South Carolina Nursing Home Blog : South Carolina Nursing Home Lawyer & Attorney : Poliakoff & Associates Law Firm : Elderly Care, Senior Care

There have been several articles about the lawsuit filed against Everett Rehabilitation and Care Center that neglected a resident's penis until it rotted off.  See articles here, here, and here.

A lawsuit has been filed against a Washington state nursing home accused of neglecting Charles Bradley's penile infection.   The lawsuit states that Bradley was taken to an emergency room, where doctors discovered his penis had decayed, leaving only a gaping wound. He died 18 days later, in March 2008.   The lawsuit cites an investigation by the state Department of Social and Health Services, which shows the nurse told a manager in November 2007 that the man had a wound on his penis. Staff noticed that Bradley's skin was breaking down while changing his diaper in November 2007.  The records say the manager forgot about the report and neglected to properly care for the wound.  Though staff notified a care manager, that manager failed to notify Bradley's doctor. Instead, the manager went on a three-week vacation and when she returned she forgot about the nurse's report.

Bradley's family claim staff at the nursing home left a wound on the elderly man untreated for months. Nursing home records allege that staff changed the man's diaper daily and provided him weekly baths between November 2007 and March 13, 2008.  During the four months that followed the initial notice of the wound, Bradley's genitals essentially broke apart bit by bit while the elderly man steadily lost weight.   By allowing Bradley's injury to fester and worsen for months, the nursing home and parent company SunBridge Healthcare Corp. violated a promise to care for him. "They trusted that the nursing home would provide the care they said they would provide," family spokesman said Wednesday. "We're not talking about extraordinary care. We're talking about basic daily needs."

An investigation conducted by the center's director of nursing "did not find any impropriety" by staff. State regulators, though, issued the center a citation for failing to meet quality of care requirements set by federal law.  The state determined that the home failed to meet a federal standard for care. The man didn't receive timely medical attention and the facility failed to notify his family or his doctor of changes in his health, the state determined. 

"There was no evidence the facility had contacted the resident's physician … to allow for timely medical intervention," the state investigators said in an investigatory report provided by DSHS. "There was no evidence the facility had contracted their social services department or the resident's family."  A financial penalty was not assessed.

“They definitely should have seen it. There was no documentation that his penis was beginning to fall off,” Gooding said. “We believe they chose not to put it in the records.”  Sounds like a cover up but no monetary fine was issued!

• Email This
• Print
• Trackbacks

New Hampshire's Union Leader had an article recently about the investigation into the death and possible elder abuse of a nursing home resident.  Detectives were called to the Southern New Hampshire Medical Center on June 28 to investigate concerns raised by staff at the hospital about the condition of the man's wounds.  The man was a resident at The Elms, a nursing home on Elm Street run by SunBridge Healthcare Corp., based in Rochester, N.Y.

Investigators and hospital staff found that the man had serious sores on his legs, which had been wrapped in Ace bandages. When hospital staff removed the bandages, he said, they found that the sores had been neglected. "The skin had grown over the bandages on his leg," said Douglas. "I've never seen anything like this."

In addition to the sores, the man's catheter was blocked with blood, his genitals were extremely swollen, and he had unexplained cuts and abrasions elsewhere on his body. The man was unresponsive to hospital personnel.  The man's catheter tube had been wrapped so tightly around his leg that significant swelling had occurred.

• Email This
• Print
• Trackbacks

State regulators have fined a West Palm Beach nursing home $16,000 after a patient was found injured on the floor with maggots crawling out of his leg cast.

The state issued the fine in March against Azalea Court.  The nursing home somehow denies responsibility and has appealed the penalty.  They will probably either argue that the maggots were benficial or that the family put them there so they can sue!

An August 2008 report states that the 120-bed facility failed to provide the necessary care and services to a resident with the cast on his lower leg, which led to an infestation of maggots. The report says the patient's leg was supposed to be treated every three days, but the documentation proved that the nursing home only cared for the wound about once a week.

If this isn't evidence of neglect and understaffing, I'm not sure what it!

• Email This
• Print
• Trackbacks

Often when maggotts are found in a resident's pressure ulcer (normally caused by the lack of proper wound care and cleaning), the nursing home tries to argue to the family that the maggotts are a method of cleaning the wound and that the nursing home intended the maggotts to clean the wound (despite no physician order typically).  Well, that frivolous argument has now been proved wrong.

Reuters had an article about a recent study in the British Medical Journal of the world's first controlled clinical trial of maggot medicine.  Maggotts may clean wounds quicker than normal treatment but this does not lead to faster healing. Some patients also found so-called "larval therapy" more painful. 

To find out more, researchers at Britain's University of York recruited 267 patients with venous leg ulcers and treated them either with maggots or hydrogel, a standard wound-cleaning product. They found no significant difference in outcomes or cost.  Larval therapy works because maggots eat only dead and rotting tissue, leaving a clean wound. They do not burrow into healthy flesh, preferring to eat each other when they run out of food. 

• Email This
• Print
• Trackbacks

The NY Times has an informative article on the multi-disciplinary approach needed to prevent pressure ulvers in nursing home residents. 

The article defines a pressure ulcer as an area of skin breakdown that occurs when sustained pressure cuts off blood circulation — usually in patients confined to their beds nursing homes — a bedsore can result in a wound so deep (sometimes to the bone) and painful that some patients require narcotics. If a bedsore becomes infected, the complications can be fatal.

Experts estimate that two million Americans suffer from pressure ulcers each year, usually through some combination of immobility, poor nutrition, dehydration and incontinence.  New research requires a team approach, enlisting everyone from nurses and nursing assistants to laundry workers, nutritionists, maintenance workers and even in-house beauticians.

In a study of a collaborative program involving 52 nursing homes around the country, The Journal of the American Geriatrics Society reported last August that team efforts had reduced the number of severe pressure ulcers acquired in-house by 69 percent. 

Dr. Joanne Lynn, who helped begin the project when she was a senior natural scientist with the RAND Corporation (she has since joined the Medicare centers), said the goal was to educate nursing home workers in bedsore prevention and to encourage them to come up with creative, low-tech solutions of their own. “It was a combination of education, cheerleading and something like systems engineering,” Dr. Lynn recalled.

Nutrition including additional protein, special mattresses made of high-density foam to reduce pressure in key areas, keeping feet elevated, repositioning frequently, keeping incontinent residents dry with routine changes, and proper fitting clothes are easy low tech solutions to preventing the developement or worsening of pressure ulcers. 

Clinicians document four stages of pressure ulcers, in which Stages 1 and 2 are superficial sores and Stages 3 and 4 are deep wounds that result from death of the skin and underlying tissues.

Dr. Horn, of the Institute for Clinical Outcomes Research, praised the collaborative as “the first major national effort driven by Medicare to reduce pressure ulcers.” But she said that better outcomes could be achieved if more nursing homes improved their documentation, so that all of the information on a given resident, including details on eating, urinary and bowel function, appeared on a single sheet, with key reminders to nursing assistants and other staff members about best practices.

Bedsores are “a major quality-of-life issue, and a self-esteem issue,” said Joanie Jones, a nurse at David Place in Nebraska. “No one wants to have sores on their bottom. I don’t care how old you are. You still want your skin intact.”

• Email This
• Print
• Trackbacks