California Elder Care Facility Operator Charged with Involuntary Manslaughter

A California elder care facility operator has been charged with involuntary manslaughter.

In February, Silvia Cata, owner of the Sacramento-based Super Home Care, was charged with felony charges of elder abuse and involuntary manslaughter in connection with the death of a woman in her care — 88-year-old Georgia Holzmeister.

“This is believed to be the first time California’s Department of Justice has filed manslaughter charges against an elder-care caregiver regarding resident care,” stated Palo Alto elder law attorney Michael Gilfix.

Gilfix said that California has rarely pursued criminal prosecution of elder care workers.

Allegations of elder abuse and neglect are typically handled in civil court.

Cata faces get as much as 12 years in prison if convicted.

Cata is currently in the Sacramento County Jail, in lieu of $300,000 bail.

The Sacramento Bee reported last week that Cata’s attorney and the California Attorney General’s office are currently in plea negotiations.

In a declaration in support of the arrest warrant, California special agent Tina Khang lays out the evidence that “Cata’s deliberate and complete reckless disregard for performing the essential duties as Holzmeister’s caretaker. . .ultimately resulted in Holzmeister’s death.”

According to the declaration, Holzmeister had been in Cata’s care since July 2007.

She had been diagnosed with dementia and her conditioned worsened over the years.

On June 19, 2012, Holzmeister was taken to  the hospital where hospital staff discovered a massive stage 4 pressure wound — a bedsore — that resulted in sepsis — a toxic reaction to bacteria — in the area of her tailbone.

“Holzmeister never recovered from her wounds and was placed on comfort care,” Khang wrote.

She died four days later on June 23, 2012.

Khang had a geriatric doctor — Kathryn Locatell review Holzmeister’s medical records.

Dr. Locatell found that the Holzmeister’s pressure sore was the “underlying cause of her death,” that she would not have died when she did “but for the severity of these conditions,” that the “sore over the buttocks must have been present for weeks, if not longer,” and that there was no indication that any medical care was sought for the wound “until Holzmeister was near death.”

Dr. Locatell concluded that Holzmeister “was neglected, deprived of needed medical attention, in addition to the basic personal care, which would have prevented such a sore from developing at all.”

Dr. Locatell said that had Holzmeister received adequate medical care “she would not have developed this wound and would not have died when she did.”

Khang also interviewed members of the Holzmeister family, who related the scene at the emergency room in June 2012.

“The family said that when Holzmeister arrived at the ER, they noticed a foul odor coming from her,” Khang wrote. “The family said that the odor smelled like ‘dead, decaying flesh.’ The family told me the odor was so strong that the entire ER waiting room smelled. They also stated the smell was so bad,  they noticed hospital nurses spraying the hallways with air freshener to try to cover it.”

The family said they met with a male doctor in the ER who attended to Holzmeister.

The doctor told the family that Holzmeister had “severe sepsis” and believed she was “not going to beat this.”

He advised the family that treatment of the sore would require surgically removing all of the dead tissue.

He told the family that there was a possibility that “removal of this dead tissue may be as deep as the bone, and leave her (body) exposed and deformed.”

He told the family that she would also require skin grafts to cover “open and exposed areas.”

The doctor told the family that Holzmeister was “severely dehydrated” and added that her wounds were “one of the worst wounds he’s seen in his life.”

He suggested “comfort care” as an option for the family if they decided not to go through with the surgery.

According to the family, Holzmeister was charged $2,800 a month and then $2,000 a month for her stay at Cata’s facility.

A Sacramento Bee review of Cata’s licensing file shows the caregiver was cited at least 40 times since 1996 for violations in her facility, including 26 Type A deficiencies — the most serious violations under state regulations, as they pose direct and immediate risks to residents’ health, safety or personal rights.

Cata’s defense attorney, Johnny Griffin III, acknowledged that his client had a history of violations but told the Sacramento Bee that the incidents were not reflective of poor patient care.

“They really can’t say she provided bad care,” said Griffin, describing Cata’s facility as neat and clean and her clients as properly washed and fed.

Griffin said the Attorney general is overreaching by charging Cata criminally.

“It boils down to, she didn’t call sooner (about Holzmeister’s bedsores),” Griffin told the Bee. “Is that truly criminal? Should this truly be in the criminal courts?”



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