Articles Posted in Nursing Negligence

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The California Department of Public Health has levied its harshest fine against a nursing home after a resident fell from a mechanical lift. According to reports, the lift was being to transfer a 60-year-old patient from her wheelchair and into her bed. As nursing assistants were transferring the woman, the sling holding the woman broke, causing the woman to fall hard to the ground. She struck her head on a nearby door, causing a severe brain injury, and ultimately causing her death four days later.

Lift.jpg An investigation by the Department of Public Health revealed that the nursing home, the Eskaton Care Center, failed to properly maintain the lift. The lift, which law required be checked monthly, had not been checked for five years. The DPH report stated that the sling appeared worn and had “what appeared to be bleached out blood stains at the center.”

The nursing home can appeal the fine (and the AA citation it received), but it’s not clear if it will. “We’re mortified,” Trevor Hammond, the nursing home’s chief operating officer, told the Modesto Bee. “We had a tragedy when a piece of equipment failed. It was a catastrophe.”

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In an ongoing investigation, journalists Tracy Weber and Charles Ornstein of ProPublica have a startling article out that says that more than 3,500 registered nurses with “clean” nursing licenses from the State of California have been punished for misconduct in other states. According to the article, approximately 2,000 of these nurses will now face discipline in California.

The article states that California officials won’t disclose the names of nurses who were discovered to have disciplinary records until charges are filed, but will be filing emergency petitions with the board for nurses who are viewed as a threat to public safety.

Weber and Ornstein easily uncovered cases involving current California nurses. Here’s a sampling:

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A Los Angeles area nursing home received the state’s most severe penalty (short of losing its license) yesterday when it received a $100,000 fine for neglectful care that resulted in the death of a resident. The nursing facility also received an AA citation.

The case involved the misplacement of a feeding tube, which is a type of case the Walton Law Firm has handled on several prior occasions. According to reports, the 84-year-old resident was admitted to the nursing home in early 2008 to rehabilitate a hip fracture. He was noted as having no problems chewing or swallowing. Because of a weight loss, his physician ordered nasogastric tube feedings.

When staff at the nursing home inserted the tube through the man’s nose, it placed it in the man’s lung, not his stomach. When feedings began, the lungs filled with feeding material, and the man became sickened immediately. Three days later he was dead from aspiration pneumonia.

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In their ongoing series on nursing oversight in the State of California, Tracy Weber and Charles Ornstein of ProPublica are out with another story about California’s shortcomings in regulating healthcare professionals. Weber and Ornstein reveal that the national database that tracks dangerous or incompetent caregivers is missing serious disciplinary actions against “what are probably thousands” of health care providers. The revelations apparently surprised federal health officials, who just last month proclaimed that “no data is missing.”

For almost twenty years the federal government has kept a database of disciplinary actions against doctors and dentist, and in 1999 individual state boards were required to include in the database reports on all other healthcare professional, including nurses, whose licenses were restricted or revoked. In California, however, not all penalized caregivers were included in the federal database. For example, California has formally disciplined 84 psychiatric technicians over the last two years, yet the federal database does not contain a single report of discipline against a psychiatric technician in the State of California.

The dangers of an incomplete database are obvious, as Dr. Sidney M. Wolfe of the Public Citizen’s Health Research Group observed, prospective employers of health care professions could be given “a false sense of security that somebody who may be really dangerous isn’t, because their name isn’t there.”

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According to new research from Brown University, elderly Hispanics are more likely to live in inferior nursing homes than their white counterparts.

In an article out in the January 10 edition of Health Affairs, a team of researchers takes the first comprehensive look at the types of nursing facilities Hispanic elderly live in, and how the care at those homes compares to homes that house a primarily white patient population. According to the study, the disparity is sharp.

“The most shocking finding is the pervasiveness of disparities in nursing home care that are primarily white, compared to nursing homes that are a mix of whites and Hispanic residences,” said Mary Fennell, professor of sociology and community health at Brown.

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In their ongoing investigation into California nursing, Tracy Weber and Charles Ornstein of ProPublica are out with an article on temporary nursing agencies being a haven for unfit nurses. Temp nursing agencies are used frequently by local hospitals and nursing homes to fill nursing positions that have been vacated for some reason; usually for day or two, but sometimes open-ended.

In its investigation, ProPublica found numerous instances in which the agencies, desperate to find certified nurses, failed to perform background checks or ignored warnings from hospitals about weak nurses in order to fill nursing orders. It is a profitable undertaking; the temporary nursing industry is a $4 billion industry.

Some of the other ProPublica findings were startling:

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There is a growing movement to ban the common practice of requiring nursing home residents to waive their right to file a lawsuit in claims of negligence, abuse, or neglect in favor of arbitration. Last week, several consumer advocates testified before congress and criticized the practice of “forced arbitration.”

Public Citizen released a report alleging that the practice of forced arbitration, essentially requiring a consumer to sign an arbitration agreement as a condition of being provided the service, has become pervasive. The report, “Forced Arbitration: Unfair and Everywhere” found that many industries, including nursing homes, banks, contractors, cable companies and auto sales, will require consumes to waive their right to file a lawsuit before the services will be provided.

For years, attorneys and consumer advocates have questioned the impartiality of arbitration, which usually has a lawyer or retired judge, or a panel of them, sitting as the trier of fact. The Public Citizen report reveals that arbitrators for the National Arbitration Forum (NAF), the largest arbitration firm in the country (but one of many), ruled against consumers 94 percent of the time.

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It’s not uncommon to hear nursing home residents to complain about the quality of the food being served. The Nevada state health officials decided to do something about it.

A routine survey last Tuesday by the health department of a North Las Vegas nursing home found some very serious food safety violations. Upon inspection, officials found a 16-foot hole in the ceiling of the kitchen that was leaking, it found perishable foods like chicken and beef being stored at unsafe temperatures, soiled and contaminated countertops, and an “overall inability of the staff to safely prepare food.”

So what did the health department do? It didn’t force the 240-bed facility to close down. Instead, it suspended the food permits, and required the nursing home to order food from local restaurants. The suspension only lasted for a day. The problems were addressed and the food permit reinstated.

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The North County Times had a good column on the cold reality that elder abuse or neglect can happen anywhere. Susan Reichel, CEO of Advanced Home Health Services in San Diego says that an estimated 2 million elderly Americans are victims of elder abuse, whether its physical, mental, emotional, or financial, and it can occur in the home or at a nursing facility.

We, of course, know this. At this law firm, we take legal action against nursing homes and residential care facilities for abuse or neglect all the time. But it’s always worth reminding people that such abuse cases are real and all around us. Remarkably, it is estimated that 84 percent of elder abuse cases go unreported.

The author makes a list of clues to look out for that might be signs of abuse or neglect, and we though it would be helpful to list them here.

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The Orange County nursing home Tustin Care Center has received a citation and a fine of $50,000 by the California Department of Public Health after a resident choked to death during lunch. A state investigation concluded that the nursing home’s failure to adequately assess the patient’s growing inability to eat as the cause of death.

According to the state report, the elderly man had been growing weaker over time, but that the nursing facility allowed him to continue to eat regular meals. In March, while eating lunch with his wife, who was also a resident at the Tustin facility, when he had difficulty breathing. As the patient struggled to breath, an attendant was called over, who tried to clear the airway.

The man died at a local hospital later that same day, and an examination found that food was completely blocking his airway.

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