R.I.P.ped

A spokesman for the hospital expressed "our condolences to Mr. Scarcella's family and friends" and cited the Collin County medical examiner's report, which "makes it clear that Mr. Scarcella's death from natural causes was not the result of the care he received during the short time he was our patient." Referencing patient privacy laws, the hospital specifically declined to comment on whether the violation of its own code blue policy might have contributed to Scarcella's death.

Cardenas and Gleisner weren't the only ones contacted by whistle-blowing nurses. Upon hearing about Scarcella's death, Shelly Martin says she "flipped out," phoning the hospital and demanding to know what had happened. She spoke with an ICU nurse, whose anonymity she is protecting, who felt that Scarcella was in no condition to be transferred in the first place. "She said doctors thought he was difficult, and they had a heart patient who needed the bed," Martin recalls. The nurse was later fired, Martin says, on grounds she had breached a "confidential relationship." The nurse also spoke with attorney Rachel Montes, who was hired by Gleisner to investigate the circumstances surrounding Scarcella's death. "The information I have gathered comes from an informant [the same nurse] who wishes to remain anonymous and says Mike wasn't stable enough to be released and was dumped because he didn't have insurance."

Before filing a lawsuit, Montes had to wait on the autopsy report, whose preliminary findings revealed that Scarcella suffered from an undiagnosed subdural hematoma (blood clot in the brain), which resulted from the blow he took to his head. Gleisner and Cardenas say they saw hospital charts, which recommended a CAT scan that was never performed. But the quality of his care became less relevant after the medical examiner ruled that Scarcella suffered "sudden cardiac death" because of a "hypertensive enlargement of the heart" and withdrawal from GHB--making litigation, at least against Plano Presbyterian, less attractive unless an expert can be found to say that Scarcella wouldn't have died if he hadn't been transferred in the first place.

More relevant were the deep feelings of loss suffered by the 150 people who attended Mike Scarcella's funeral on August 29. "I can't explain to you how much my heart hurts," says Martin, who gave one of five eulogies. All eyes were fixed on 5-year-old Brock, who did his best to remain seated, fidgeting anxiously and looking uncomfortable in an oversized tie. Finally, Brock couldn't contain himself. He marched toward his father's coffin and lingered in front of a large portrait of a younger, formally clad Mike Scarcella. Brock traced his fingers over the photograph, placing his hand over his father's heart and bringing it back to touch his own. Huge strongmen and everyday gym rats broke into tears. It seemed the perfect moment to preach about the dangers of GHB and the havoc of getting hooked, just as Scarcella had. Gleisner had laid out a stack of Narcotics Anonymous literature, which all but disappeared. Nearly a dozen people thanked her for saying what they needed to hear.

"Mike just wanted his story told," Gleisner says. "We just hoped for a different ending."