Wrong Medication Kills Survivor Of Massacre -- Physician Ordered That No Corrective Measures Be Taken

YAKIMA - Mary Jo Estep survived what is believed to be the nation's last massacre of Indians. But she could not survive taking the wrong medicine in a nursing home.

At least three investigations are under way into the death of the 82-year-old Estep, who was given no treatment after taking the medicine.

Estep was a member of the Shoshone Mike band of Bannock Indians, one of the last groups that continued its nomadic ways and did not settle on a reservation.

During the winter of 1911, a posse of ranch hands and Nevada lawmen ambushed the band in the foothills outside Winnemucca, Nev., killing Estep's parents, grandparents, aunts and uncles.

Of the four children who survived the three-hour battle, all contracted tuberculosis and - with the exception of the baby Estep - died the following year.

She was raised by whites and eventually became an elementary-school teacher. She never married nor had children. But she had friends and many are outraged.

"You look at what happened here, and you could say she died at the hands of the white man, too," said Louis Jarnecke.

The state Department of Social and Health Services is investigating the death at the Good Samaritan Health Care Center in Yakima, agency spokesman Gordon Schultz said yesterday.

Schultz said the agency could not yet say whether the improper medication was directly responsible for the death.

A DSHS report on Estep's death was referred to the Yakima

County prosecutor's office, which said yesterday that no decisions had been made on possible charges.

On the morning of Dec. 19, Estep was accidentally given three doses of prescription medicine intended for another resident, the DSHS report said.

The error was discovered within a half hour.

But Estep's attending physician, Dr. Cornelis D. Brandt of Yakima, ordered that no corrective measures be taken, the DSHS report said.

That was because of Estep's advance directive barring heroic measures to keep her alive, the report said.

Officials of the nursing home told state investigators the doctor advised the nurse that Estep was a "no code" patient. The term refers to patients who want no extraordinary measures to keep them alive.

Estep was informed about the incorrect medicine, but was not told the severity of her condition or given any treatment options, the report said.

Brandt would not comment pending completion of official inquiries.

The incorrect medicines were Tenormin and Apresoline for hypertension and Procardia XL for heart problems.

Estep remained alert for much of the day, but her heart rate and blood pressure fell in the evening and she died around 11:30 p.m.

DSHS fined the nursing home $2,500 last month for the medication error.

A nurse who had power of attorney over Estep's health matters declined the nursing home's offer to have the patient rushed to a hospital, the state said.

"She informed the investigator that at that point she felt it was too late," the DSHS report said.

Several of Estep's friends arrived at the nursing home that afternoon to pick her up for a party, and stayed until her death.

"All we could do was stay at her side until the end," friend Esther Jarnecke of Wapato said. "The nurse who made the mistake in the first place was crying. She had worked her full shift that day, then stayed the rest of the night at Mary Jo's side."

Two days after her death, Brandt wrote "age-related" for contributing factors to the cause of death. The death certificate It made no mention of the medication error.

On Dec. 23, a new death certificate was issued by Yakima County Coroner Leonard Birkinbine, who had ordered an autopsy. That certificate lists "accidental ingestion of prescription drugs" as a contributing factor and says "nurse gave patient wrong medication."

Estep's death is also being investigated by Yakima police and the Yakima County Medical Society.

Sam Vanmeter, administrator at Good Samaritan Health Care Center, said the nursing home's corporate office is re-evaluating the advance directive forms given to residents.