DES MOINES, Iowa — If life were fair, Kyle Brown and Pamela Dennen deserved more time together.
The couple from Marshalltown, a city of about 28,000 residents, had spent years overcoming personal obstacles and the physical distance between them, Dennen told the Des Moines Register. They celebrated three years of marriage in February.
About two months later, in mid-April, Brown worked his final shift as a maintenance technician at TPI Composites in Newton. Brown, 54, died 12 days later, on April 29, at a Des Moines hospital from COVID-19 complications.
During those 12 days, Brown and Dennen made five trips to healthcare providers, Dennen said. It took two visits to secure a test for the novel coronavirus.
Brown’s symptoms then worsened to the point where he couldn’t speak. The couple made three drives to emergency rooms in Marshalltown and Newton. Twice, he was sent back home with Dennen, even after nurses over the phone told her he needed treatment.
“It’s hard not to wonder if he had been taken seriously earlier, if they had intervened sooner, could his lungs have responded better?" Dennen asked. "Could he maybe have been spared? I mean, nobody will ever know that."
On the fifth trip, which was either April 23 or 24 — the two days ran together, Dennen said — UnityPoint Health in Marshalltown admitted Brown after his blood-oxygen levels dipped severely. At the end of the weekend, an air ambulance took him to Iowa Methodist Medical Center in Des Moines.
Back in Marshalltown, Dennen started to experience symptoms of her own. Dry coughs frequently interrupted her interview with the Register on Friday. She’s been left quarantined in her home, unable to grieve with friends and family, lest they get sick.
“I haven’t had a single hug, which is a really strange thing,” she said. “It’s just really hard to have this loss and be sick and be quarantined all at the same time. I mean, it’s a nightmare.”
‘Living our dream’
Brown and Dennen's relationship was bumpy early on, but not because they didn’t love each other.
They met on eharmony, an online dating site. She lived in Chicago then and admits she ignored Brown at first because he lived in a different state. But, she said, he had eyes that “were just so kind.”
Emails eventually turned into phone calls and in-person visits. Brown was honest about spending most of his adult life trapped in drug addiction, which eventually put him in prison. He told Dennen how he found his faith as he walked through the prison yard one day.
“He got saved, and he was instantly delivered of all his addictions,” Dennen said. “He never had one withdrawal symptom.”
TPI hired him once he got out, and he returned to living in Marshalltown. His work schedule gave him three-day weekends every other week, so he and Dennen switched off who would visit whom for five years, she said.
They married a year before moving in together. Dennen suffered from severe back problems that put her in a wheelchair temporarily. They were already engaged, but they wed early so Dennen could get on Brown’s health insurance plan. She was again mobile after two years of intense physical therapy.
After her youngest daughter moved out of their Chicago home, she joined Brown in Marshalltown in 2018. Three weeks later, a tornado ripped through the city. It did about $80,000 worth of damage to their home, but Dennen said it was later fixed, and the house is better than it was when she moved in.
“We were both living our dream, so to speak,” Dennen said. “We both have been through a lot of heartbreak and heartache and just really tragic times, and we were both really healing to each other.”
Dean Lawthers, Brown’s friend since high school, lives on the same street as the couple. The two friends helped each other with house and yard work. Weeks ago, Brown told Lawthers that with his job, house and Dennen, he felt like he'd won the lottery.
“I told him he had, and he deserved it,” Lawthers said.
Getting a test
Brown worked his last shift at TPI on April 17. He felt a burning in his chest and was coughing. By the evening, he had a fever and severe body aches, Dennen said.
He tried to get a test the next day, but a UnityPoint urgent care facility in Marshalltown denied him, he wrote on Facebook, because he was under 65 and not an employee at a meatpacking plant. His social media post drew more than 200 comments and 1,000 shares.
The same day, he was able to secure a test at the MercyOne Medical Center in Newton, where other TPI employees had gone.
UnityPoint spokeswoman Laura Rainey said the health care provider follows testing guidance from the Centers for Disease Control and Prevention and the Iowa Department of Public Health.
According to IDPH protocols as of April 17, the State Hygienic Laboratory would accept tests from patients if they were hospitalized with respiratory symptoms or a fever; over 60 with symptoms and a chronic medical condition; any person with symptoms who lives in a congregate setting; or an essential worker with symptoms. Health care providers could, however, test a patient through a national laboratory without IDPH approval.
Dennen said her husband had worried about catching the virus at work. On April 13, the Newton Daily News reported that two TPI employees had tested positive for the virus. TPI temporarily halted production at its Newton facility, which employs more than 1,000 workers, on April 24 after 28 employees tested positive.
“He had been exposed to many different people at TPI who ended up testing positive,” Dennen said.
On Saturday, TPI announced that after testing nearly all of its Newton employees on April 25, 20% of the tests, or roughly 200 people, came back positive for COVID-19. The wind blade manufacturer said it also deep-cleaned its plant.
The company supplied surgical masks to its workers and their families to prevent community spread, TPI said, and secured hotel rooms for employees who tested negative so they could isolate.
Three ER visits
By April 20, two days after Brown got his test, his condition had worsened. He couldn’t talk without coughing, so Dennen called the UnityPoint hospital in Marshalltown.
She said a nurse she spoke to told her Brown’s symptoms warranted a 911 call. Dennen said no, she could bring him in. They arrived at the emergency room, where Brown went inside while Dennen waited in the car. She assumed he’d be admitted, but he came out three hours later.
His blood-oxygen level was measured at 95, considered too high to be admitted, Dennen said. They went back home, and he started to feel worse. He lost his appetite, and sitting up in bed triggered fatigue and coughing attacks.
“I can’t describe the sounds he would make,” Dennen said. “They were awful. They were the most awful thing to listen to, but doctors must’ve heard it because he couldn’t do anything without making those sounds.”
Two days later, a nurse in Newton called with Brown’s test results. She heard Brown coughing in the background and, like the Marshalltown nurse, urged Dennen to bring him to the hospital, even offering to send an ambulance.
But when he went to the MercyOne hospital in Newton, it was the same story. Doctors saw Brown as Dennen waited in the car outside. He texted her that they were discharging him, and she reached a doctor on the phone. The doctor told her his blood-oxygen level was still above 90 and his cough was dry, part of the reasoning to send him back home.
“I just hung up on him because I was so angry,” Dennen said.
Gregg Lagan, a spokesman for MercyOne, confirmed that doctors saw Brown on April 22, but he declined to offer more information, citing the Health Insurance Portability and Accountability Act.
Brown was so tired after the trip to Newton that it took about 30 minutes to summon enough energy to get back into bed at home. His cousin dropped off a pulse oximeter so Dennen could keep track of his oxygen levels at home.
The reading soon dropped below 90, eventually to 86. It was time for the third trip to the ER.
“He just almost started to cry,” Dennen said. “He’s like, ‘They won’t help me. They won’t do anything for me.’”
When they arrived again at the UnityPoint ER in Marshalltown, Dennen stayed by her husband’s side, insisting to the staff that they take him in. She wasn’t taking no for an answer this time, and the hospital admitted him.
Lagan and Rainey both said their hospitals are following patient screening guidelines from the CDC and IDPH.
“The decision to monitor a patient in the inpatient or outpatient setting should be made on a case-by-case basis,” the CDC wrote on its website. “This decision will depend on the clinical presentation, requirement for supportive care, potential risk factors for severe disease, and the ability of the patient to self-isolate at home.”
Because of HIPAA, Rainey said she couldn’t confirm or deny that Brown was a UnityPoint patient.
“Our thoughts and prayers go out to all the individuals and families dealing with this illness,” Rainey said in a statement. “That’s why it’s extremely important to help stop the spread of the disease by washing your hands, wearing a mask and social distancing.”
‘Very, very frustrating’
Brown died around 3 a.m. on Wednesday after he was taken to Des Moines. He had been sedated and put on a ventilator. Dennen was still in Marshalltown, sicker than she’s ever been.
She’s so far not having trouble breathing, so she plans to ride it out. Friends have told her to go to a hospital, but after her experience with her husband, she figures she also won’t be admitted.
Dennen told the Marshalltown Times-Republican that state guidelines for patients could be the culprit.
“It was a very, very frustrating string of events,” she said.
Lawthers said he understands the hospitals have protocols, but he said it “boggled his mind” that it took so long for Brown to be admitted.
“I don’t understand why they wouldn’t make an exception and take him in,” he said.
A memorial or remembrance service will have to wait. Even though she’s alone, Dennen said her church family at Restore Church in Marshalltown is keeping an eye on her and her symptoms.
Dennen said if she does get sicker, there’s a plan to get her to the hospital — in a different city.
Austin Cannon covers the city of Des Moines for the Register. Reach him at firstname.lastname@example.org or 515-284-8398. Your subscription makes work like this possible. Subscribe today at DesMoinesRegister.com/Deal.