge of what happened,” Meyers said. “But I can’t believe someone receiving that level of constant care wasn’t recognized as being pregnant prior to the time she delivered.”