Amy Knopke's Online Review Report Card

An absolutely horrible experience. My 90 yo sister had been admitted to North Memorial thru the ER for sepsis. The ER Dr. looked back in her record and found a similar incidence a year previous and followed the same protocols established to treat that episode of sepsis. My sister's Advance Directive only prohibited intubation and CPR as both would be most detrimental to her health. However, as far as aggressive treatment using medications and other measures, my sister wanted that to be done. The initial Dr in the ICU followed the recommendations of the ER physician and within 48 hours my sister was showing marked improvement as well as an increase in her mental status. She had progressed to the point that she wanted to take water and nutrition orally. Dr. Knopke took over my sister's care and felt that due to her age and her medical problems, that aggressive treatment was not recommended by her. She challenged the Advance Directive and said that because my sister did not want CPR, that my sister was saying she did not want aggressive measures to be implemented; this was totally untrue and against my wishes as her Power of Attorney, but also my sister. AFter taking over my sister's care she discontinued the first antibiotic which had previously been found very effective in fighting any secondary infections that might have been missed on a culture and it was reversing the sepsis along with Vancomycin which was a second antibiotic given as methicillin resistant staph had also been cultured in my sister's blood. Again, we noticed marked improvement within 24 hours of hospitalization. After Dr. Knope took over her care and about 48 hours later, my sister appeared unresponsive and almost comatose again. The day before she had shown marked improvement with her mental status, alertness and wanted to take fluids orally. This had been a pattern with her on previous similar illness which seemed to occur about once a year. I learned from the nurse that Dr. Knopke had discontinued the first antibiotic and reduced the Vancomycin from every day dosing to every other day. The sepsis began to return after the change in the antibiotics. Dr Knopke's justification was that my sister's kidney lab values had gotten worse from the antibiotics and she was lowering the doses to decrease the affect on her kidneys. I told her and it was documented in the medical record that whenever Toni was given antibiotics it had this same affect on her kidneys and that after the infection was treated and the antibiotics discontinued, her kidney values would return to their previous levels. Dr. Knopke kept steering me and Toni's caregiver in to the direction of Hospice and not treating her illness. Again, I didn't agree, I didn't want her care minimized to allow my sister to die.All I could hope was that Toni could be transferred out of ICU and back under the care of a physician from our clinic that knew her. I wanted her transferred to 5th floor where I knew the nurses would offer progressive treatment and encourage her to take fluids. Once on the medical unit I would have gotten our clinic Drs to put her back on the antibiotic regeime that would reverse the sepsis as it had on previous occasions. The Dr said that being her "power of attorney," I had no authority over managing the type of care my sister would receive??? She also went to the Hospital Ethics Committee and portrayed a very negative picture of my sister, her medical history and totally misconstrued the Advance Directive. She told the Ethics Committee that she had spoken to Toni's Dr. and that he agreed with basically "non-treatment" and said that our Dr. said he had told me many times to put Toni in Hospice. This was a total lie, she never spoke to Dr. Frane. He told me he would have never said that, he felt such decisions were "family decisions." Again, Dr. Knope ignored my wishes and transferred my sister to a "palliative care unit" where their only concern was "comfort" and not care to restore her. Toni died 10 days later in a hospice unit, a miserable death.