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Snyder v. Arkansas Department of Human Services

Court of Appeals of Arkansas, Division II

October 3, 2018

RANDA SNYDER APPELLANT
v.
ARKANSAS DEPARTMENT OF HUMAN SERVICES, DIVISION OF MEDICAL SERVICES, OFFICE OF LONG-TERM CARE APPELLEE

          APPEAL FROM THE PULASKI COUNTY CIRCUIT COURT, SECOND DIVISION [NO. 60CV-17-305] HONORABLE CHRISTOPHER CHARLES PIAZZA, JUDGE

          The Law Offices of Darren O'Quinn PLLC, by: M. Darren O'Quinn, for appellant.

          Trevor Townsend, Office of Chief Counsel, for appellee.

          DAVID M. GLOVER, JUDGE

         Randa Snyder appeals the Pulaski County Circuit Court's affirmance of the order from the Arkansas Department of Human Services, Office of Long-Term Care (DHS or OLTC) finding there was sufficient evidence she had abused a resident of a long-term facility by jerking the resident's arm in an inappropriate manner as she attempted to take the resident's blood pressure. As a result of this finding, Snyder's name was placed on the Adult and Long-Term Care Facility Resident Maltreatment Central Registry (Registry). On appeal, Snyder argues (1) the circuit court erred in not awarding her a default judgment when DHS filed the record late in circuit court; (2) her conduct did not rise to the level of abuse under the statute; and (3) the punishment was too harsh. We affirm.

         The incident in question occurred in a hallway of the long-term-care facility and was videotaped. SM, an 85-year-old resident of Sherwood Nursing and Rehabilitation Center (Sherwood) who suffers from Alzheimer's disease, psychosis, diabetes, hypertension, and hypokalemia/low potassium, is required to have her blood pressure checked during every shift. Snyder was attempting to take SM's blood pressure, but SM was not being cooperative. Snyder pulled SM's arm in an attempt to secure the blood pressure cuff, which was the reason for this action.

         In a letter dated May 11, 2016, OLTC informed Snyder it had investigated an incident of alleged abuse against her, determined the allegation was valid, and was issuing a "Founded Report" against her. Snyder was informed of her right to appeal the ruling, which she did, and in a decision dated December 30, 2016, the DHS hearing officer upheld the OLTC decision finding abuse. Snyder then appealed to circuit court, which affirmed the finding of abuse and the placement of Snyder's name on the Registry. Snyder now appeals that decision to our court.

         Administrative Hearing Testimony and Evidence

         In a prepared statement to the hearing officer, OLTC representative Barbara James stated that OLTC received a report on May 6, 2016, that Snyder, a CNA at Sherwood, had abused SM while adjusting a blood-pressure cuff by forcefully moving SM's right arm to hold it down and then jerking her arm in a forward motion two or three times to the degree SM's wheelchair rocked back and forth. Based on that information, OLTC determined the allegation of abuse was founded.

         At the agency hearing, Dawn Bearden, a registered nurse and director of nursing at Sherwood at the time of the incident, testified she reviewed the video of Snyder attempting to obtain the blood-pressure reading from SM and confirmed there was inappropriate treatment by Snyder. Bearden said Snyder was having difficulty placing the cuff and jerked SM's right arm several times to straighten it; SM's wheelchair was physically moved due to the force used by Snyder. Bearden's stated definition of abuse was physical harm to a patient, which included infliction of pain; based on what she saw on the video, Bearden believed SM experienced pain as a result of Snyder's actions.

         On cross-examination, Bearden admitted Snyder was a caring CNA who never had an allegation of abuse made against her before this incident. Bearden stated that after the incident, a body audit was performed on SM, which revealed no bruising or discoloration; likewise, x-rays of SM's right arm and shoulder were also negative. Bearden explained that while SM had some rigidity, it was not to the point where her arm had to be "yanked" in order to provide care, and the video showed very aggressive jerking of SM's arm. While she agreed there was no physical evidence of injury, such as bruising, fractures, or a break in the skin, Bearden nevertheless concluded SM had suffered physical abuse at the hands of Snyder because, in her professional medical opinion, SM suffered pain from Snyder's actions.

         On redirect examination, Bearden explained that while SM was resistant to treatment at times based on her dementia, there was a care plan in place when a patient was resistant, which was to back away and allow the patient time to calm down and then reattempt the care after the patient's agitation has subsided. Bearden remained steadfast in her belief there was physical evidence of maltreatment of SM because her arm was jerked on multiple occasions so forcefully that her wheelchair moved, which was sufficient in her mind to rise to the level of abuse.

         Gerlonda Porter, who worked in housekeeping at Sherwood, observed the incident between Snyder and SM. She said she saw Snyder "yank" SM's arm while attempting to take her blood pressure, and when she "yanked it really hard" a second time, Porter asked Snyder why she did that. Snyder told Porter she did it because SM was fighting back, but Porter testified SM was not fighting back. Porter stated she heard SM make a sound like the pulling of her arm hurt her; she asked SM if she was okay after the incident, and SM shook her head. This incident concerned Porter enough that she felt she had no choice but to report it to Dalphine Webb, the charge nurse; Porter also spoke to Renee Phillips, Sherwood's administrator, as a result of the incident, and she reiterated to Phillips what she had written in her statement-she saw Snyder yank SM's arm and when she asked Snyder why she did it, Snyder told her that SM was fighting back. Porter said she had never seen Snyder neglect or abuse any other resident, but it was her opinion Snyder appeared to be frustrated in the video.

         Nathan Rivers, who also worked in housekeeping at Sherwood, testified he was in the hallway with SM, Porter, and Snyder when the incident occurred. He heard Porter ask Snyder why she was yanking SM's arm, but he did not see the incident. After Rivers watched the video of the incident, he said there was an obvious jerk, and Porter asked why Snyder was jerking SM's arm. ...


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