But Who's Going to Foot the Bill?

A Wisconsin nurse is accused of amputating a patient’s foot without permission and wanting to display it in her family's taxidermy shop.

38-year-old nurse Mary K. Brown removed the frostbitten right foot of a 62-year-old patient at Spring Valley Health and Rehabilitation Center in Pierce County, according to a criminal complaint. She was charged last week with elder abuse.  Investigators were contacted about a death at the assisted living facility by the county medical examiner, who said the body was sent for an autopsy because of “the unusual circumstances of his death.”

The medical examiner said he noticed the victim’s foot was not attached to his body “but was rather lying beside him.”  Pete Koch, a Pierce County sheriff’s investigator, interviewed staff members at the rehabilitation center and found that the victim, who was not publicly identified, had been admitted several months before the death.

He was taken to the center because he had fallen in his residence when the heat went out, which caused him to have “severe frostbite” on both of his feet. His feet became necrotic, meaning his tissue had died.  Brown cut off the foot in what she said was an act of compassion because of the dire state of his feet.  According to the accounts of nurses Koch interviewed in the criminal complaint, the foot was no longer fully attached to the patient's leg, it smelled and it was “black like a mummy.”

Tracy Reitz, the center’s director of nursing, said that a few days before the amputation, the victim’s right foot “was dead, foul smelling."  The patient's foot was cut off by Brown as she and two other nurses, identified as Nurse 3 and Nurse 4, were in the victim's room.  The foot was then placed in a bag in a freezer, to be sent with him when he passed away.  Brown admitted to Koch that she had not received a doctor's order to cut off the foot.   She said that the victim didn't show any signs of pain and she covered up his stump with gauze.

However, Nurse 4 said she was holding the victim’s hand and his grip was “extremely tight and he was moaning a little bit.”  And another staffer, identified as Nurse 1, said she spoke with the victim two days after the amputation. According to the complaint, he told her "that when they cut his foot off he felt everything and it hurt very bad."

Brown said that she “was trying to make the quality of life better for him." She explained that the patient always complained about the smell and she thought he “would like it better.”  Nurse 3 told Koch that during the amputation, Brown talked about taking the victim’s foot home and “epoxying it," which the nurse found to be strange.  Another nurse, identified as Nurse 5, who was not in the room for the amputation, recalled that Brown said her family has a taxidermy shop. Brown told the nurse “she was going to preserve the foot and put it on display with a sign that said ‘Wear your boots kids.’”

Kevin Larson, administrator and CEO of the facility, told Koch that Brown did not do a report on the incident. Larson said nobody wrote anything in the victim’s chart on May 27 except for a notification about medications.  Larson said Brown had not asked him if she could remove the foot and there was no doctor’s order to do so.  Spring Valley Health and Rehab Center did not immediately respond to an NBC News request for comment.   Brown was charged on Nov. 3 with physical abuse of an elder person intentionally causing great bodily harm and mayhem, with increased penalties as the victim is an elderly person.