CA nursing home fined $100,000 after man suffers fatal head injury

A Northern California nursing home was fined $100,000 after its staff allegedly failed to prevent a patient from falling twice and suffering a fatal head injury for which he was not treated, state public health officials announced this week.

The 85-year-old patient, who had a heart condition and diabetes, was supposed use a walker and be supervised when walking, according to a state investigator’s report released Tuesday on Pilgrim Haven Health Facility in Los Altos.

But a state investigator found Pilgrim Haven staff failed to install an electronic fall monitor as ordered by the patient’s doctor and also failed to ensure that the patient’s walker was within reach. On Oct. 3, staff members discovered the man sitting on the floor of his room, having fallen and scratched his head, according to a fax sent to his doctor.

Los Altos nursing home fined $100,000 after man suffers fatal head injury

CA nursing home fined $100,000 after man suffers fatal head injury

A Northern California nursing home was fined $100,000 after its staff allegedly failed to prevent a patient from falling twice and suffering a fatal head injury for which he was not treated, state public health officials announced this week.

The 85-year-old patient, who had a heart condition and diabetes, was supposed use a walker and be supervised when walking, according to a state investigator’s report released Tuesday on Pilgrim Haven Health Facility in Los Altos.

But a state investigator found Pilgrim Haven staff failed to install an electronic fall monitor as ordered by the patient’s doctor and also failed to ensure that the patient’s walker was within reach. On Oct. 3, staff members discovered the man sitting on the floor of his room, having fallen and scratched his head, according to a fax sent to his doctor.

Los Altos nursing home fined $100,000 after man suffers fatal head injury

Legislators fail to help Iowa elderly in Nursing homes

Legislators fail to help elderly in Iowa Nursing Homes homes

Kentucky Nursing Home in Trouble

Attorney General Jack Conway announced, Hazard Nursing Home Incorporated and its owner, Sheila Noe, 61, are charged with failure to report suspected abuse.

The state alleges, Noe was told about a case of sexual abuse last year but did not report it to authorities.

Noe has been summoned to appear in Perry District Court September 13th.

The news comes on the same day the Bluegrass Care and Rehabilitation Center in Lexington was placed on the federal government's list of nationally troubled facilities.

The government found 22 deficiencies at the home in fiscal year 2010 more than three times the national average.

Two homes in Kentucky, Arbor Place of Clinton in Hickman County, and James S. Taylor Memorial Home in Louisville, have been on that list for at least six months.

Both are categorized as showing no signs of improvement.
Several Nursing Homes in Trouble

Falls in Nursing Homes Facts

How big is the problem?

* In 2003, 1.5 million people 65 and older lived in nursing homes.3 If current rates continue, by 2030 this number will rise to about 3 million.4
* About 5% of adults 65 and older live in nursing homes, but nursing home residents account for about 20% of deaths from falls in this age group.
* Each year, a typical nursing home with 100 beds reports 100 to 200 falls. Many falls go unreported.
* As many as 3 out of 4 nursing home residents fall each year.2 That’s twice the rate of falls for older adults living in the community.
* Patients often fall more than once. The average is 2.6 falls per person per year.
* About 35% of fall injuries occur among residents who cannot walk

How serious are these falls?

* About 1,800 people living in nursing homes die each year from falls.
* About 10% to 20% of nursing home falls cause serious injuries; 2% to 6% cause fractures.
* Falls result in disability, functional decline and reduced quality of life. Fear of falling can cause further loss of function, depression, feelings of helplessness, and social isolation.

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Medical Error List of Never Events includes Pressure Ulcers

The National Quality Forum calls these 28 medical errors "never events," meaning, of course, that they should never happen.

Most of these mistakes are likely to happen while a patient is being cared for in a healthcare facility. Others can happen anywhere, including in a patient's home.
Surgical Events

* Surgery performed on the wrong body part
* Surgery performed on the wrong patient
* Wrong surgical procedure on a patient
* Retention of a foreign object in a patient after surgery or other procedure
* Intraoperative or immediately post-operative death in a normal healthy patient

Product or Device Events

* Patient death or serious disability associated with the use of contaminated drugs, devices, or biologics provided by the healthcare facility
* Patient death or serious disability associated with the use or function of a device in patient care in which the device is used or functions other than as intended
* Patient death or serious disability associated with intravascular air embolism that occurs while being cared for in a healthcare facility

Patient Protection Events

* Infant discharged to the wrong person
* Patient death or serious disability associated with patient disappearance for more than four hours
* Patient suicide, or attempted suicide resulting in serious disability, while being cared for in a healthcare facility

Care Management Events

* Patient death or serious disability associated with a medication error
* Patient death or serious disability associated with a hemolytic reaction due to the administration of ABO-incompatible blood or blood products (transfusion of the wrong blood type)
* Maternal death or serious disability associated with labor or delivery on a low-risk pregnancy while being cared for in a healthcare facility
* Patient death or serious disability associated with hypoglycemia, the onset of which occurs while the patient is being cared for in a healthcare facility
* Death or serious disability (kernicterus) associated with failure to identify and treat jaundice in newborns
* Stage 3 or 4 pressure ulcers acquired after admission to a healthcare facility
* Patient death or serious disability due to spinal manipulative therapy

Environmental Events

* Patient death or serious disability associated with an electric shock while being cared for in a healthcare facility
* Any incident in which a line designated for oxygen or other gas to be delivered to a patient contains the wrong gas or is contaminated by toxic substances
* Patient death or serious disability associated with a burn incurred from any source while being cared for in a healthcare facility
* Patient death associated with a fall while being cared for in a healthcare facility
* Patient death or serious disability associated with the use of restraints or bedrails while being cared for in a healthcare facility

Criminal Events

* Any instance of care ordered by or provided by someone impersonating a physician, nurse, pharmacist, or other licensed healthcare provider
* Abduction of a patient of any age
* Sexual assault on a patient within or on the grounds of a healthcare facility
* Death or significant injury of a patient or staff member resulting from a physical assault (i.e., battery) that occurs within or on the grounds of a healthcare facility

Many patients are surprised to learn that hospital-acquired infections such as MRSA or C.Diff are not included on this list.

Patient safety is now being addressed by a number of groups across the country. The National Patient Safety Foundation sponsors a week in March each year to call attention to patient safety issues.

What Is a Medical Error -- A Master List of Never Events from the National Quality Forum

Jacksonville nursing avoids being shut down

The scheduled closure of a Jacksonville nursing home is on hold indefinitely while an appeals court decides its fate.

Glenwood Nursing Center, whose license had been revoked by state authorities, had been ordered to close its doors by Aug. 26. But the center appealed the decision, saying it hadn't been given enough time to respond to the charges.

The Florida Agency for Health Care Administration revoked the center's license in July, saying it failed to stop problems with resident-on-resident abuse and other dangers. Lawyers for the center say they planned to file a response and ask for a hearing on the matter, but weren't given the proper amount of time. The agency said the center missed the deadline to file.

On Friday, the First District Court of Appeal ordered that the center's closure be delayed until that question is resolved. If the center wins its case, it would be given a chance to appeal the license revocation.

In the meantime, the center agreed to be inspected every six months.

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How Useful Is the Concept of "Failure to Thrive" in Care of the Aged?

In an issue of American Family Physician, Robertson and Montagnini1 reviewed the challenges of caring for an aged patient with multiple problems whose health and vitality are rapidly declining. The term “failure to thrive,” which was borrowed from health care for children to describe this accelerated decline, began appearing in the geriatric literature more than 30 years ago to denote a range of circumstances including physical and mental deterioration, abuse and neglect, and rapidly progressing frailty.

In a study2 of physicians who used the term “geriatric failure to thrive,” the authors noted that it “is a term irregularly used and poorly defined.” They questioned whether the concept should be used in reference to geriatric patients, fearing that it “can reinforce the stereotype of elderly people as demented and decrepit” and “may actually hinder the urgent search for treatable, reversible causes of an elder’s deterioration.”2 Other authors3 concluded that “the label ‘failure to thrive’ promotes an intellectual laziness—accompanied by a certain resignation, passivity, or fatalism.” These authors3 responded with a recommendation for “the abandonment of the term ‘failure to thrive’ and the adoption of a more measurement-oriented approach” that explicitly assesses impaired physical function, malnutrition, depression, and dementia.

A review of MEDLINE citations and geriatric textbooks shows that, although “failure to thrive” is still a fairly common focus of authors in nutrition and nursing, it has become less prominent in the medical literature in the past six years as a central conceptualizing theme.

Contributing to concern about the use of the term “geriatric failure to thrive” are the generally vague or broad definitions, the huge clinical territory to which the term has been applied, and the difficulties of formulating a coherent research agenda. Family physicians should be wary of the application and implications of this label. First, geriatric failure to thrive should not be treated as a diagnosis or a specific disease.3 Second, it should not be equated with frailty.4 Decreased function, strength, and stamina are hallmarks of the frail aged person; however, frailty is primarily a state of increased risk and low reserve to stress, a state which all people who live into their ninth decade manifest at varying levels.4,5

Failure to thrive should be seen as an unexpected and significant falling away from the normal curve of declining vigor, weight, function, and reserve that affects even the healthiest aged persons.5 Finally, failure to thrive should not be a summary concept of a patient’s situation that prompts resignation and withdrawal of efforts to find underlying causes,2 and it should not be the final clinical thought.

If the term “geriatric failure to thrive” is of any use, it is as a brief reminder to the clinician that there is major work ahead in carefully reviewing potentially reversible underlying processes in aged patients who are manifesting unexpected and unexplained declines in nutritional intake and weight, self-care, cognitive function, and interest in life. It is true that a single major problem may not be identified or, if identified, may not be reversible. However, multiple contributors often can be found, and some of them can be ameliorated; some, when thoughtfully addressed, can serve to leverage improvement in other issues that had seemed refractory.6

Encountering the unexpected and unexplained acceleration of decline in a frail aged patient gives family physicians a wonderful opportunity to do what they do best: serve as human ecologists, as expert observers and investigators, and as healers of dysfunction in a complex hierarchy comprising a biological system and an individual with a mind, feelings, and personality, who is living within a family, community, and environment.

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Woman awarded $7 million in court case

Jury holds Hillcrest Nursing Home responsible for former resident’s pain, suffering and medical expenses

LAUREL COUNTY, Ky. — A jury awarded a London woman $7 million last week for pain, suffering and medical expenses for injuries she incurred while recuperating from knee surgery at a southern Laurel County nursing home.

Grace Fugate filed a lawsuit against Hillcrest Nursing Home in 2004, claiming staff members at the facility were negligent in caring for her after her surgery.

After a three-day trial in Laurel Circuit Court, a jury awarded Fugate $383,097.95 for past medical expenses, the maximum amount allowed by Kentucky state law. She was also awarded $766,195.90 for future medical expenses and $1 million for past and future physical, mental and emotional pain and suffering.

Additionally, the jury awarded Fugate $5 million in punitive damages for the nursing home’s negligence during her stay.

Annette Morgan with Morgan & White Law firm in Manchester, Fugate’s attorney, said she is thrilled with the unanimous decision.

Tipton & Tipton Law Offices in Corbin represented Hillcrest Nursing Home and its owner Terry E. Forcht in the lawsuit. Messages seeking comment were not returned by press time Tuesday.

Fugate, who was 67 at the time of the incident, had undergone knee replacement and was placed in rehabilitation at Hillcrest in July 2004.

According to the lawsuit, on Aug. 3, 2004, Fugate needed help getting up from bed and rang for a nurse assistant.

“An employee of Defendant Hillcrest Nursing Home rudely told her to ‘Do it yourself,’ adding the insult, ‘Get over yourself.’ Said employee placed the call button and/or beeper so that the plaintiff could not request the assistance of another aid and/or nurse and left the room after refusing to give assistance to the plaintiff,” the lawsuit reads.

Fugate then attempted to get out of bed on her own to use the bathroom, and fell in the floor beside her bed. The impact of the fall caused the surgical incision to rupture and damaged the ligaments around her knee.

“The nurse who came in and found her said that it was a horrific sight,” Morgan said. “Grace was taken to Baptist Regional Medical Center and had to be resuscitated due to the blood loss.”

Fugate, who now lives in Laurel Heights Home for the Elderly, remained at the Corbin hospital for two months. Morgan said Fugate’s son tried to care for her in his home, but she continued to have ongoing infections around the knee and eventually had to have the leg amputated.

Fugate has a long history of health problems prior to her fall at Hillcrest Nursing Home. She was diagnosed with rheumatoid arthritis when she was about 30 years old, Morgan said, and also suffered severe osteoporosis and multiple joint replacement at the time of the accident.

It took nearly seven years for a jury to hear Fugate’s case in part because the nursing assistant who allegedly denied helping Fugate that day in 2004, Ginda Rogers, was unable to be located.

“We spent several years trying to locate the employee,” Morgan said. “Seven years is a long time. But we did have to put off the trial three times due to Grace’s (Fugate) health. She’s had ongoing infections since the day she fell. And Grace wanted her day in court. She always told me that they knew what they did to her and that no one should ever be treated that way.”

Fugate’s health, however, prevented her from attending the trial last week, Morgan said.

The attorneys representing Hillcrest Nursing Home have 30 days to file an appeal.

“After those 30 days are up, I have the job of trying to collect this money for Grace,” Morgan said. “I want Grace to have some of this money while she is still living.”

Morgan said Fugate wishes to “go home.” Morgan wants to secure the award money for her so Fugate can pay a qualified person to care for her in her home.

“She wants to spend her last days at home,” Morgan said. “Now it’s my job to see that she gets some of this money so that she can.”

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Large damages set in Phila. bedsores case

In an highly unusual step for such a case, a Philadelphia jury yesterday leveled $5 million in punitive damages against Jeanes Hospital and a Wyncote nursing home in the death of a man who developed ultimately fatal bedsores while at both facilities.

The damages -- $1.5 million against Jeanes and $3.5 million against the Hillcrest Convalescent Home -- came two weeks after the same Common Pleas Court jury awarded $1 million in compensatory damages in the case. The damages were awarded to the widow of Joe N. Blango, who died of bedsores in 2008, two years after being discharged from Jeanes Hospital in the city's Fox Chase section.

While compensatory damages are not unexpected in such cases, punitive damages are, according lawyer Robert L. Sachs, who handles nursing-home cases and serves as liaison to the Philadelphia court for other nursing-home litigators.

"To my knowledge, this is the first nursing-home case to go to the jury on punitive damages in Philadelphia," said Sachs, who was not involved in the Blango case.

Rebecca Harmon, a spokeswoman for Temple University Health System, which owns Jeanes, said Temple would appeal the verdict.

"There is not one shred of evidence to support any liability in this case as it relates to Jeanes Hospital, and the contemplation of punitive damages is simply inexplicable," she said in an e-mail. "We're very proud of the high-quality care provided to patients each and every day at Jeanes Hospital."

Attempts to reach a representative for Genesis HealthCare Corp., which owns Hillcrest, were unsuccessful.

Steven R. Maher, who represented Blango's widow, said that in his 25 years of handling such cases, this was only the second time a jury had awarded punitive damages.

One reason, he said, was the high standards required to permit punitive damages to be considered. A jury must find that a facility had engaged in "outrageous and reckless conduct," he said.

Blango went to Jeanes on May 21, 2006, after suffering weakness and confusion. He was 74 at the time and was thought to have suffered a stroke.

According to Maher, doctors at Jeanes failed to properly diagnose that Blango was suffering from a urinary-tract infection that, as a result, worsened and left him susceptible to the bedsores that ultimately killed him.

After about a week at Jeanes, Blango was transferred to Hillcrest, where he stayed two weeks until his condition worsened and he was returned to Jeanes. He was released to go home after three days.

Maher contended that workers at Jeanes and Hillcrest allowed the bedsores to fester and Blango to go malnourished to the point that he lost 28 pounds.

After he returned home, Blango was cared for by his wife, Shirley, before dying from the bedsores two years later.

"This verdict sends a message," Maher said, "that this type of care is unacceptable and will not be tolerated."

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Jury awards $5 million punitive damages in nursing malpractice case

A Philadelphia jury has awarded $5 million in punitive damages in a nursing home medical malpractice case. Just a week and a half ago the jury found Hillcrest Convalescent Home, owned by Genesis Healthcare Corp. of Kennett Square, and Jeanes Hospital of Northeast Philadelphia liable for $1 million in damages in the 2008 death of Joe Blango.

The jury's punitive award was for $3.5 million against Hillcrest and $1.5 million against Jeanes, which is part of the Temple University Health System.

In May 2006 Blango, then 73, developed serious bed sores during admissions - first to Jeanes Hospital, and then to Hillcrest, according to court filings. Over the next five weeks Blando contracted infections, became seriously malnourished and dehydrated during hospital and nursing home stays, according to the complaint filed by the lawyers for Blando's estate. The complaint also noted that the man's bed sores became progressively more serious and "led directly to his death" according to the plaintiffs' medical expert.

"Mr. Blango was treated at Jeanes Hospital for five days in May 2006 and again for 3 days in June 2006," said Temple University Health System spokeswoman Rebecca Harmon in a statement. "He was discharged in June 2006 in stable condition - with no complaints, no pain, and normal vital signs. Mr. Blango expired two years later - in April of 2008. There is not one shred of evidence to support any liability in this case as it relates to Jeanes Hospital, and the contemplation of punitive damages is simply inexplicable."


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Nursing home owners can be liable in neglect cases

A three-judge Superior Court panel has overturned an Allegheny County Common Pleas judge and declared that a local nursing home and its owner may be held liable in a patient neglect death.

The court's ruling means that nursing home owners now may be sued for neglect in any of their homes. It also expands the legal interpretation of liability, which once restricted corporate negligence liabilities, to include not only hospitals and health maintenance organizations but also nursing homes.

"This is the first case in Pennsylvania to have such a holding," said Peter Giglione, a Pittsburgh lawyer who represented Richard Scampone in his suit on behalf of the estate of his mother, Madeline Scampone. She died Feb. 9, 2004, at Highland Park Care Center.

The suit filed in Common Pleas Court charged that Mrs. Scampone died of dehydration and presented witnesses who said the facility was understaffed, medical records were falsified and water was not provided to residents because the employees were overworked.

The Scampone estate won a judgment of $193,000 but sought and won a new trial after arguing that Judge Robert J. Colville erred in allowing the home's owner, Grane Healthcare, to be excluded from the suit.

The Superior Court panel was made up of Judges Mary Jane Bowes, Christine L. Donohue and senior Judge Zoran Popovich.

The judges concluded that Grane, the parent firm, played a substantial role in managing the Highland facility, including establishing quality assurance.

"We conclude that plaintiff's evidence established that both Highland and Grane acted with reckless disregard to the rights of others and created an unreasonable risk of physical harm to the residents of the nursing home," the court declared in its ruling. "The record was replete with evidence that the facility was chronically understaffed and complaints from staff continually went unheeded."

The court also declared that employees of the company "not only were aware of the understaffing that was leading to improper patient care, they deliberately altered records to hide that substandard care by altering [Activities of Daily Living records] that actually established certain care was not rendered."

Read more: http://www.post-gazette.com/pg/10205/1075085-455.stm#ixzz0v6EduzW4

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Hardee County Florida woman charged with elderly neglect

Florida Attorney General Bill McCollum has announced the arrest of a Hardee County woman who has been charged with operating assisted living facilities without a license and neglecting elderly adults under her care.

The arrest followed a joint investigation by McCollum's Medicaid Fraud Control Unit's Patient Abuse, Neglect and Exploitation (PANE) Team and the Hardee County Sheriff's Office.

Investigators said that Juanita Jackson Wright, 52, was operating three assisted living facilities in Wauchula without a license. She currently has two licensed facilities, but failed to get licenses for the three others.

Two of the unlicensed facilities were condemned in June by the county as unfit for habitation, which is the basis for the charges of neglect.

If convicted, Wright could face a maximum penalty of 25 years in prison and $25,000 in fines.

McCollum's PANE Team has played a key role in the investigation of this case. The group acts to detect abuse and neglect of elderly and disabled adults and ensure that efficient and effective health care is being provided.

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Jury Gives $114 Mil. in Winter Haven Nursing Home Abuse Case

The verdict is one of the largest ever by a Polk County jury.

Juanita Jackson died July 6, 2003, after staying at Integrated Health Services at Auburndale.

A lawsuit filed the next year claimed that Jackson's treatment at the facility led to her death.

The allegations included that Jackson was hurt after falling down and received other injuries from pressure sores, overmedication, malnourishment and dehydration.

A representative for Delaware companies listed in the lawsuit as operating the nursing home at the time of Jackson's stay, Trans Healthcare and Trans Health Management, could not be reached Wednesday for comment.

Blair Mendes, one Tampa lawyer representing Jackson's family, said the companies weeks ago stopped participating in the lawsuit after years of litigation.

A default judgment was entered against them on July 7, and jurors were asked to determine the amount of money in damages.

On Tuesday, jurors awarded $14 million in damages and $100 million in punitive damages to Jackson's family, which includes three daughters and a son.

"We are going to try to collect," Mendes said.

Jackson's children declined a request for an interview but released a statement.

"We are proud that we fought for our mom, and we are glad that people recognized the suffering she went through. We hope this will help make sure no one else has to go through such a horrible experience."

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Decubitus Ulcer Treatment Pioneer

How one nurse helped stop killer bedsores

It sounds obvious today, but it took the work of an innovative nurse in the 1950s working with a group of elderly patients to realise it.

Bedsores, also known as pressure ulcers or decubitus ulcers, are lesions caused by a number of factors including unrelieved pressure.

The elderly and infirm are particularly vulnerable, with bony areas of the body particularly prone.

Relieving pressure

Before Doreen Norton carried out her research, nurses had over a hundred remedies on offer - but none worked.

Martin Johnson, professor of nursing at the University of Salford, said the work of nurses like Doreen had changed the face of patient care.

Her work, and that of countless other nurses over the last 50 years, is being celebrated next week by the Royal College of Nursing at its annual research conference in Cardiff.

Professor Johnson said that, before Ms Norton's paper, bedsores or pressure ulcers were a major killer of hospital patients and nothing seemed to help.

"If one had a bedsore on the sacrum (at the base of the spine) or the heel, there were about 150 different prescriptions that ward sisters would issue to remedy this. None of these were very successful.

"She was able to show that really the only successful way of treating pressure sores was to remove the pressure - really obvious!

"This had an immediate implication that the nurses had to turn the patients at least every two hours.

"And this was a study that that was based on science rather than just what people thought."

Kate Gerrish, professor of nursing at Sheffield City Hospitals and Sheffield Hallam University, said that the bedsore study had been seminal, reversing the practices of years for nurses like herself.

"Looking back, what we did was horrifying.

"I was taught to do certain things for bedsores that have subsequently been shown to be harmful to patients.

"When we were trying to prevent pressure sores we would put all sorts of things on their skin - including menthylated spirits and soap, and we would massage the areas.

"All that has been proved to be detrimental to patients."

Innovator

As well as altering the approach to bed sores, Ms Norton, who died two years ago, also helped design the King's Fund bed, an adjustable bed used in many hospital wards.

She said she had "always had a feeling for mechanical things", and her first job had been in engineering in her father's refrigeration engineering firm.

Dr Peter Carter, chief executive and general secretary, of the RCN agreed: "Nurses spend more time with patients than any other health professionals and so really understand patient needs.

"Due to this, over the last 50 years, nursing research has been instrumental in bringing about significant healthcare advancements. "