Late Johnson County Sheriff Tester’s wife sues Ballad over death

GREENEVILLE, Tenn. (WJHL) — A federal lawsuit filed recently alleges Ballad Health and its doctors provided improper care to then-Johnson County Sheriff Eddie Tester last August 8-10, leading to a fatal heart attack Aug. 11, 2023.

The complaint filed on behalf of Brenda Tester, Tester’s widow, seeks $7.5 million in damages. It also lists the Tennessee Department of Health (TDH) and Commissioner Dr. Ralph Alvarado as defendants.

In addition to the monetary damages, the suit filed by Knoxville attorney Russ Egli seeks a declaratory judgment that the Certificate of Public Advantage (COPA) under which Ballad operates is unconstitutional. Ballad, which has an inpatient hospital monopoly in the Tri-Cities region, was created by state action and must be “actively supervised” by TDH and continue showing “public advantage” compared to a non-monopoly situation — including in quality of care.

Ballad officials declined to issue a statement other than to say the organization does not comment on pending litigation.

At its root, the lawsuit claims that doctors performed an ill-advised liver biopsy on Tester while he was on blood thinners Aug. 10, leading to a precipitous drop in his hemoglobin and other blood levels that resulted in the Aug. 11 cardiac arrest.

The suit claims Eddie Tester was at Sycamore Shoals Hospital in Elizabethton Aug. 8, 2023 after a scan found a blood clot on his lung. It says a doctor ordered an intravenous Heparin drip (Heparin is a blood thinner) during his inpatient stay, which continued to Aug. 9.

The doctor determined Tester needed a liver biopsy and sent him by ambulance to Johnson City Medical Center, where he underwent the biopsy early Aug. 10, the suit says.

Ballad and the doctor who ordered the biopsy “grossly fell outside the standard of care regarding a liver biopsy with a patient that was actively taking Heparin by not evaluating Sheriff Tester to ensure he had no complications from bleeding out due to the Heparin,” the suit states.

“Had the proper standard of care been followed, Sheriff Tester would not have suffered life ending internal blood loss, which lead (sic) to his cardiac arrest and ultimately his sudden death,” it continues.

Sometime after Tester was returned by ambulance to Sycamore Shoals Aug. 10, he was discharged and sent home with a prescription for Eliquis, an oral blood thinner, which he was instructed to take daily according to the suit.

On Aug. 11, Tester was taken by ambulance to the Johnson County Community Hospital emergency department, with personnel providing CPR throughout the 25 to 30-minute trip. Those efforts continued for almost an hour at the hospital, the suit claims.

When he arrived at Johnson County Community Hospital, Tester’s hemoglobin level was 5.4 and it dropped to 4.1, which the suit claims is far below the standard of 13.5 to 18 for a man his age. It says other measures also indicated internal bleeding.

The lawsuit says doctors and staff should have known Tester’s blood counts were moving in the wrong direction throughout his treatment and should have delayed the liver biopsy.

Its second count claims negligence by Ballad and doctors was the “direct and proximate cause” of the damages Brenda Tester has sustained. The third count of mental and emotional anguish says that after seeing her husband in cardiac arrest and witnessing emergency personnel trying to save his life, she has suffered emotional damage ranging from difficulty sleeping and nightmares to nausea, inability to eat, and depression and anxiety.

The COPA count

The first of the lawsuit’s three counts is the one that attempts to draw in TDH and Alvarado, as well as being the count that would give it standing in federal court, rather than being a state-level malpractice claim. At the center of that is the COPA and its potential links to federal law.

Egli argues that Tester and his wife are entitled to the federal Affordable Care Act’s protections — and that “under color of law” the state of Tennessee “has plenary control over the Defendant hospitals herein pursuant to Tennessee’s COPA.”

The suit claims Alvarado and TDH have failed to properly exercise the “continuing supervision over the (Ballad hospitals) that Dr. Alvarado is tasked with.” It sets out a litany of alleged failures by Ballad on quality measures, staffing and other issues it claims should be monitored more effectively by TDH.

The suit claims that taken together, those alleged failures harm the public.

“By Tennessee allowing the Defendants herein to monopolize and in doing so harm the public … Tennessee’s COPA is unconstitutional and cannot meet constitutional scrutiny in any sense of the word,” the suit argues in the federally related count.

News Channel 11 also reached out to TDH and to Egli’s office requesting comment.

For the latest news, weather, sports, and streaming video, head to WJHL | Tri-Cities News & Weather.