Charris, the lack of COE isn't the problem here. I wish it was the answer, but it's not. The problem is this surgeon of hers seems highly incompetent and she hopefully will never let him touch her with a ten-foot pole once this hell is over for you guys. Since she is a Medicaid patient, there is bound to be some unit within Arizona's bureaucratic machine to report this horrific situation to. I'd be damned sure to get them all over this situation in a heartbeat. Continue to monitor and record everything you can, including dates and times and summaries of conversations. Don't transport her anywhere yourselves...only by ambulance and make sure it's to a Level 1 trauma center like the others have said. Even if that place isn't a COE. That's actually more of a Medicare designation than anything else anyway.
You are doing AWESOME caring for your cousin and keeping their feet to the fire. Make sure you are taking care of you too. You've got so much you are dealing with regarding your own health plus your pregnant daughter and now your cousin.