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For Immediate Release
April 23, 2003
Contact: Sean Caine, 410-576-6357
scaine@oag.state.md.us

BALTIMORE CAREGIVER CONVICTED OF ABUSING
DISABLED PATIENT IN HER CARE

J. Joseph Curran, Jr. announced today that Elizabeth Ann Smith, a former house manager at Progress Unlimited, Inc. was found guilty of abuse of a vulnerable adult and reckless endangerment for an incident that occurred while she was feeding a developmentally disabled woman who was in her care.

Judge Vicki Ballou-Watts of the Circuit Court for Baltimore County sentenced Smith to two years incarceration, suspending the entire sentence. She also ordered the Defendant to refrain from providing care to vulnerable individuals for a period of two years. Judge Ballou-Watts further placed the Defendant on two years supervised probation followed by two years unsupervised probation.

Smith, 57, of the 6100 block of Alta Drive was a paid caregiver for three developmentally disabled women who reside in a group home. One of the women who Smith was paid to care for is profoundly mentally retarded, non-verbal, and suffers from a swallowing disorder known as dysphagia. According to the consumer’s physician’s orders, her caregivers are required to puree her food in a food processor with thickened liquids before feeding her. Otherwise the consumer runs a high risk of aspirating on her food.

According to the eyewitness account, on March 17, 2002, Smith was feeding the consumer her lunch. Instead of pureeing the consumer’s food as the doctor had ordered, Smith fed the consumer a whole submarine sandwich. When the consumer refused to open her mouth to eat the sub, Smith "popped" the consumer on the mouth with a forcible slap. The slap left a red mark around the victim’s mouth. Smith turned to the eyewitness and told her not to worry, that the victim did not bruise for long. Smith then shoved the sandwich into the victim’s mouth. The victim was having difficulty swallowing the sub. As she was attempting to chew the food, she was making choking noises as if she were struggling to breathe. At that point, the eyewitness confronted Defendant Smith about the victim’s aspiration precautions. Smith told the eyewitness that she was aware of the doctor’s orders to puree the victim’s food but that the victim could eat whole food that was not pureed. Smith also told the eyewitness that she had fed the victim food that was not pureed on several other occasions.

When Smith fed the victim whole food rather than pureed food, she created a substantial risk of death or serious physical injury. Feeding whole foods to an individual with dysphagia against doctor’s orders causes a high risk of aspiration. In addition, if an individual with dysphagia swallows whole food, the food can settle in the lungs, causing aspiration pneumonia, which can lead to severe medical complications or death.

"Ms. Smith knew that the victim could only have pureed food, yet she forced the victim to eat whole food after exacting physical abuse," Attorney General Curran said. "She is the perfect example of the kind of person who should not be allowed to care for another individual."

This case was prosecuted by Attorney General Curran’s Medicaid Fraud Control Unit, which has jurisdiction to investigate and prosecute abuse of vulnerable adults in facilities that receive Medicaid funds.

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