Morristown Memorial Hospital petitions for the appointment of a guardian for Robert Quackenbush, an alleged mental incompetent and patient at the hospital, to authorize the guardian to consent to an operation to amputate the legs of Quackenbush and to consent to other medical treatment necessary due to gangrenous conditions in both his legs.
The verified complaint asserts an advanced gangrenous condition in both legs and the incompetence of the patient to give his consent for the treatment. A treating physician's affidavit indicates extensive gangrene in both legs, the likelihood of one foot falling off and the probability of death within three weeks unless amputation and treatment occur.
Based on the complaint and the supporting affidavit, an order to show cause issued directing Quackenbush to show cause why the relief sought should not be granted. In absence of any next of kin being noted in the complaint and based on the allegation of mental incompetency, Martin Newmark, an attorney, was appointed guardian ad litem for Quackenbush.
An answer was filed on behalf of Quackenbush asserting his mental competency, his right of self-determination and seeking dismissal of the hospital's complaint.
An affidavit was filed by Martin Newmark setting forth that he had spoken with Quackenbush, that the latter was reasonably responsive to the attorney's questions, that he was aware of his condition and that he expressed "in no uncertain terms he had a right not to have the surgery performed
against his will." Mr. Newmark indicated that Quackenbush is lucid and aware of the consequences of his position and the alternatives available to him.
A plenary hearing was commenced within 24 hours of the issuance of the order to show cause.
The facts elicited at the hearing indicate that Robert Quackenbush is 72 years old and has lived as a semi-recluse of the last ten years in a trailer in Chester, New Jersey. He is divorced, has no children, his parents and siblings are deceased and he is unable to provide any significant information concerning relatives except for a Mrs. Kagan, an 83-year-old cousin with whom he lived in the trailer. The cousin is presently in a nursing care facility.
A local rescue squad brought Quackenbush to the hospital emergency room at the request of his neighbors. He refused treatment and was rambunctious and belligerent. Because of the refusal to accept treatment, hospital officials attempted to send him home, but all available agencies for transportation refused to transport him. Finally, he was admitted at the direction of Dr. Ames Filippone, who became his treating physician.
Dr. Filippone, mainly through other sources, but with some information from the patient, learned that Quackenbush was hospitalized about two months prior to his admission. At that time he was diagnosed as suffering from arteriosclerosis in the legs and advised to have an operation, but he refused and left the hospital. Aside from that hospitalization and medical attention, he shunned medical treatment for the prior 40 years. Dr. Filippone described him as a conscientious objector to medical therapy.
A medical examination by Dr. Filippone indicates that Quackenbush has gangrene in both legs. On his left leg the skin is black from the knee down, is partially mummified and the foot is dangling, about to fall off. On the left leg, there is an open sore, which is draining fluid and ...