Trial begins for nurse accused of killing patient

January 12, 1993|By William Thompson | William Thompson,Staff Writer

SNOW HILL -- Although nurses at Hartley Hall Nursing Home routinely "borrowed" drugs prescribed for one patient to give to another, the facility's medical director said he never authorized TC morphine-based painkiller for Maidie Lang Shay because she was comatose shortly before she died.

"She was unable to experience pain," Dr. Edward J. Colwell said yesterday during the first day in the murder trial of Marjorie Karen Alpaugh, the former Hartley Hall nursing director who prosecutors claim instructed another staff nurse to give the 91-year-old patient what amounted to a lethal dose of the painkiller Roxanol.

Mrs. Shay died Jan. 29, 1992. While the cause of her death was originally listed as respiratory failure brought on by pneumonia and other natural causes, rumors swept through the Pocomoke City nursing home that Mrs. Shay had been the victim of a mercy killing.

After the state medical examiner found traces of morphine in the remains of Mrs. Shay, a Worcester County grand jury indicted Mrs. Alpaugh and Delores Lee Walker, a licensed practical nurse, on murder charges. Charges against Sherrie Lee Agar, a third staff nurse, were later dropped after Deputy State's Attorney Joel J. Todd said he could find no evidence that she contributed to Mrs. Shay's death.

Mrs. Alpaugh, 52, who took the job as Hartley Hall's top nurse on April 29, 1991, resigned a week after Mrs. Shay died.

James V. Anthenelli, Mrs. Alpaugh's lawyer, said yesterday he will attempt to prove that Mrs. Shay was given the Roxanol on Dr. Colwell's verbal order and that due to an administrative oversight, no record of the authorization was made on the patient's medical chart.

In opening remarks later corroborated by Hartley Hall employees, Mr. Anthenelli said nurses sometimes made efforts to alleviate a patient's pain by "borrowing one patient's medication for another if the medicine was not around."

"They bent the rules of nursing a bit," said Mr. Anthenelli, explaining that prescriptions were sometimes shared to help a patient because it was often hours after medicine had been ordered that it would be delivered to the facility.

Hartley Hall nurses who testified yesterday said that the procedure was followed only if prescriptions were approved by Dr. Colwell, who sometimes gave his OK by telephone because he was not always at the facility.

Mr. Anthenelli said Mrs. Shay received "one therapeutic dose of Roxanol" because she appeared to be in pain. Later, he said, questions about the drug's authorization grew into speculation that Mrs. Shay's death was caused by foul play.

"There's rumor. There's innuendo. There's cloak-and-dagger," he said. Brushing that aside, he concluded: "It isn't a homicide case at all."

He said the woman's death was natural and that Dr. Colwell, who at the time was the medical director of three nursing homes and had a private practice, forgot that he had ordered the dose of Roxanol for the elderly patient.

Mr. Todd spent much of yesterday compiling testimony that Mrs. Shay was not in pain and did not require a painkiller.

He also called witnesses who said Mrs. Alpaugh kept a cache of prescription narcotics in her office against state regulations.

In at least one case, written records indicated that drugs found in Mrs. Alpaugh's office had been destroyed.

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