MACHIAS, Maine — The actions of a nurse who discharged a 61-year-old hospital patient later found dead in the snow were “unprofessional and highly disturbing,” according to a Machias District Court judge.
But the Maine State Board of Nursing, which revoked nurse John Zablotny’s license for two years, did not prove that his actions demonstrated incompetence or an inability to practice, ruled Judge David Mitchell.
In his decision issued on Dec. 2, Mitchell overturned the revocation and instead imposed concurrent 90-day suspensions of Zablotny’s license to practice nursing over what he deemed two instances of unprofessional conduct.
“I consider it a major victory,” Zablotny’s attorney, Joseph Baldacci of Bangor, said Wednesday, adding that the sentence amounted to time served. “It shows the importance of an independent judicial review of the decision of a bureaucratic board.”
Zablotny was the nursing supervisor on duty the night of Jan. 1, 2008, at Down East Community Hospital in Machias. That night, Eastport resident Reid Emery, 61, who had been admitted five days earlier with severe abdominal pain and a history of pancreatitis, asked to leave the 50-bed health care facility despite his doctor advising against it.
Zablotny spoke with Emery and found him competent enough to sign a standard “against medical advice” form. At about 8:30 p.m. on New Year’s Day, the nurse discharged Emery, who was wearing only jeans and a flannel shirt as he headed out on foot into a snowstorm. Emery had told the nurse that he was walking a short distance to a friend’s house.
Emery’s body was found the next morning beneath more than a foot of snow about 380 feet from the main entrance of the hospital, according to court documents.
He died of hypothermia and opiate toxicity, according to an autopsy.
The Maine State Board of Nursing ruled in June 2010 that Zablotny had violated his professional duties and it revoked his license for two years. The revocation was announced by Attorney General Janet Mills in a case that drew widespread attention.
The revocation later was affirmed in Machias District Court, but on appeal, the Maine Supreme Judicial Court in March 2014 ruled that Zablotny had been i mproperly denied a revocation hearing. The high court sent the case back to the lower court to conduct its own hearing rather than rely on the nursing board’s record.
During his appeal process, Zablotny was without a license to practice for 108 days before obtaining a court order allowing him to go back to nursing, according to Baldacci. Except for those days, Zablotny has worked as a nurse at Mount Desert Island Hospital in Bar Harbor since January 2008, according to the court.
During the new hearing in May, the nursing board did not argue that Zablotny shouldn’t have discharged Reid, but rather that Zablotny should have quizzed Reid more thoroughly about his plans.
In so doing, “the board … implicitly and explicitly conceded that Mr. Emery was physically and mentally competent to discharge himself,” Mitchell wrote in his December ruling.
Mitchell also determined that the nurse did not have a duty to contact either the police or Emery’s wife about the discharge, since neither “could have prevented Mr. Emery from leaving in the manner he chose to depart the hospital.”
The judge also ruled that the evidence did not support any finding of incompetence in the practice of nursing. Mitchell pointed out that Zablotny has been a certified registered nurse for 18 years and has not been the subject of any professional complaint either before or after this incident.
The evidence instead supported findings that “he has been a caring and devoted member of his profession whose clinical skills are solid,” Mitchell wrote.
Nevertheless, the judge concluded that Zablotny failed to inform Emery of the risks of hypothermia and death for leaving the hospital while improperly dressed during a snowstorm and failed to inform Emery that the hospital doors would close and lock behind him when he left.
“Nurse Zablotny’s actions on the night of Jan. 1, 2008, were unprofessional and highly disturbing,” Mitchell wrote. “His failure to warn Mr. Emery of the real risks he faced in leaving the hospital — hypothermia and death — and that the hospital doors would lock behind him — increasing the very risks of hypothermia and death — cannot and are not viewed as insignificant.”
Mitchell then determined that the appropriate sanction for those two instances of what he deemed unprofessional conduct were 90 days for each, to be served concurrently.
Assistant Attorney General Andrew Black, who represented the state nursing board, did not immediately return calls Wednesday.
However, Tim Feeley, spokesman for the attorney general’s office, said the AG’s office intends to file a motion for reconsideration and was not commenting further at this time.