Family Medicine practitioners - Fort Stockton, TX

"My 86 year old mother was a patient at the Pecos County Memorial Hospital to have wound care. Due to failure to heal, the determination to perform a debridement was required. Early morning Thursday, March 15, 2023, Resident Medina, under the direction of Dr. Gougler, advised my mother she would be under conscious sedation to perform the procedure. Within an hour, Dr. Gougler, Resident Medina, Dr. Rodriguez, Lori Villa (hospital nurse) and myself were present in the room Dr. Gougler advised my mother she would be doing the procedure using lidocaine injection. The procedure began at approximately 9:10 am. I was present before and during the procedure. No meds were offered or provided prior to the procedure. I asked Dr. Gougler if they had topical lidocaine, her reply was "No we don't have that here". Dr. Gougler injected my mother's calf violently from the bottom of the wound, causing my mother to scream out in agony. Gougler then injected her again on top of the wound, causing my mother to again scream out in agony. Gougler indicated to Medina to begin the removal of flesh. I interrupted and insisted they allow my mother a moment to take a breath and the lidocaine to take effect. My mother was screaming in agony, repeatedly saying "it hurts, Oh my God". Gougler ordered the nurse to bring in a dose of morphine. The nurse injected 2mg of morphine into the IV tube. Immediately after Gougler ordered Medina to begin the procedure. As Medina was gently peeling back the 1st layer of flesh, Gougler took the tweezer from Medina and aggressively tore up the flesh from the wound, causing my mother to scream again in agony. Medina was attempting to remove the flesh from the wound with scissors, however the flesh was too thick (Gougler was still holding the flap of flesh up), so Gougler requested a scalpel. Medina took the scalpel and was cutting, as he got to the end of the flesh, it was thicker, Gougler said, "just cut it". My mother was screaming in agony the entire time. The nurse (Lori Villa) who was present during the procedure, later described the procedure as "brutal". My mother has suffered from what can only be described as post traumatic stress since that procedure. The evening of March 15, 2023, my mother's anxiety grew so much she could not rest, she shared her feelings to Dr. Rodriguez. Dr. Rodriguez gave my mother a dose of lorazepam and hydrocodiene. The next morning, approximately 8am, Dr. Gougler, Resident Medina and Dr. Rodriguez came in to announce the insurance had only authorized 3 days of "swing bed" therapy, however, "if you want to you may go home today". We chose to go home. "