As testimony in the National Labor Relations Board case involving Cayuga Medical Center continued into a third day.

After a patient being treated at Cayuga Medical Center complained about a blood transfusion she received in September, the hospital investigated the incident and terminated two nurses – Anne Marshall and Lauren Lamb.

Though the hospital says it fired the nurses for violating its blood transfusion policy, the nurses claim they were just doing what was “common practice” in the Intensive Care Unit and the hospital targeted Marshall and Lamb because of their union involvement.

On Wednesday, the sister of the patient who made the complaint testified about the blood transfusion, which she called “shoddy.”

Though it was out of order with the hearing, Raymond Pascucci, representing Cayuga Medical Center, called the patient’s sister to testify Wednesday morning due to travel constraints.

The patient’s sister is from Maine and said she has been a registered nurse for 20 years. She also said she has 15 to 17 years of blood transfusion experience.

The sister was asked recall when the patient, her sister, needed a transfusion on Sept. 11. Her sister was admitted to the hospital with sepsis, her sister said. When it was time for the transfusion, she said Marshall came in with the blood, “spiked it, hung it and attached it.” She said she remembers the patient asking “What about the protocol?” And she said Marshall told her it was done at the desk. The sister testified that the patient then said there had always been two nurses who checked her bracelet before. According to the sister and patient, Marshall then said it must have been a new nurse who did that.

Her testimony is similar to the statement made by the patient, provided by Cayuga Medical Center.

The patient voiced her concerns to a charge nurse after the transfusion, and the sister said they did not remember seeing Marshall again.

According to hospital policy as explained in testimony, blood or products being used in a transfusion are supposed to be checked in two places with two nurses. First, the nurses verify information a nurses’ station where the two nurses compare patient name, date of birth, consent form, account number, expiration date of the blood and other information. The two nurses are then supposed to do additional checks to verify the identity of the patient at the bedside, like look at the patient’s wristband.

However, two nurses have testified in the hearing so far that usually everything is checked and signed off on at the nurses’ station and then the primary nurse goes into the patient’s room to do the blood transfusion.

While testifying Wednesday, the sister called the blood transfusion “shoddy” and when asked why she felt that way, she said she felt the care “was disrespectful.”

After the incident, the sister said was called by two people from Cayuga Medical Center to follow up on the blood transfusion. In addition to recalling concerns with the blood transfusion, the sister said she also voiced concerns about the inconsistent use of gloves and masks she noticed while visiting her sister at the hospital. She did note Marshall was wearing a mask. The sister said she told the two hospital staff that interviewed her about the blood transfusion, but heard no follow-up.

Mimi Satter, a legal representative for 1199 SEIU United Healthcare Workers East, which has brought the charges against Cayuga Medical Center, asked the sister if Cayuga Medical Center paid for her airfare, and she said no. She did say the hospital paid for car mileage from Buffalo to Ithaca.

Last year, Cayuga Medical Center was investigated by the NLRB and found to have violated federal labor laws by interfering with unionizing efforts. The judge presiding over that case also found that nurse Anne Marshall was unlawfully suspended and demoted.

On the first day of the hearing, Satter said Marshall was the “face” of the union activity at the hospital. Satter said Cayuga Medical Center was “more than anxious” to rid itself of its most vocal union advocate.

Jessica Noto, a field attorney for the NLRB, said in opening statements that Marshall and Lamb acknowledge they did not follow protocol when administering the blood transfusion, but did it “in the same manner that many of the ICU nurses performed the blood transfusions throughout the years.”

In addition to testimony from the patient’s sister, the court heard continued testimony from Christine Monacelli, a nurse in the ICU who has worked at Cayuga Medical Center for 16 years.

When asked if she knew of anyone ever being disciplined for not following the hospital’s blood transfusion policy, she said she did not. Monacelli also told Noto that that she was never told she or other nurses could be disciplined for not performing the policy at the patient’s bedside.

After Anne Marshall and Lauren Lamb were terminated, both Monacelli and another nurse that testified earlier in the hearing said nurses changed their behavior after the termination and began following the hospital policy more carefully.

Noto asked Monacelli if she had observed anyone in the ICU following the hospital’s policy every time prior to Marshall and Lamb’s termination. Monacelli said “No.”

The hearing will resume at 8:45 a.m. Thursday in the Tompkins County Courthouse.

Kelsey O'Connor

Kelsey O'Connor is the managing editor for the Ithaca Voice. Questions? Story tips? Contact her at and follow her on Twitter @bykelseyoconnor.