2 doctors told investigators disabled woman was neglected, report says

A woman accused with her father of neglecting a disabled sister who ultimately died told an emergency room doctor that her sister "had been going downhill for about a week" but had not seen a doctor in a “long time,” according to a report by the Office of Inspector General.

Doctors at Texas Health Harris Methodist Hospital Fort Worth told internal investigators that Marci Lynn Garvin, 39, was unresponsive, severely dehydrated and septic with low blood pressure when she entered the hospital on the night of March 9, 2013.

Dr. Robert Genzel diagnosed Garvin with, among several other things, pneumonia, acute kidney failure, being in respiratory distress, covered in dried feces and having multiple bed sores. He told investigators that he believed Garvin’s care “was unacceptable and that neglect was involved.”

Dr. Kauser Javed, who treated Garvin in the emergency room, told investigators that when he spoke to family members, Tabby Elaine Martinjak told him that her sister “had been going downhill for about a week.”

“When asked by Dr. Javed, Martinjak said they had not seen [Garvin’s] doctor in a long time,” the report states. “Dr. Javed said that if Martinjak had the responsibility to care for [Garvin] and failed to call for assistance or seek proper medical care, then [Garvin’s] care was neglected.”

Garvin died two days after being admitted to the hospital.

Martinjak and the disabled woman’s father, John “Michael” Garvin, a retired investigator with the Tarrant County district attorney’s office, were indicted last week on a charge of injury to the disabled by omission in connection with the case. The pair are accused of not seeking timely medial care for Garvin and withholding nutrients, hydration and proper hygiene from the disabled woman.

The pair’s defense attorney, Jim Lane, has said the family had been living together so they could all help care for Garvin and that there was another side to the story that grand jurors didn’t get to hear. He also pointed out that it was Martinjak who sought hospitalization for her sister.

Michael Garvin, 69, and Martinjak, 46, remain free on $25,000 bail.

Internal affairs investigators with the Inspector General’s Office had began investigating the case March 13 after receiving a complaint that Martinjak, a contract care provider for Rock House Inc., had neglected Garvin — a Rock House client, according to the final report, dated July 5, 2013.

Rock House provides residential living, at-home care, and programs in Texas for the mentally handicapped and developmentally disabled.

But Rock House founder J. Brad Allen said Monday that Garvin was not yet a client of Rock House at the time of her death.

He said about a week and half before Marci Garvin’s death, the company had met with MHMR officials and Martinjak about transferring Garvin from another provider into Rock House’s home and community services program and employing Martinjak as a contract care provider to continue to care for her sister.

Under such an arrangement, Medicaid would pay Martinjak’s salary and pay Rock House an administrative fee for oversight.

But Allen said that the admissions process was still pending at the time of the woman’s death.

“We learned that she had been admitted to the hospital, then we learned a few days later she had passed away, so the process was never completed,” Allen said.

Among the uncompleted tasks, Allen said, was a home inspection.

“… We never saw her. Never laid our eyes on her. Never had the opportunity to lay our eyes on her,” Allen said. “If we’d been able to complete the admission process and schedule the home visit, then our systems would have caught any inappropriateness. A nurse would have seen her.”

According to the final Inspector General’s report, investigators concluded that the neglect allegation was “substantiated” based on the statements of the two doctors who treated Garvin upon her hospitalization and that of Glenda Kupferle, a nurse certified in the treatment of wounds, who was asked to review Garvin’s medical chart regarding her bed sores.

“After the review, Kupferle said that [Garvin’s] case is unusual; that her bed-sore condition was ‘severe.’ ” the report states. “In regard to the care of [Garvin], Kupferle believed that care was lacking and that negligence was involved.”

The Inspector General’s Office referred the matter to the Department of Aging and Disability Services and the Tarrant County district attorney’s office.

The DA’s office, however, recused itself from the case because the allegations also involved Michael Garvin, a former employee.

Michael Jarrett, first assistant criminal district attorney with McLennan County, has been appointed special prosecutor in the case.

This story was originally published September 22, 2014 at 5:40 PM with the headline "2 doctors told investigators disabled woman was neglected, report says."