Local Senior "Care Home" Operator Under Investigation After Patient Dies

A local man running a “personal care home” on the edge of town has come under investigation recently, when a female patient of his was admitted to the hospital with severe bedsores that alarmed her doctors.

Court records indicate that Ramon Ricardo Garcia, 54, called for emergency medical services to respond to his residence in the 4200 block of Armstrong St. on March 30, stating a 74-year-old woman with a few medical issues was ill and presenting with bedsores.

When medical staff arrived, they picked up Edna Adian and transported her to Shannon Medical Center, where she was examined by Dr. Russwurm. The doctor noted that Adian’s bedsores were severe and had become infected.

Soon thereafter, Adult Protective Services and San Angelo Police were called to the hospital, and after evaluating the situation, detective Jake Russell was called to investigate. Upon arrival, Russell took a look at Adian’s injuries before she went into surgery, and observed open wounds on her hip, legs and feet caused by bedsores.

Jeremy Sobotka, a supervisor with APS, explained that the agency occasionally receives calls from hospitals or law enforcement officers for patients that meet their criteria of either being an adult with a debilitating and chronic illness or a senior citizen over the age of 65. APS investigations may be launched surrounding persons who have a personal care provider or self-sufficient individuals caring for themselves.

“It could be either way,” Sobotka said. “If there’s somebody living with them that’s abusing them or supposed to be taking care of them and neglecting them, then we can investigate that. Or, we can also look at self neglect if they’re at home alone and not able to take care of themselves, then we may investigate that too.” Either way, Sobotka confirmed, APS investigations center on neglect and criminal abuse.

After leaving the hospital, detective Russell and detective James Hernandez paid a visit to Ramon Garcia, who allowed them inside his residence on Armstrong St. and showed Russell Adian’s room, the complaint states. Garcia then explained to Hernandez that he is the owner/operator of a “personal care home” and told him he had assumed care of Adian.

“She was here, yes. For six or seven years,” Garcia’s wife said, standing at her door the day after her husband was arrested. “She walked, smoked, so she went to the smoke room a lot. The thing is, if she didn’t want to get up and go to the bathroom she could, but she chose to sit there for eight hours and wet on herself. We gave her pull-ups, she just, you know, gave up.”

The complaint states that Garcia told detectives he had confined Edna Adian to her bed about three weeks prior and provided her everyday care, including feeding, showering and changing her adult diapers.

He also told detectives that he had only noticed Adian’s injuries three weeks prior and was aware that they were bad, but they had progressed in a rapid state and he was treating the wounds, the complaint states. Dr. Russwurm, however, told Russell that he determined that Adian’s injuries were so extensive they would have begun appearing months prior to her March 30 hospital visit.

“She didn’t want to go to the nursing home, she didn’t want to go to the hospital, so she got some bedsores,” Garcia’s wife said. “She wasn’t sick, it was just the bedsores, you know. It got a little bit too out of hand, but we were putting medication, trying to do the best we could…I did, I did tell him several times, ‘you’ve got to take her to the hospital’. She (Adian) said, ‘No, no…I don’t want to go, I don’t want to go.’”

In the weeks following Adian’s hospital admission on March 30, detectives continued working the case and, in the process, on April 3, Edna Adian died at Shannon Medical Center. A death certificate completed by forensic pathologist Dr. Thomas Parsons listed the cause of death as complications from severe decubital ulcers, or bedsores.

Confronted with the news of Adian’s death almost three weeks prior, Garcia’s wife reacted with surprise and said she “didn’t know”. She said she and her husband were concerned about Adian knew that she didn’t have any family locally to take care of her, but that she wouldn’t go to a nursing home, presumably because she wanted to smoke.

The house the couple occupies was once a nursing home, Garcia’s wife related, but has since been converted to their home, where they take care of a limited number of patients. Edna Adian had been there for roughly six to seven years, she said, and had either paid her husband cash or with check each month.

Garcia’s wife explained that she and her husband “could only take care of three [patients] without a license” and described her husband as a “medication aid”.

The Department of Aging and Disability Services manages licensing for care homes and assisted living facilities in the state of Texas, and only requires those providers with four or more patients to be licensed through the agency.

“I have one more that I’m taking care of,” Garcia’s wife said. “He’s 95. But his niece, they come everyday, every other day, but Edna had nobody to come. She has two sons, one was in Turkey and one was somewhere around here. He came two years ago for like five minutes and that was it….Rick was her family, you know. Anything she needed she called Rick. I didn’t know she passed away, I didn’t know.”

Nearly three weeks after her death, Precinct 2 Justice of the Peace J.P. McGuire issued a warrant for Garcia’s arrest on one first-degree felony count of injury to an elderly individual causing serious bodily injury. He was picked up the following day and remains in jail, held in lieu of a $100,000 bond.

Adian’s body has already been sent off for autopsy, and detectives are awaiting results from the examiner.

“All of the leads that we’re getting are being pursued,” Russell said. “Anything that does come up or anything that we already have we are working on. It’s still being actively investigated.”