Lawyers make opening statements in trial of nursing home employees charged in the death of 72-year-old patient

The only thing state prosecutors and defense attorneys for five health care workers on trial in the death of a 72-year-old patient agreed on Tuesday was that she died on Oct. 26, 2012 at a Medford nursing home.

Whether anyone is responsible for the death of Aurelia Rios -- a frail woman with a host of serious medical problems -- is a matter of dispute, attorneys said Tuesday during opening statements before two juries in Riverhead.

Rios' death certificate lists a heart attack as the cause. There was no autopsy and Rios was cremated.

Prosecutors said Kethlie Joseph, 63, a respiratory nurse, didn't follow Rios' doctor's order and failed to connect Rios to a ventilator. But her attorney reminded jurors that prosecutors are asking them to decide whether his client killed her patient, not whether she should have performed her job differently that day.

Joseph has had an "exemplary" career in nearly two decades, and her professional conduct, until now, has never been called into question, said her attorney, Jonathan Manley, of Hauppauge.

"She is not a killer," said Manley, who contended Rios' doctor's order did not require she be connected to a ventilator at night.

State Attorney General Eric T. Schneiderman's office alleged that Joseph and three nurses ignored audible and visual alarms for nearly two hours from 1:40 a.m. to 3:36 a.m. that indicated Rios' pulse and blood-oxygen levels were low or nonexistent, and their failure to provide her care during that time lead to her death.

Prosecutors also alleged that the four women and a fifth co-defendant attempted to cover up Rios' death or their roles in her death by lying to investigators from the state health department and the nursing home, Medford Multicare Center for Living, which launched separate inquires.

The case came to light when an employee at the nursing home reported the death to the state health department on Nov. 5, 2012.Both inquiries did not find evidence Rios was neglected or abused, defense attorneys said.

Besides Joseph, the other four employees on trial are Christine Boylan, 50, of Mastic, former director of respiratory therapy, and three nurses -- Victoria Caldwell, 52, of Medford, Marianne Fassino, 54, of Shirley, and Kimberly Lappe, 33, of Southold.

All five women face various charges, including neglect and falsifying business records. Joseph is the only one charged with criminally negligent homicide.

State Supreme Court Justice John B. Collins is holding one trial but with two juries, one for Joseph and one for the four co-defendants.

William Kephart, attorney for Boylan, said his client was not on duty the day Rios died and had no reason to cover up her death. "Nothing to be gained ... What's the motivation to cover up?," Kephart told jurors.

Lappe, who was assigned to care for Rios, responded when summoned by a nurse's aide, said attorney Scott Gross in his opening statement. Before Rios died, Gross said his client went into Rios' room twice- once at around 7 p.m. on Oct. 25, 2012 to change the oximeter attached to her finger and again at 12:19 a.m. On Oct. 26, 2012, to help Rios go to the bathroom and clean her up.

"When Kim was called, she responded," Gross said.

Ray Perini, Caldwell's attorney, said his client was not assigned to care for Rios nor was she assigned to work in Rios's section on the ventilator unit. Caldwell happened to be near the nurse's station and responded when an aide asked her to look in on Rios.

"She treated a patient she didn't know," Perini told jurors.

In all, nine employees and the nursing home were charged in Rios' death. Two nurse's aides have pleaded guilty and will not have to serve any jail time. The remaining defendants, including the nursing home administrator, are set to stand trial as early as June.The trial resumes Wednesday. Rios' daughter is expected to testify.