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Friend could not find the actual papers, how can a hospital just take someone's word for such an important matter and let this person make life or death decisions, anyone could say they have a medical POA if that is the case?

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BTW, to me it would make more sense to have a state database listing POAs, and that part of the responsibility of naming or changing a POA was registering it on this database. Qualified medical services should be able to access this online. But, alas, I am not in charge of these policies.
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My health care directive, which names my medical POA, is filed at my clinic and the local hospital and a couple of other places where I would likely be taken for medical care. My husband's papers were similarly filed. This is a good way to increase the likelihood of having one's wishes carried out, or at least known!

Was your friend conscious and coherent when he was admitted? Perhaps the hospital asked him who his health care proxy was and he named this friend. Or the friend showed up claiming be the medical POA and your friend confirmed that. The hospital may not have simply taken the word of the POA, but also had the authorization of your friend. Did someone in your friend's family have medical POA? Did they produce their document at the hospital?

My mother had no POA of any kind. When she was hospitalized and not coherent enough to make her own decisions the staff simply asked any family member present. Perhaps they asked her who she wanted to make decisions for her, and if she understood the question she may have said "any of my kids." I don't know about that, but that is how it worked -- they asked one of us. Once the doctor came to me in the waiting room and asked if they could give my mother a pneumonia shot. I said no, simply because I knew that mother did not want vaccinations in the past. Then I discussed it with my sisters and they convinced me we should do what we honestly thought would be best for mother, even if that was not what she would have wanted in the past. So I found the doctor again, said I'd discussed with other family members and we decided she should have the vaccination. He was very glad to hear that and he ordered the shot.

Doctors need someone to authorize some treatments or procedures. If there isn't time to hunt down a legitimate, verifiable POA, they still need someone to make decisions.

Was this person by any chance a life partner?

If this friend did bring in a POA document, the hospital still wouldn't know if a later document superseded the one presented. The hospital isn't in the detective business and doesn't have time and resources to verify claims to POA status.

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