After learning her father was in a Buffalo hospital with brain and lung cancer, Sheila Rybar flew 1,400 miles from her home in Fort Worth, Texas, to see him.
She said she arrived in Buffalo on Sunday, Oct. 11, and spent hours the next day filling out paperwork to get a special Covid-19 exemption from the state Health Department, allowing her to make an end-of-life visit with her father without putting herself in quarantine for 14 days.
On the morning of Tuesday, Oct. 13, after obtaining the exemption and getting a Covid-19 test that verified she did not have the virus, she went to see her father at Buffalo General Medical Center.
But hospital officials would not allow her to visit him.
“They looked at my exemption letter from the state and told me several times that I could not see him. They said this was not an end-of-life situation, and I could only see him after going into quarantine,” Rybar told The Buffalo News.
She never did get to see her father. Thomas A. Cuccia, 67, of Fredonia, died the next day, on Oct. 14.
Although hospital officials dispute why Rybar was prevented from visiting, the case illustrates the difficulties the Covid-19 pandemic is creating for out-of-state Americans with loved ones in New York State hospitals. It also shows the tough situation hospital officials are in as they try to protect patients from the virus.
“I followed all the New York State procedures, got myself tested, and still, they would not let me in to see him,” Rybar said. “When I found out he died, I felt like my heart was ripped out.”
A hospital official did not dispute that Rybar was turned away one day before her father died.
But Mike Hughes, a senior vice president at Kaleida Health, which runs the hospital, said that about a dozen Buffalo General officials told him Rybar did not present them with a New York State quarantine exemption.
Even if she had the exemption, Hughes said, Thomas Cuccia was not considered by the medical staff to be near death, so the hospital could not let her visit her father.
“His death was completely unexpected,” Hughes said.
He said Buffalo General followed New York State guidelines for visitors from states with high Covid-19 outbreaks.
“These are New York State guidelines and they are very clear,” Hughes said. “They are not Buffalo General’s nor are they Kaleida Health’s. This type of situation — unfortunately — happens every single day in hospitals & nursing homes across Western New York and New York State.”
Over four days, as The News questioned Hughes about the case, his explanation for why the hospital barred Rybar from visiting her father shifted several times.
He initially said Rybar’s allegation that she was not permitted to visit Cuccia because he was “not in an end-of-life situation” is “categorically false.”
He said Thursday that Rybar was not allowed to visit because of “a family dispute” between Rybar and Cuccia’s wife and health care proxy, Lisa Cuccia. He said the hospital was following the directions of Cuccia’s health care proxy.
Lisa Cuccia — who told The News she does not get along with Rybar — insisted four times in interviews with The News that she did not ask the hospital to keep Rybar from visiting until Wednesday, Oct. 14, a few hours before he died.
The widow added that she was told by her husband’s doctor as late as Wednesday morning that Thomas Cuccia’s condition appeared to be improving and he was not facing an end-of-life situation.
Based on her own conversations with hospital officials, Lisa Cuccia said she believes Rybar was barred from visiting her father because his life did not appear to be in danger.
“My husband was hospitalized Friday. He was not doing well over the weekend but was doing much better on Monday and Tuesday,” Lisa Cuccia said. “He went into the hospital with swelling of his brain, but they gave him steroids and was responding well to that treatment. He seemed to be doing much better. Wednesday morning, his doctor told me he was doing much better. He was sitting in a chair, watching TV when he suddenly went into cardiac arrest around 2:30 Wednesday afternoon. Then he died. Everyone at the hospital told me they were surprised, they were shocked that he died.”
She said her husband of 25 years had a pacemaker in his heart after suffering two heart attacks in recent years.
After he was asked about Cuccia’s comments, Hughes criticized Rybar — calling her “an extremely uncooperative estranged family member” — and offered another explanation.
“Ms. Rybar did not have an exemption letter from New York State to exempt her from a 14-day quarantine,” Hughes said in an email to The News.
He said she produced correspondence from the State of Texas that allowed her to fly from her home there to Buffalo, but did not have a New York document allowing her to make an end-of-life visit with her father.
The News sent Hughes a copy of Rybar’s New York State exemption letter dated Oct. 12 and the Covid-19 test results dated the next day that showed she did not have the virus.
“And again, even if she did produce it to someone at Buff Gen it would not have mattered,” he said, pointing out, “Her father was NOT end-of-life. He was undergoing full treatment and did not have any type of “do not resuscitate” order.”
A family divided
For her part, Lisa Cuccia said she doesn’t think the hospital erred in not letting Rybar visit.
“I have no problem with what the hospital did. They are trying to protect their patients from Covid-19,” she said.
Lisa Cuccia said she does not like or trust Rybar, and that’s why she instructed the hospital on Wednesday not to let Rybar visit her father.
“She had very little relationship with her father, she hadn’t seen him in two years and he hadn’t talked to her in months,” Lisa Cuccia said of Rybar.
Rybar, 45, said her dispute is with the hospital, not her stepmother, and told The News she plans to sue the hospital. She said she stayed at Lisa Cuccia’s home from Sunday until Wednesday and was not aware that her stepmother was upset with her until after her father died.
Thomas Cuccia ran a furniture upholstery business and was a Navy veteran. His daughter said he was proud of his military experience and loved talking about it.
Rybar said she barely knew her father most of her life and only began to establish a relationship with him about four years ago. She said her father and her mother divorced more than 40 years ago.
“I was born in Dunkirk, but after the divorce, my mother moved to Texas with my sister and me,” Rybar said.
Rybar said she was thankful that she reconnected with her father and cared deeply for him.
“When I got the call last week that he had cancer, I immediately booked a flight to Buffalo to see him,” she said. “I flew out of Texas on Sunday and called him at the hospital from the airport. I told him that I loved him and he told me he couldn’t wait to see me. Those turned out the be the last words he ever said to me.”
State regulations
Texas is one of 37 states that New York’s Health Department considers areas with high infection rates for Covid-19. Most people who travel from Texas to New York are required to quarantine for 14 days before having contact with New Yorkers.
A Health Department spokeswoman, Erin Silk, confirmed the department gave Rybar the quarantine exemption but declined to comment on Rybar’s case. In any case involving efforts to visit a hospital patient, “the attending physician” determines whether a patient is facing an end-of-life situation, Silk said.
In guidance the Health Department issued May 20 to hospitals, it stated, “The Department defines imminent end-of-life situations as a patient who is actively dying, where death is anticipated within less than 24 hours.”
Rybar’s Covid-19 exemption letter from the state gave her permission for “end-of-life visitation” with a hospitalized loved one without spending 14 days in quarantine, as long as she tested negative for Covid-19 and agreed to wear a mask during the visit.
Rybar’s aunt, Marge Burns of Fredonia, confirmed that she gave Rybar a ride to Buffalo General Medical Center Tuesday morning.
“I walked up to the visitor kiosk and handed my letter to a lady working there. Another lady grabbed it out of her hand, and told me, ‘Get out of here. You’re from Texas. You need to quarantine. You can’t be here,’ ” Rybar said.
Rybar said she left the hospital, distraught, and headed back to Fredonia with her aunt. Later that day, she said she called the hospital to plead her case. Rybar said she talked to a hospital administrator, a supervisory nurse and another nurse, all of whom repeatedly told her that she could not see her father because he was “not in an end-of-life situation.”
“One day after them telling me, over and over, that this was not an end-of-life situation, my father died. This was a man who had two previous heart attacks and a pacemaker. It turned out the hospital was wrong,” Rybar said.
“I cannot tell you how painful that was. I traveled a long way to see him one last time.”
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