This is the list of proposed witnesses that Harvey Berkal has just sent to the media regarding his private prosecution against the Simkin Centre which will begin Monday morning Nov 7.
It remains to be seen, if and when, the Attorney General of Manitoba will decide to prosecute this matter in place of Berkal, such that it would take it over and Berkal's private prosectution will cease.
Based on the number of proposed witnesses, one can expect this hearing to take several days. Note that as indicated in the list below, it is possible that there will yet be further witnesses called. The Winnipeg Jewish Review has received a tip from a reader regarding another posssible witness to be called, and we are in the process of verifying whether this is accurate or not.
Another issue that has arisen is whether or not the professional bodies that supervise nurses conducted any independent investigations of the nurses involved in this matter, and if so, what their findings were--in other words, were they disciplined and if so how?. The Winnipeg Jewish Review has learned that the Simkin Centre did file complaints regarding the seven nurses involved, but it is not known how long after the date of Lilian Peck's death those complaints were filed.
LIST OF PROPOSED WITNESSES AS PROVIDED BY HARVEY BBERKAL
1.) Marsha Palansky – daughter of victim Lilyan Peck who witnessed her mother’s condition on leaving the Sharon Home Inc. and being admitted to Victoria Hospital. She was questioned by hospital staff as to whether she was caring for her mother at her own residence. Marsha Palansky will testify she had no sense of what her Mom’s condition was when she arrived at the hospital. The Home had never informed her about the existing wounds on her buttocks and perineal areas
2.) Carla Smith - Lead investigator for the Protection of Persons in Care Office (PPCO) of Manitoba Health. This office is charged by provincial legislation with the task of investigating allegations of abuse against persons in care. Victoria Hospital on seeing the condition of Mrs. Peck when she entered hospital reported the case as a “critical incident”, suspecting abuse, to the Protection of Persons in Care Office. More than 8 months later the PPCO reported on the results of their investigation. They concluded that there was evidence that the Sharon Home Inc. was guilty of “physical abuse by neglect”. Their report points out that most of the nurses interviewed acknowledged that “they did not follow accepted nursing standards” and were “overwhelmed and stressed by workload issues” and they were “burdened by the issues of staff shortages and staff replacements”. The Sharon Home’s records showed “poor documentation” (including six days of missing nurses’ notes),the "absence of a comprehensive treatment plan” and “an apparent lack of communication between staff and management”. The report called for a review of the facilities licensing status, the creation of a quality improvement plan and a leadership review. It noted the "failure in its system to adequately care for this ressident."[Peck] .
3.) Dr. Ian J. Thorlakson – Mrs. Peck’s treating physician at the Victoria Hospital. His hospital notes indicate that he found that Mrs. Peck had a serious skin wound that was “necrotizing” (i.e. causing the death of tissue) in the perineal area. He also found that Mrs. Peck had “sepsis” (i.e. an infection in the blood stream) that was “likely from sacral and perineal skin necrosis secondarily infected”. He can explain his notes and findings in a document that he prepared called “Death Summary”. (An outside physician should also be called to review the photos of Mrs. Peck and the hospital charting notes. ( for example; Mrs. Peck’s Myoglobin levels were at 10,000 and her blood glucose levels were at 27.)
4.) Nurse Jane Doe #1 - An unknown Emergency Room nurse at Victoria Hospital who discovered Mrs. Peck’s serious wound on her buttocks and perineal area. She was shocked at the condition of the wound and told Mrs.Peck’s daughter, Marsha Palansky, that she had never seen anything like it in her many years of nursing.
5.) Nurse Jane Doe #2 – Another nurse whose name we do not yet know who took photos of Mrs. Peck’s wounds and will comment on her reaction to them.
6.) Nurse Donna Reid – One of seven nurses who worked at the Sharon Home caring for Mrs. Peck. She was the one of seven nurses disciplined by the Home for misconduct in the care of Mrs. Peck. She was the only nurse terminated as a result of the Home’s own investigation.
7.) Sandra Delorme– Chief Executive Officer of the Sharon Home at the time of Mrs. Peck’s residence at the home. She is now on medical leave. She will be questioned on the systemic problems in the home. As well, she will be subpoenaed to bring with her all documentation in her possession relating to the Lilyan Peck case.
8.) Alana Kull – Director of Nursing at the Sharon Home at the time of Mrs. Peck’s residence there. She is now Director of Care and Acting Chief Executive Officer of the Sharon Home. She will also be questioned on issues pertaining to the nursing standards in the care of Mrs. Peck . She now leads up the Action Plan put into place after Mrs. Peck died, which is very comprehensive and speaks to the chaanges that need to be implented.
9.) Phyllis Spigelman – Current Chair of the Board of Directors of The Sharon Home Inc. At the time of Mrs. Peck’s residence at the Sharon Home, Phyllis Spigelman was the Co-Chair of the Board of Directors. She can speak to the Board’s response to this critical incident, and the organization structure re: reporting critical incident.
10.) Real Cloutier , Chief Operating Officer of the WRHA- He has been integrally involved in the monitoring of the Home.
We reserve the right to subpoena other witnesses as the need arises.
11.) Documents – Photographs of Lilyan Peck’s critical wounds
12.) Documents – Quality Improvement Action Plan – lengthy document prepared by Winnipeg Regional Health Authority in consultation with the Sharon Home and with concerned families. This document stipulates dozens of areas of care in the home that are in need of quality improvement.
13.) Document – 26 Standards Review – Report of Full Standards Review ordered and conducted by Government of Manitoba Department of Health released to the press on nov 2, 2011. The report found that the Home never met one of the standards in the area of Integrated Care Plans, which require the Home to set forth an interdisciplinary individualized care plan for each resident. The Home has 8 weeks to set forth these plans, which are so encompassing. This would include: cumodin and blood sugar glucose monitoring. This failure was also referred to in the Protection of Persons in Care Office report referred to in Item No. 2 above.
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