Infection claims inmate
Dorothy Dian Palinchik dies only hours after her family decides to remove her from life support.
By Johnathan Abel, Times Staff Writer
Published February 29, 2008
Dorothy Helen Palinchik began the last day of her daughter's life with a terrible choice.
Her daughter, Dorothy Dian Palinchik, was in a medically induced coma at Largo Medical Center, suffering from a staph infection and pneumonia, both of which the family said she contracted at the Pinellas County Jail.
Just before 7 a.m. Thursday, doctors told Palinchik that her 42-year-old daughter's blackened hands and feet were irreversibly damaged and her bowels were not viable.
The only choice was between amputating all of Palinchik's limbs or taking her off life support. Just a few hours later, doctors amended their decision, saying amputation was out of the question.
"They said she would never live through something like that," Palinchik's mother said.
At that point, the family decided to remove Palinchik from life support, once her sister Annette Olds drove in from Fort Myers this morning.
But Palinchik's ravaged body couldn't wait.
At 4:14 p.m. she was pronounced dead, ending a tortured two-week illness that has raised questions about the medical care at the Pinellas County Jail.
Palinchik's family blames the jail for not recognizing the illness earlier and for not treating it aggressively enough. They believe her life could have been saved if she'd been taken to the hospital sooner.
On Thursday, Palinchik's mother had a preliminary conversation with St. Petersburg lawyer Thomas D. Masterson about suing the jail.
Sheriff's Office spokeswoman Marianne Pasha said privacy laws prevented her from discussing Palinchik's medical treatment. She said an internal investigation is under way, which is standard in any case where an inmate becomes gravely ill.
The only thing she could say about Palinchik's condition is that she showed no signs of the methicillin-resistant Staphylococcus aureus infection when she was booked into the jail on Feb. 13.
One of the remarkable aspects of Palinchik's death is how quickly she deteriorated.
She was arrested the day before Valentine's Day, charged with stealing a $9 Philly cheesesteak sandwich from Publix. Her bail was set at $250, but she didn't pay it. Boyfriend Michael Mullican said he offered, but Palinchik said she would rather do her time and get it over with.
By Feb. 17 she had a fever of 101.5, according to Mullican, who visited her five days later on Feb. 21. The jail staff had given her only a Motrin and a Sudafed, Mullican said she told him.
"Michael, I've never been this sick in my life," Mullican quoted Palinchik as saying. She could barely lift her head and after two or three minutes, she had to lie down.
Mullican said he complained to the staff at the jail about Palinchik's condition and was brushed off by hostile guards.
The next day, Feb. 22, an ambulance brought Palinchik to Largo Medical Center. For almost a week, doctors fought her infection and the pneumonia that had taken over her lungs. She was kept on a ventilator. Her pulse raced above 150. Her hands and feet turned dark blue and black.
This condition can be caused by drugs called pressors, which are sometimes used to boost blood pressure in patients with severe infections, according to Dr. Jose Montero, an expert on the treatment of infectious diseases.
When blood pressure drops because of an infection, drugs are used to constrict the blood vessels and thus boost the pressure. But, in some cases, that can cause serious trouble.
"The medication is trying to save the patient's brain and core body functions, but it's doing it at the expense potentially of the extremities and the bowels," Montero said.
Experts on MRSA said it would be difficult to determine where and when Palinchik picked up the infection or why it progressed so severely in her case.
MRSA is a problem in crowded places with questionable sanitation, including jails, hospitals, schools and nursing homes.
The Pinellas County Jail has made progress in the past year in easing overcrowding and the problems that come along with it, such as MRSA, Pasha said.
An inmate count showed 3,457 on Wednesday, which is only slightly above the design capacity of 3,327. In previous years, the jail saw as many 3,800 inmates crowding into a complex designed for 2,400 people.
Studies estimate that staph can be found on 20 to 30 percent of the population. The U.S. Centers for Disease Control and Prevention estimates that 1 percent of the population carries the antibiotic-resistant staph MRSA.
But why it strikes some people and not others is often mysterious.
"You don't know what triggers a bug that's in your nose to invade and cause an abscess," said Dr. Lennox K. Archibald, hospital epidemiologist at the medical school of the University of Florida. He added that conditions such as diabetes, HIV-AIDS, renal failure and others could all make a person susceptible, but MRSA has a "striking ability" to infect even the young and the healthy.
Palinchik's family said she was in good health aside from passing a kidney stone a few years ago. She worked as a waitress and did odd jobs, family said.
She lived in St. Petersburg with Mullican, her boyfriend of more than 15 years.
Mullican was keeping watch at the hospital when Palinchik died. He called Palinchik's mother, who had returned to her hotel for a short break.
Palinchik's mother, aunt and a close family friend took over the grim business of signing papers and finding a funeral home.
Her family plans a cremation and said they were told no autopsy was necessary because doctors knew the cause of death. But Pasha said an autopsy would be performed on Palinchik's body.
Palinchik's mother and her aunt, Fran Lakatos, went in to take a final look.
"It was terrible," Dorothy Helen Palinchik said of her daughter.
A couple of hours later, she and her sister went to a local Publix to buy a box of chocolates and a thank-you card for the nurses at the hospital.
Jonathan Abel can be reached at jabel@sptimes.com or 727 445-4157.