Overmedicated | Doctor accused of not following drug protocols

By Andy Pierrotti

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    ATLANTA (WANF) — Christy Carr discovered her mother had just days to live through a Facebook post.

“[S]he might not make it another week,” wrote Carr’s uncle, Buren Roberts, in the June 2017 social media post. “So, please be praying for her.”

When Carr reached her mother, Shirley Couch, she found her lying lifeless in bed. “Something bad is going on here,” Carr recalled thinking. “And we need to figure out what’s going on because I don’t trust this at all.”

Carr had good reason to worry; not because her mother was nearing the end of a long battle with a disease, but because she suspected one of her own siblings was trying to kill her.

Unknown to Couch, her oldest daughter, Renee Bonner, had placed her into hospice care, which typically focuses on end-of-life needs.

When Madison County, Georgia, Coroner Julie Harrison arrived, she found Couch had been prescribed morphine, antipsychotics and fentanyl patches, a powerful combination of narcotics usually restricted to patients shortly before death.

“She’s actually been overdosed,” said Harrison in a video recorded on a deputy’s body camera .

Bonner worked at Homestead Hospice at the time as an administrative assistant and helped administer the drugs to her mother. Couch, a long-time Danielsville, Georgia, received care at a family member’s home, not at a facility.

But the 81-year-old was far from knocking on death’s door. According to her medical records, Couch was in fairly good health for her age, despite a stroke nearly a decade before. “Sharp as a tack,” Carr said. “Still to this day.”

A doctor had also cleared her for knee surgery, meaning doctors thought her heart, lungs and mental health were all strong enough for surgery, hardly someone about to die.

Suspicious of her big sister, Carr called police.

In 2019, a judge found Bonner guilty of attempted murder following a bench trial. Today, six years after the family was told she was about to die, Couch is still alive.

“To have your own child try to kill you, that’s hard to live with,” said Couch in an interview with Atlanta News First Investigates this past February. “I love her. I’ll aways love her, but I really don’t like her.”

Couch’s family believes someone else is to blame for nearly killing their mother.

Dr. James Shiver never met Couch, but ordered all of her drugs as the medical director for Homestead Hospice at the time.

In a 2021 deposition that was part of a pending lawsuit, Shiver said he prescribed Couch morphine, fentanyl and other drugs, after consulting with nurses on the phone.

Shiver’s phone records, though, tell a different story. According to court records filed by Couch’s attorney, which includes the doctor’s Verizon call logs, Shiver and the nurses never spoke.

Couch’s family also raised issues in the lawsuit over Shiver’s drug orders. Georgia and federal law require prescriptions for controlled substances, including the drugs Shiver ordered for Couch, to be manually signed on paper or electronically.

According to all of Couch’s prescription orders, Shiver’s signatures are exact matches. If the signatures were photocopied or stamped, it could be a crime.

Shiver denies any wrongdoing. “There were no stamps or signature reproduction,” he told Atlanta News First Investigates this past February. Shiver also said he can’t remember speaking with Couch’s nurses. “Whether or not they were, and when they were called, I don’t know,” he said.

In a recently settled lawsuit, Shiver said he did not see Couch “physically.”

“Exact duplication of a signature is beyond human experience, an impossibility,” said Couch’s attorney, James Hugh Potts. “Our expert showed those were not ‘live-ink genuine signatures’ on those drug orders.”

During Bonner’s criminal trial, Shiver testified under oath he was certified by the American Board of Family Medicine when he worked at Homestead. That wasn’t true. In the deposition, the doctor admitted he hasn’t been board certified since 2015. “Yeah, that was in error,” said Shiver in the deposition.

Certification is not required to practice medicine, but it’s often required by hospitals and health care systems because it shows physicians receive continuing education in their fields. According to his deposition, Homestead Hospice wanted him certified in hospice and palliative medicine within three years of employment. That never happened.

In 2022, Carr submitted a complaint with the Georgia Composite Medical Board against Shiver. The regulatory body, which licenses physicians, declined to confirm whether an investigation is underway, but according to emails and text messages shared with Atlanta News First Investigates, a state investigator is reviewing the complaint.

“I can’t give details of the investigation, but I am taking all necessary steps to make sure this case will be well presented to the Board,” the investigator wrote to Carr in a January 31, 2022, text.

Complaints submitted to the medical board against doctors accused of misconduct are largely concealed from the public. Even when the board references the complaint in a public meeting, it only uses the licensee’s initials or case number. If the board takes disciplinary action, it is published on its website.

While Couch was not located in a nursing home at the time, patients under hospice care are often cared for in long-term care facilities.

According to the Centers for Medicare & Medicaid Services, nursing homes were cited at least 3,846 times for failing to keep residents ” free from unnecessary drugs” from 2016 to 2023 across the country. Twenty-two of those happened in Georgia.

Traditions Health, which acquired Homestead Hopsice in 2021, declined comment.

Couch and her family believe Shiver and the hospice company should be held accountable. “They’ll answer to God for what they have done,” Couch said.

“How is that any different than putting a gun to your head and pulling the trigger?” Carr asked. “They’re just doing it with drugs.”

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