Baltimore County police and state health officials are investigating a homicide at Franklin Square Hospital Center involving an 80-year-old patient who had her arms - which had permanently locked together - pulled or pried apart last month.
In what officials are calling one of the more bizarre homicide cases they have seen, detectives are trying to determine why and how someone pulled apart the patient's arms, which were locked across her chest.
The patient, Ruth F. Bowen, who had Parkinson's disease, died a few days later of multiple fractures to her rib cage and hemorrhaging, state officials said.
"The feeling is someone had to deliberately straighten out her arms, and that led to her death," said Bill Toohey, a county police spokesman. "Given the nature of her problem, her arms simply would not have been moved easily. It would have taken some effort to do that."
Toohey said homicide detectives are considering everyone who was in Franklin Square on Nov. 2 - doctors, nurses, other staff and visitors - potential suspects.
Bowen, of the 9100 block of Deborah Ave., was admitted to Franklin Square on Oct. 30 for a swallowing disorder, police said.
Toohey said Bowen had Parkinson's and another disorder - "bilateral contractors of upper extremities" - that caused her arms to be permanently crossed in a fixed position. It is unclear whether the disorder was caused by Parkinson's.
But on Nov. 2, hospital personnel noticed that Bowen's arms had been straightened and were at her side, Toohey said.
Bowen died four days later.
Mary Ripple, an assistant medical examiner, ruled on Dec. 1 that Bowen's death was a homicide. The amount of pressure it would take to unlock Bowen's arms was so great that police consider the action a homicide, Toohey said.
Homicide detectives began investigating on Dec. 5, Toohey said.
"It has been a fairly extensive investigation," he said. "We have been talking to visitors, staff, family and anybody who might know anything."
Carol Benner, director of the state Office of Health Care Quality, said the agency is trying to determine whether state regulations governing hospitals were violated.
Benner said her agency would examine whether the hospital's staff and administrators followed proper procedures after discovering the patient. Benner said the investigation could be completed this week.
Carl Schindelar, president of Franklin Square, said an internal investigation was unable to "identify answers to the questions" he had about the situation.
He declined to answer additional questions until the police investigation is completed.
Bowen's children were unavailable to comment yesterday, but her neighbors said she had been sick for several years and required around-the-clock care.
Many were stunned to learn that her death has been ruled a homicide. "I can't imagine this would be a homicide," said next-door neighbor Ruth Walkemeyer. "I just could not imagine what happened."
Parkinson's disease, which affects about 1 million people in the United States, is a "neuro-degenerative disorder" that "affects movement or the control of movement including speech and body language," according to the World Health Organization.
The main symptoms are tremor and rigidity; in some patients, rigidity can cause "sustained `lead pipe' resistance to movement," according to WHO.
But Joel Gerstel, executive director of the American Parkinson's Disease Association, said he has never heard of a Parkinson's patient who was unable to move crossed arms.