I attached a video link above that tells my mom’s story in detail. Below is the documented daily happenings to my mom while in the (lack of) care of Mayo Clinic in Austin, MN.

Mary Brion – care notes given at Mayo Clinic, Austin, MN 

November 3, 2021 – November

Tuesday, Nov. 2nd 

• Mary was brought to Monticello ER 3pm with O2 levels at 83%
• Tested positive for COVID-19 and diagnosed with COVID-19 Pneumonia
• Put on High Flow O2 so Monticello could not admit her to their ICU
• Monticello began search for nearest ICU bed
• 1 am Wednesday a bed opened at Mayo Clinic Austin, MN

Wednesday, Nov. 3rd

• Transported from Monticello to Austin around 1:30 am
• She was hooded for the transport and is claustrophobic which stressed her and caused O2 level to dip into 80’s so she was sedated during transport to calm her
• Dr _______ admitted Mary to Austin
• Upon Tim and Julie arriving, they stopped at the Hospital and picked up a Healthcare Directive & Patient’s Bill of Rights. Got it filled out and nurse (Allayna) went over it with Mary; they signed it w/ 2 witnesses. Requested informed consent and any changes in meds must be discussed with Julie & Tim.
• Mary remained on Max High Flow with O2 levels 80% to 90%
• Early afternoon she tried to eat some soup and drank some boost. She was very alert and seemed to be doing better since Tuesday.
• Discussed IV steroids with Dr.______
• Julie requested Vitamin C, D, and Zinc
  • Dr _____ approved vitamins C and D only by oral application
  • Julie requested IV vitamins be administered when she was on a BiPAP
  • Julie was told IV option did not exist and/or was not safe
• On high flow they turned Mary on her stomach to ease her breathing
  • On her stomach she was in pain from her hip replacement and bad shoulder
  • Mary rang the nurse multiple times to get repositioned
  • She was crying from the intense pain
  • She was left on her stomach for an hour with pain and anxiety which lowered her O2 levels further
  • Mary told Julie she could not tolerate that position
• Mary was repositioned and given Ativan to calm her
  • She was switched to an IV sedative and attempted BiPAP
• Her conditioned continued to deteriorate

Thursday, Nov. 4th

• Julie spoke to Mary in the morning before they sedated her and put her on the BiPAP
• Nurse updated us later in the day that Mary was struggling when they attempted to remove the BiPAP and use High Flow
• List of attending Nurses
  • Allayna
  • Angela
  • Skylar
  • Diana, night nurse
  • Kayla
  • Kristina, night nurse
  • Monday Nurses – Quin & Tamara
• Thursday Afternoon a CT scan was given to look for blood clotting
• in morning, Allayna discussed with Julie about adding anti-inflammatory drugs to help with inflammation in her lungs. They were waiting for the Infection control team to assess her
  • One option was Barcitinib (oral application)
  • Another option was Actemra (IV)
• Thursday night updated by nurse that they were alternating BiPAP and High Flow
  • Having a hard time keeping O2 levels in 90’s on High Flow
  • BiPAP kept her levels in the 90’s
  • CT scan showed no sign of clotting but lungs were full

Friday, Nov 5th

• Mary was having trouble with the BiPAP due to claustrophobic anxiety
  • She was given Precedex to help her sleep
• Friday morning Julie consulted with the attending Dr______ and discussed Baricitinib (anti-inflammatory drug in pill form)
• 10:00 am Julie spoke with Dr ____ about the following
  • Adding vitamins through IV
  • concerns about lack of nutrition
  • Also was concerned about lack of fluids
  • Dr. stated Mary was on her 5th day of steroids… Julie had to correct her that we were only starting day 3.

Dr. said they would give her through the weekend but we should start thinking about comfort care.

• Afternoon Update – 

Julie asked again about IV vitamins Dr. said she would look into it and Nurse in the background said Pharmacy would not allow it. Too dangerous…

• Dr._____ approved Baricitinib
• Patient unable to swallow pill due to BiPAP
• Asked about IV option Actemra? The Dr. said there is a nationwide shortage and could not get it
• Dr._____ approved 5000 mg ascorbic acid injections
• Discussed a pick line as option for nutrition
  • Dr._____ was not worried about nutrition because it has only been 2 days
  • Julie corrected them and informed them that Mary had not eaten for 2 weeks prior to being admitted
  • Dr._____ reiterated that Mary wasn’t going to survive
  • Family did not agree with giving up and contacted a Patient Advocate, Michaela Wright

• Last Update from Dr. ____  we were told not to keep hope because she was not responding to the treatments
• Family proceed to hire the Patient advocate (Micheala)
• Patient advocate researched the side effects of Baricitinib
• Family researched the use of Budesonide and spoke with Advocate 
  • Advocate sent us package inserts from Baricitinib and Budesonide.
• Julie and Tim decided that Budesonide and Vitamin C were the best option
• Conference called with Nurse, due to Dr. was not available, and advocate
  • Julie advocated for Budesonide Nebulizer treatments at the recommended dose of .5mg to 1 mg
  • Dr._____ agreed to 2 doses at .25 mg
• Around 9:00 pm nurses started her on .25 mg of Budesonide
• Julie spoke to Nurse at 3am
  • Nurse said Mary was struggling from 12am to 2am but was able to get her to relax
  • She was able to reduce BiPAP from 80% to 70% and maintained O2 levels in the 90’s but her breathing rate increased
  • Julie requested another Budesonide treatment at the full dose of .5 mg
  • Nurse contacted the Dr.____ and the Dr. approved of the dose
  • She received a second dose around 3am

Saturday, Nov 6th

• Julie called Nurse at 9:30 am for an update
  • Nurse told her Mary was maintaining 92% to 97% on High Flow with mask but waiting for her to wake up
  • These were the first signs of small improvement
  • Nurse informed Julie that the Budesonide treatments Vitamin C and Vitamin D were being stopped by the Dr. Vahket______
• Julie and Patient Advocate conference called with the Dr.______
  • The nurse informed Julie that she had been assigned a new Dr.____ and 2 new nurses
  • During the conference call with the New Dr.______  she informed Julie that the treatments had been discontinued
  •  Dr.Vahket______ refused to listen to their request to reinstate the Budesonide
  • Dr.Vahket____ told them that Budesonide would not work and it was not part of the COVID-19 Protocol
  • Dr.____ said there were too many side effect chances with Budesonide
  • The Patient Advocate asked what the side effects of Barcinitib were
    • Dr .Vahket said could cause fungal infections in lungs
    • She failed to disclose the high warning side effects of Barcinitib (see insert)
    • Dr._Vahket failed to give us informed consent
    • Patient Advocate asked the Dr.Vahket what would happen if she gets fungal infection or thrush from Barcinitib
    • Dr. Vahket replied they would just treat side effects
  • Patient Advocate asked why can’t you treat the same side effects from Budesonide.
    • No response from the Dr. Vahket_______
  • Dr.Vahket_____ said Nutrients were not important, the focus needs to be on Mary’s lungs
  • Julie question Dr.Vahket____ – if her lungs were the focus why could we not continue the Budesonide since it helps open airways to the lungs as it is an anti inflammatory
    • Dr.Vahket_said it was not protocol
  • Julie could make no progress with the New doctor and ended call
• Julie contacted charge Nurse and requested a new doctor
• Charge Nurse had her Manager Luke contact Julie
  • He refused to allow the Patient Advocate to be on the call
  • Julie made no progress and Luke said he would have the legal department call her and that he was going to hang up
• Jenna Herzog the Hospital administrator, contacted Julie and teleconferenced with Michaela. Jenna allowed the story to be told, she agreed that she did not like it that the Dr.Vahket used protocol as the excuse to discontinue the treatment. She then had Dr. Liwonjo (Regional Director of Drs.) contact Julie.
• The discussion with Dr. Liwonjo was similar to the discussion with the Hospital administrator. She would have to look into the issues. Julie reiterated that the family was requesting a second opinion (new Dr.). Patient Advocate continued to question how they can justify taking away a treatment that appeared to be helping. She said she would have to look into things and get back to Julie on Sunday. We reminded her that time was of the essence.

Sunday, Nov 7th

• Julie was informed there would be a new doctor assigned to Mary’s care.
• Julie was also informed they started giving Mary Morphine w/out consulting Julie or Tim. 
• Julie asked the day nurse – ‘in your professional opinion how did Mary respond Saturday versus Sunday’. The nurse stated Mary was able to go on high flow Saturday and maintain O2 levels in the low 90s. On Sunday she would drop into the 70s and 80s when Mary was put on high flow and they would have to go back to the BiPAP.
• Dr. Liwonjo contacted Julie to see if she was able to come in to see Mary.  
  • Julie again requested a new doctor. Dr. Liwonjo responded we are working on finding a new doctor.
  • Dr. Liwonjo stated she had met with the Infectious Control team who all agreed that their Protocol is the only thing they have identified that works.
  • Advocate asked Dr. Liwongo how many patients they have tried treating with Budesonide… She said the team has done lots of research and did not see anything about it working…Also asked for data on how successful their protocol treatments have been. Said she would get us that info and never provided it to us.
• The patient advocate drafted a letter with the request for treatment including the documentation showing the effectiveness of Budesonide and the Drug insert for Barcinitib. This letter included another request for the removal of Dr. Vahket from Mary’s care. This letter and Documentation was delivered to Dr. Liwonjo and Jenna Herzog Monday morning. See attached for details.
• Julie and Tim were able to visit Mary. she was not responsive due to being on Morphine
• Julie and Tim conferenced in the family on a discussion with Dr. Liwonjo 
  • The Hospital was offering Remdesivir but would not consider Ivermectin because it would not work, has too many side-effects, and was not approved. Julie provided Nurse (Skylar) with the NIH document of approved drug treatments for COVID which includes Ivermectin as an approved drug for COVID (See NIH for details)
  • Julie questioned why the Hospital is limiting treatment options and questioned why the only allowed protocols were for treatments that the Hospital receives additional compensation for. The Doctor stated that she has nothing to do with the billing and it would be unethical to receive payments from the drug companies. (See MS.GOV memo on additional payments)
  • Treatment options That were discussed
    • Discussed inserting a NG tube so that they could deliver the oral Barcinitib. The family agreed to the Feeding tube and Baricitinib as long as Vitamin C and Vitamin D were also administered and some additional nutrients.
  • Dr Liwonjo agreed to write an order for the feeding tube, Baricitinib, Vitamin C, Vitamin D, and nutrition.  
  • Julie provided Nurse Skylar with documentation for how High Dose Vitamin C is effective for treating pneumonia.
  • Sunday night Julie was notified that they had successfully inserted the NG tube and had administered the Barcinitib, but the vitamins and nutrients were not yet available.

Monday, Nov 8th 

• Julie contacted the Nurse for an update (9:30 am – 10:00 am)
  • She was informed that only the Baricitinib was delivered and that Dr. Vahket canceled all other agreed to items
  • Dr. Vahket remained as the primary doctor
  • Julie contacted LegalShield and requested a letter on her Mom’s behalf

Tuesday, Nov 9th

• Dr. Vahket remained as the primary doctor
• 10:00 am WFJ law firm sent a demand letter for a second opinion on Mary’s treatment plan
• 3:25 pm the nurse requested Julie come to the hospital due to Mary having a leak in her lungs and they were going to have to stop the BiPAP. Julie started a contact chain with the family.
• Upon arrival at the hospital Mary was alert and able to talk with Julie, the nurses and Dr. Liwonjo.
• Julie discussed with Mary her will to continue to fight and that she is not in pain, but struggling to breath.
• There was a family teleconference with the nurses and Dr. Liwonjo:
  • Dr. Liwonjo explained that due to air leakage into Mary’s chest cavity she could no longer be put on the BiPAP and would only be able to be on the high flow and rebreather O2 mask. One of the treatment options was to get x-rays to see the extent of air buildup and assess if chest tubes would be effective to remove some of the air. If chest tubes were not an option the family should strongly consider putting her on comfort care.
  • Mary responded that she wanted to try the chest tubes if it was possible.  
  • Julie went in to discuss this with Mary and Mary stated she has to try the chest tubes if possible.  
  • Then Dr. Liwonjo informed Mary and the family that it will not help very much and may cause more harm than good. So the family should consider comfort care.
  • Julie requested a nebulizer treatment which was given and gave Mary instant relief. The family all agreed that if it is possible a chest tube procedure should be performed.
  • Then Dr. Liwonjo questioned Mary several times if she just wanted to be comfortable. Mary continued to state NO she wanted to try… she still wanted to fight but was tired and wanted something to make her be able to sleep. Dr. Liwonga questioned Mary again if she wanted comfort care?
• Tony arrived at the Hospital and another family teleconference was initiated with the oncoming and off going nurses and Dr. Liwonjo. Dr Liwonjo initiated a briefing on the events of the day leading up to Mary’s current condition and some of the treatment options. The Night nurse (Chris) Provided very clear explanation of the small air pockets on the top of each lung and why chest tubes on the bottom of the lungs would not provide much relief. The family agreed chest tubes at this time would not be beneficial.  Chris also said if the air on her chest wasn’t getting worse it was not dangerous and could be managed
• Other options discussed were to replace the small NG Tube with a larger one so they could remove the air that had built up in her digestive tract (first time family informed of the air in the digestive tract). The family agreed to this being a logical step.  
• The family agreed to a treatment plan that included:
  • Duo nebulizer every 6 hours with Albuterol on an as needed basis. 
  • Replace the small NG tube with a larger one to release the air in her digestive tract. 
  • The air above the lungs is not a concern at the current time and should dissipate over time.  
• 22:00 Nurse Chris contacted Julie and gave an update on the actions taken:
  • The NG tube change out resulted in a large release of air. Mary’s abdomen went from distended and rock hard, to noticeably smaller and soft to the touch.
  • Nebulizer treatments were helping keep her more comfortable and small improvement in O2 levels.

Wednesday, Nov 10th

• Dr. Vahket remained as the primary doctor until Sarah replaced her around 09:00 am.
• Sarah agreed to start treatments of Budesonide (.5 every 12 hours) and vitamin C via the NG Tube. Sarah stated that this would be a 48-hour trial that would be reassessed at the end of the trial period. If no improvement or any adverse side effects were noted the Budesonide would be stopped.
• Julie was with Mary from 6:00 am to 11:00 am and observed the following condition:
  • Mary was agitated in the early morning and not resting so the nurses contacted Julie to request her to come and visit to try to calm her down.  
  • 6:00 am – O2 was maintaining 86 to 88, Mary was having short spurts where she would get agitated and anxious which caused her O2 to drop into the 70s.  When she calmed down the O2 would climb and stabilize around 83 as the morning went on.
  • Julie noted that her moaning during breathing was no longer constant but still intermittent. Nurses stated that Mary calmed down after Julie arrived and it was the most restful they had seen her in over the last couple of days.
  • The Nurses administered the dual nebulizer (~9:00 am) and her O2 raised during the nebulizer and stabilized 86 to 88 again. Mary became more relaxed following the nebulizer.
  • Informed Mary has a bladder infection
• 2:30 pm – Julie talked to nurse – O2 is at 86-88 – she is more rested and most relaxed they have see Mary
• 7:00 pm – Julie talked to nurse – O2 85-87, Mary was a little more restless but not bad. 
• 9:00 pm – Hospital called Julie – Mary’s O2 in 60’s-70’s
  • Julie & Tony heading to hospital to sit with her
  • Mary cycled like this previous night
• ~9:30-10 pm 
  • O2 dropping in 60’s & 70’s – new nurse seems worried & uncomfortable with Mary’s breathing – Tony & Julie to hospital
  • Mary is highly sedated so unable to respond to questions
  • Received another Budesonide nebulizer – O2 spiked up
    • Nebulizer was not being administered properly so relief for Mary is less than what we have seen

Thursday, Nov. 11

• ~12 am – Dr. ______ family meeting
• We wanted clarity on how long these lower O2 levels can go before concern of long-term issues
  • Answer was vague – talked in circles – never clarified
  • Dr.____ mentioned she has indications of brain damage – first time this has been mentioned – is this true? Julie asked how she could have brain damage when just the day before she was talking and understanding exactly what was going on.
• ~12:20 am – new nurse noted all of her vitals are good – O2 is the concern
• Dr. ______ seemed to be vague, talked in circles, noted chances are low for recovery – same story as previous Doctors
• When asking Dr. about continuing Neb treatments he stated it would not help her. Julie Questioned how is it that everytime she received a treatment with the mouth piece neb Mary’s O2 would go up?
• Following meeting with doctor, family notes:
  • Stay status quo through the night
  • Doctor seems to just want to give up
  • Nurse is new to Mary’s situation, so is seems hypersensitive to her situation
  • Mary seems much more sedated today
  • Tony ask nurse @ 1:00 am:

• Abdomen is hardening again – need to find out if they release air again (we thought so, but nurse indicated no)
  • NURSE: they are vacuuming – it is continuing
• Did they back off on the IV steroid – if not, this could cause issues
  • IV dexamethasone steroid – this needs to be weaned off/reduced to properly implement Budesonide
  • NURSE: noted this was completely stopped
• Nebulizer – properly execute
  • NURSE: 
• NURSE: ~1:00 am current status of Mary
  • Calm & more relaxed when nurse out of room, so letting her rest
  • A little coughing
  • O2 – 77 and staying in upper 70’s

• NURSE: hi-flow at 100% now and this can cause issues for lungs to breath on own 
• Nurse spoke with Tony & Julie after meeting with Dr. and expressed her dislike of how the Dr. handled answering our questions.
• 2am Julie & Tony checked in on Mary… Nurse was in room with her and didn’t notice her O2 mask was below her chin. Requested she put it back over her mouth and she put it up too high so O2 continued to drop. Asked again to have her put it on correctly. O2 than started to go back up
• NURSE: noted she would be an advocate for us and empathized with our situation

• Tony shared with nurse – of all the years in a medical family, going through Karen’s cancer and other hospital experiences – this has been the worse
  • Doctor’s care has been horrible – Sarah has been the most compassionate and actually showed 
• Julie to talk to Sarah in morning

• 6:40am – Tony & Julie head to hospital – Mary’s O2 is maintaining in upper 60’s
• 7:00am – family conferences in 
  • Maxed out on Precedex ( which later learned reduces O2 intake)
  • Same condition as at 1:30am
  • O2 hovering in 70-72 (up in low 80’s when family talks)
• ~8:20am – Doctor Sarah
  • Mary actively dying from COVID
  • We have all done what we can at this point
  • Focus care on keeping her comfortable 
    • Start meds – keep comfortable not to make process faster – body will pass when ready to pass
    • Morphine – help with pain
    • Ativan 
    • Oxygen – transition her off hi-flow – cannula option family noted to keep her comfortable
      • Get meds going first
    • Family will be allowed in the room
    • Pending length of transition, hospice can be brought in – we can gauge timing to see what we want to do
  • Mary passed at 1:01pm on 11/11/21

Family lost over 5 days in fighting for Mary due to Dr’s unwillingness to try treatments that have been shown to work. When protocols aren’t working Dr.’s took a Hippocratic Oath to do what they can to save lives!!!! What is happening in our hospitals is 100% criminal! They are letting people die!