$3.1 million Verdict in Morphine Overdose case

The Orange County Register reported the jury verdcit in conservative Orange County of $3.1 million to Barbara Lefforge who suffered a brain-damaging morphine overdose at St. Edna skilled nursing home.   Lefforge went to St. Edna on Sept. 17, 2007, to recuperate from tendon repair surgery.  Her doctor, Kobayashi, mistakenly recommended 50 mg of morphine for pain instead of 50 mg of Demerol.  The mistake clearly should have been caught by staff at St. Edna's. The pharmacist warned that the dosage was too high.  But nurses at the facility, unable to immediately retrieve the full dose, obtained 30 mg from an office emergency kit and gave it to Lefforge.  The woman suffered an overdose but was not monitored or taken to the hospital until the next morning, causing brain injury.

St. Edna Subacute & Rehabilitation Center is one of 25 homes in California owned by Covenant Care.  After two days of deliberation, the jury found that St. Edna was 90 percent responsible for the damages and Kobayashi was 10 percent responsible. Jurors awarded Lefforge $2 million for pain and suffering and $1.1 million in medical costs, Wacker said.  The unanimous jury also awarded punitive damages -- which will be set on Tuesday --who was barely at the hospital 5 1/2 hours when the overdose occurred.

Covenant Care facilities are among hundreds of California skilled nursing centers that received $880 million in additional compensation from the state since 2004 to increase staffing and wages at homes that serve Medi-Cal patients. An analysis by the non-profit newsroom California Watch found 232 of those homes statewide slashed staff and let nursing ratios fall below the state minimum.  St. Edna and 12 other homes in the Aliso Viejo-based Covenant Care chain stood out: they accepted $15 million in additional compensation from the state -- but still cut caregivers.

 

 

 

 

 

Low Fine for Careless Violations

North Carolina's  Department of Health and Human Services issued a recommendation for $20,000 in penalties against Britthaven of Chapel Hill nursing home where a nurse is accused of murder and patient abuse related to morphine overdoses. Incredibly $20,000 represents the federal maximum the two centers can legally fine the facility for the violations that occurred.

The violations are connected to the activities by Angela Almore. Almore was a registered nurse at the facility charged with second-degree murder and patient-abuse surrounding Rachel Holliday’s death.  Holliday died of pneumonia from asphyxiation; the morphine levels in her body were believed to have contributed to her death.  Injuries involving morphine and six other patients are also involved.  Prosecutors say Almore drugged patients to make them more manageable.  Of note, none of the patients were prescribed the potent pain reliever.

See articles here and here.


 

$4.85 Million Verdict for Morphine Overdose

The Toldeo Blade reported a significant verdict in a recent nursing home trial in Michigan.  The family of Burr Needham,  who died in 2002 of a morphine overdose while undergoing physical therapy at Mercy Memorial Nursing Center, has been compensated $4.85 million by a jury aftera three-week trial with the jury finding that a doctor and nurses were negligent.

Mr. Needham's family filed a civil lawsuit in 2005 against the home, contending that Dr. Arun Gupta and five nurses were responsible for the overdose of the painkiller administered to Mr. Needham after he entered the center April 26, 2002. 

The Wayne County medical examiner said the May 2, 2002, death of Mr. Needham was caused by acute morphine intoxication and ruled his death a homicide. The jury determined that nursing home staff were professionally negligent in the care and treatment of the 76-year-old man.

Court records showed that the jury awarded $3 million of the judgement to Mrs. Needham for the noneconomic loss of society and companionship she experienced in the loss of her husband. 
The panel decided that Mr. Needham should get $1.5 million for the pain and suffering he experienced in the nursing home. The remaining $350,000 was awarded to the family to pay for damages that Mrs. Needham incurred, including burial costs and the loss of gifts and valuables she would have received until her death on Oct. 24, 2007.

 

Morphine as a Murder Weapon

The News & observer had an article about the tragic death of nursing home resident Rachel Holliday.  Angela Almore was arrested and accused of murdering Holliday after an investigation found that Almore gave Holliday morphine that was not prescribed or needed. The indictments allege that Almore intentionally caused each to "ingest morphine that proximately caused serious bodily injury."  Almore has been a registered nurse for four years, and was responsible for taking care of  84-year-old Alzheimer's patient holliday at Britthaven of Chapel Hill.

A medical examiner reported that Holliday died of pneumonia from asphyxiation, and that the levels of morphine in her system likely contributed to her death.  The report listed "morphine toxicity" as a contributing factor to her death, noting that tests done at UNC Hospitals before her death determined she had a morphine level of more than 50,000 nanograms per milliliter of urine.

Almore was also charged with six counts of felony patient abuse related to other Britthaven patients who were hospitalized after they became lethargic. Tests indicated they had been given morphine, even though none had been prescribed the powerful pain medication. All but Holliday survived.

Nursing homes that receive Medicare and Medicaid funding must follow specific regulations about how medications are bought, stored, ordered and distributed. If the nursing home's oversight was lacking, it must correct the problems and could face fines and be held liable for the death of holliday.

See other article about these incidents here and here.

Investigation into Morphine Overdose

The News observer had an article on the investigation into the death of a nursing home resident at Britthaven of Chapel Hill.   Rachel Holliday died in February from toxic levels of morphine in her body.   A medical examiner's report said Holliday had not been prescribed any opiate painkillers.  The State Bureau of Investigation is looking into her death after several residents tested positive for opiates following her death.

UNC Hospitals caregivers found more than 50,000 nanograms of morphine per milliliter in Holliday's urine. More than 2,000 nanograms would trigger a positive result in employment screenings, based on federal guidelines.

The nursing home has had regulatory issues in the past few years and had been labeled a "special focus facility" for its substandard care. During inspections in 2008 and 2009, the nursing home was found to have put some residents in jeopardy by failing to protect them from abuse.

 

Use of Antipsychotics

McKnight's also ran an article about the recent studies that prove the off label use and over use of dangerous antipsychotics to elderly and vulnerable patients. Antipsychotic medication use is still widespread in nursing homes, even after the federal government issued a “black box” warning on the drugs in 2005 according to two new studies.

The drugs in question include clozapine, risperidone, olanzapine and paliperidone. Doctors prescribe these drugs, which are designed to treat bipolar disorder and schizophrenia, off-label for residents with dementia. Both studies appeared in Monday's issue of the Archives of Internal Medicine.
 

Police investigating suspicious death of nursing home resident

Newport News Dailypress.com had an article about a suspicious death of a resident of a nursing home.  There appears to be a link between his death and medicine he got the day before.

A nurse who gave unauthorized medicine last week to a nursing home resident who later died has been fired.  Police are considering whether the medication caused or contributed to the death of John P. Stratton, 76, of Newport News, who was staying at the James River Convalescent and Rehabilitation Center.  Stratton was given the medicine on May 5, and died about 4 a.m. on May 6.

The nurse's decision to give Stratton the medicine was not an accident.   "She intentionally gave him the medication," police said. "Her intent in giving it to him will have to come out later."

Police are trying to find out whether Stratton was given an increased dose of a medicine he was prescribed, or medicine he wasn't supposed to get at all.

Joseph Law, James River Convalescent's administrator, said the nurse — whom he declined to identify — was fired after an internal investigation. The actual reason for her firing, Law said, was separate from the issue surrounding Stratton's death. "The nurse was terminated because of facility protocol," Law said. "During our investigation some other information was discovered." He did not elaborate. What a bunch of nonsense. Clearly the facility does not want to admit what happened or what they found out in their "internal investigation". 

It could take a month or longer for the toxicology results.  The examination will include any possible interaction between the medicine the nurse gave him and other drugs Stratton was taking.

One of Stratton's daughters, Denise Barnes of Newport News, said the family doesn't know what drug or drugs the nurse gave her father.   A staffer at the home brought to his attention the possible link between the medication and Stratton's death. He then called police and state agencies.

I'm surprised they didn't fire the staffer who refused to cover it up.

Jury compensates family for death of resident from overdose

Tucson Citizen had an article about a recent jury verdict where a jury awarded a Tucson family $6 million for a death involving an 81-year-old relative who died of a morphine overdose.  Mary Culpepper and two other relatives were awarded $2 million each.  Culpepper sued Manor Care, TMC, a doctor, nurse and pharmacy over the Dec. 8, 2003, death of her mother, Sylvia Culpepper.

She was admitted to TMC on Dec. 2, 2003, suffering from sciatica, a painful nerve condition.
On Dec. 4, 2003, she was prescribed 15 milligrams of morphine twice a day. Two days later, her dosage increased to 30 milligrams, twice a day.   When Culpepper was transferred from TMC to Manor Care, prescription orders contained both dosages.

The Manor Care staff failed to note the discrepancy in the prescriptions and gave her both dosages, both twice a day causing her death.  An autopsy determined that Culpepper died of acute morphine intoxication.

According to the jury's verdicts, the doctor, nurse and pharmacy weren't to blame for the death. The nursing home had the ultimate rersponsibility for the medications given to the resident at their facility.

"Mercy" killings or just murder?

Today we have a guest writer, Heather Johnson. who is a regular contributor to RNCentral.com, a great site for nurses and others interested in the nursing field.  We thank Heather for help insightful contribution.  Below is her entry.

Nursing Home Workers Face Neglect, Fraud Charges

Chicago Sun-Times reports that Nurse Marty Himebaugh and nursing director Penny Whitlock of a Woodstock, Illinois nursing home have been charged with criminal neglect of their patients and fraud. Police are currently investigating the deaths of six patients, which may be related to Himebaugh's reputation for playing "Angel of Death" to her patients. Allegedly, she gave patients overdoses of morphine when she worked at the nursing home and Whitlock failed to reprimand her.

Complaints had been filed against Himebaugh many times before she was eventually put on leave from her job in 2006. Some allege that Whitlock not only failed to discipline Himebaugh in a timely manner, she could have been encouraging the illegal actions. Authorities exhumed the bodies of three patients to determine if they had died as a result of an overdose, though results have not been made public.

In addition to criminal neglect, Whitlock has been charged with obstruction of justice after she allegedly ordered the destruction of drugs in the nursing home. Himebaugh also faces additional charges for fraudulently obtaining and illegally dispensing morphine. Police are not expected to file any more criminal charges against current or former employees of the nursing home.

According to attorney Steven Levin, who was hired by the family of an alleged victim, "It was flat out an attempt to kill people. I mean we don't kill old people in nursing homes in this country."



By-line:

Heather Johnson is a freelance writer as well as a regular contributor for RNCentral.com, a site which covers all things related to RN. Heather welcomes your comments and emails related to job inquiries at her email address, heatherjohnson2323@gmail.com.

Investigation into suspicious nursing home deaths

The Chicago Tribune has a story about the suspicious deaths possibly caused by morphine overdose at a nursing home.  McHenry County prosecutors acknowledge the suspicious deaths at the Woodstock Residence nursing home in Woodstock have been difficult to pursue.  Three bodies were exhumed last year, and tissue samples were sent to a Pennsylvania lab for analysis.

The bodies of three others whose deaths investigators consider suspicious could not be examined because they were cremated.  Alissa Nataupsky, administrator of the Woodstock Residence, has denied any wrongdoing at the home and has said the investigation was triggered by a former employee.

When Cole, 78, died in September 2006, the cause of death was listed as pneumonia. Cole had been living at the Woodstock Residence for two months.

If lab results do not conclusively show that morphine overdoses caused the deaths of the three former residents whose bodies were exhumed, a grand jury might be used to further investigate the case, a law enforcement source said. 


Poliakoff & Associates, P.A., is one of South Carolina’s most respected and distinguished law firms. The Poliakoff firm began nearly 60 years ago by three attorney brothers: Matthew, J. Manning, and Bernard. With a history of believing the justice system...More...