PHOENIX — Sensitive life and death decisions involving some of Arizona's sickest COVID-19 patients are being made inside hospitals all over the state every single day.
If you are a family member who has a loved one hospitalized with the virus, it can be heartbreaking and frustrating to be on the outside, not allowed to visit your relative. So many families are relying on hospital staff to get updates on the condition of their loved ones, who are unable to communicate as they are on ventilators.
For one family whose mother was hospitalized with COVID-19, what ensued was a desperate back and forth with hospital staff, administrators, and nurses, as they fought to get alternative treatment for their mother who was unable to communicate.
What they faced was a wall of hospital policies and now, with the death of their mother, they can only wonder if doctors could have saved their mom's life if they had just tried some of the therapies and treatments that have been known to save others.
Jason Betyou reached out to ABC15, desperate to get anyone to help save his mother. The last few weeks of his life have been filled with talking to hospital administrators, Arizona state lawmakers, hospital lobbyists, only to be told it might be too late to save his mother.
Betyou spoke to ABC15 from his home in New Mexico.
"The last time I saw my mom was July 24. I Facetimed with her. She was fighting hard," said Betyou.
"I called her and I said, 'mom,' I saw the life in her eyes just fading, I told her, 'mom you're going to get off this in a week. You're going to be with us and say Happy Birthday to me in person,'" he added.
A day later, his mother Helen Betyou succumbed to COVID-19 and died. Now along with grief and heartbreak, Betyou said he could not help feeling frustrated and angry. Betyou says he feels hospital officials at Abrazo Arrowhead did not fight to save his mother's life, as he had hoped they would. Doctors and nurses that he communicated with told him they wanted to do more, but they were bound by hospital policies.
Betyou stresses he has nothing against the medical professionals who work on the front lines to help those dying of COVID-19, but he tells ABC15 the first red flag for him was when his mother was denied the promising drug Remdesivir, which has helped heal so many other sick patients. Betyou says his mother and his aunt were hospitalized for COVID-19 on the same day, last month. Both women even shared a hospital room. The infectious disease doctor prescribed Remdesivir for his aunt, but his mother Helen was denied Remdesivir because of hospital policy.
"They told me it was outside the therapeutic window of symptoms going more than seven days," said Betyou. He called the policy "harsh."
"To me, that means that they are picking and choosing who lives and who dies, and I know, I have messages from the Infectious diseases doctor saying she did not agree with that decision. It was Abrazo Arrowhead's administration that made the decision of a seven-day window," added Betyou.
His aunt recovered quickly and was released from the hospital within days, while his mother's condition continued to get worse. Now Betyou says, he can't help but wonder, would his mother have recovered as well, had she been administered the Remdesivir, just like his aunt?
Another hospital policy Betyou learned about too late involved the use of potentially life-saving equipment that has helped the lives of several COVID-19 patients, called an ECMO machine, which stands for Extracorporeal Membrane Oxygenation. It is a life support machine used on those who have severe illnesses that stop their heart or lungs from working properly. When the Betyou family pleaded with Abrazo hospital officials to consider their mother as a candidate for an ECMO machine, their request was denied.
"They told me the patient has to be on a ventilator and within seven days, only can they transfer. That is the therapeutic window, or that is when they say a patient does well," said Betyou.
Too late again for Helen Betyou, who had been on a ventilator for more than seven days. Now, Betyou wants to know why hospital officials are not discussing these life and death policies they have put in place with families who just want to know how their loved ones are being treated, and if the Care team assigned to their relative is considering all treatments out there, to help save their family member's life.
ABC15 reached out to Abrazo Arrowhead to learn more about their hospital policies related to COVID-19 treatments, and if these policies were being explained to families, a spokeswoman sent us this statement:
"While we are unable to provide any information about a specific patient or case due to patient privacy laws, we are committed to providing every patient with excellent care in accordance with the patient's treatment plan as determined by his or her physician and their clinical conditions. In the case of COVID, our physicians rely on recommendations made by the CDC, FDA and other expert bodies who have published official guidelines. We at the hospital stay up to date on those recommendations to provide them to our care team to help inform their decisions to balance risks and benefits of new therapies. Patient care plans are discussed with families so that they are aware of the care being provided for their loved ones and involved if key decisions points exist."
To get a better insight into hospital policies, ABC15 reached out to Dr. Christopher Worsham, a Pulmonologist, Critical Care physician, and research fellow at Harvard Medical School in Boston.
"Unfortunately, no matter what happens, when you have limited resources and too many people for the resources, you have to have some people who aren't going to get them," said Worsham.
He added that studies he had seen showed Remdesivir was most effective in the early stages of COVID-19. With supplies of the drug limited, Worsham said hospitals could set policies on which patients they determined would benefit most from the drug.
"It is however, always a good idea to tell your patients and or their family members how they do things at this hospital, and what they should expect," added Dr. Worsham.
Abrazo officials stated patient care plans were discussed with families, but Betyou says the communication did not go far enough.
"Communicate with your patients. Be honest with them and find alternative solutions. Don't just say well, it's just COVID, and put your shoulders up, because that's exactly how I feel," said Betyou.
The family is now considering taking legal action against the hospital.