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.

Kathleen Glanville, a writer for The Oregonian, wrote an article about a $900,000 verdict for a resident who was treated ridiculously bad by a nursing home.  The jury ruled that an 86-year-old woman with Alzheimer’s disease suffered a loss of dignity when Lake Oswego police forced her to the floor of her nursing home and handcuffed her.   The jury awarded more than $900,000 to the family of the late Elvera Stephan for the way she was treated the night of April 13, 2006, at The Pearl at Kruse Way in Lake Oswego.

The jury agreed that Avamere Health Services, the corporate owner of the Alzheimer’s care center, had acted with malice or reckless indifference.  Stephan’s children moved her into the Alzheimer’s care center in early April 2006 after her husband became seriously ill and was hospitalized. Within a few days she became agitated, wandering the nursing home barefoot in her pajamas, confused and, according to her caretakers, dangerously aggressive.

The staff notified a registered nurse in another part of the nursing home, who called the woman’s doctor for guidance. He said Stephan should be taken to the emergency room for evaluation and medication.  The nurse called 9-1-1 to summon an ambulance, and because she told the emergency dispatcher that the patient was extremely aggressive, Lake Oswego police responded as well.

But jurors said she didn’t look dangerous on a surveillance video from the nursing home. She was gesturing with a telephone receiver but didn’t try to hit anyone with it.

Two officers forced the elderly woman to the floor, where they rolled her onto her stomach and handcuffed her hands behind her back. She remained on the floor on her stomach for six minutes until paramedics put her on a stretcher and took her to the hospital, according to Kocher. She returned to The Pearl the next day, when a nurse reported that her wrists were bruised.

A state investigator found the nursing home at fault for failing to assess the woman’s condition and intervene in a timely manner.   Stephan’s son, James, testified that he didn’t learn about what had happened to his mother for six days, when he was told by the relatives of another patient at The Pearl.

The video of the police subduing the woman was played for the jury.   Kocher had asked the jury to award Stephan’s family $1 million to send a message to corporations that care for Oregon’s elderly and vulnerable.

The jury agreed on $4,200 in economic damages — the cost of Stephan’s shared room for a month — and $400,000 in noneconomic damages. The jury then awarded $500,000 in punitive damages. Under state law, 60 percent of punitive damages go to the state victims assistance fund.

 

In Dallas, Texas a local television station has been running background checks on licensed nurses. They have found "thousands of nurses with arrest records." That much didn’t surprise me – but the arrests include murder, kidnapping and arson.

What? Murder?

My immediate thought was, don’t employers do background checks? My second thought was, are these nurses currently employed?

Turns out that the Texas Board of Nursing "wanted to run background checks of all nurses in 2005" but the state didn’t allow the funding at that time. When they finally got the money to do it, they didn’t have enough staff to do it – short staffed at the Board of Nursing.

At any rate, it seems to me that even if the state Board didn’t check, surely employers do – But I certainly wouldn’t assume that. There is a lot of talk out there about a shortage of nurses,but stories like this only confirm my suspicion that it’s more than that – its a shortage of qualified and trustworthy nurses. Imagine if your loved one was being taken care of by a murderer . . . Unacceptable.

To check out the article, click here.

Rome News Tribune has a story about a male resident found dead in the nursing home’s utility closet.  Typically, these closets are locked and only certain staff members have access.  No one knows how the resident got into the closet or how he died.  

The man had been missing from a Georgia nursing home for two weeks but was found dead Wednesday in a utility closet at the facility.  The body of Walter T. Heath was found in a closet near the dining area of the Tara at Thunderbolt Nursing and Rehabilitation Center.

Heath had been missing since 5 p.m. April 16. He admitted himself into the Thunderbolt facility in February.  After he disappeared, the facility’s staff and Heath’s family members grew concerned about him.   Heath’s wheechair was left near the dining area the day he disappeared, not far from the utility closet where his body was found Wednesday morning.

Hopefully, the autopsy and investigation will reveal what truly happened.

Alabama NewsChannell 19 had a horrendous story of neglect on their website.  NewsChannel 19’s Carson Clark reported that a Marshall County Nursing Home is in trouble with state and federal officials after a patient died there. A doctor says the Golden Living Center in Boaz allowed a young woman to scream for help for more than six hours, before finding her dead.

The patient, 20-year-old Felicia Ann Engle of Boaz, suffered from kidney disease. She had to be placed in Golden Living because her father was no longer capable of taking care of her needs.

According to state records obtained by NewsChannel 19, Engle began to yell for help around 3:00 p.m. on April 3, 2008. The records quote nurses at the facility, with one saying Felicia was, "…begging us to call her doctor that something was really wrong this time. She was hurting so bad it was unbearable."

The nurse tells investigators she went to another nurse to tell her of Engle’s request. The nurse reportedly replied, "Yes, we know, we’ve heard all about it four times at least."

NewsChannel 19 contacted Dr. Tom Geary with the Alabama Department of Public Health in Montgomery. He says the way in which Engle was treated violates the law.

"If the patient requests to go to the hospital, [if] they say something is wrong, I need to go to the emergency room, they are supposed to take them to the emergency room. They are not supposed to make a judgment that the person is just trying to disrupt the normal services in the facility, close the door and leave them alone," he says.

The director of Golden Living, Kevin Cogan, refused an on-camera interview and asked NewsChannel 19 to leave the property when they visited.

The Atlanta Journal constitution wrote a story about a Georgia Judge finding tort reform caps to be unconstitutional.  The cap on monetary awards in a medical malpractice case was found to be unconstitutional.

Superior Court Judge Marvin Arrington wrote in an order that the legislative cap of $350,000 for noneconomic damages such as pain and suffering was unconstitutional because it gave special protections to the medical profession. This meant people injured by doctors had less protection than those injured by others.

"It is absurd to say that if you get injured by a product that the jury can decide your noneconomic damages, but if you get injured by medical malpractice, it can’t," said Trent Speckhals, one of the lawyers for Cheon Park, the plaintiff in the case.

The legislature approved the $350,000 cap in 2005 as part of a civil-justice tort reform law over the opposition of the Georgia Trial Lawyers Association and consumer groups.   In 2006, the Georgia Supreme Court stuck down another provision of tort reform when it ruled that defendants couldn’t decide in which county their medical-malpractice case was tried.

In his written opinion, Arrington complained that limiting the caps meant that in many cases, large jury awards would be issued only to wealthy people who could point to the loss of large incomes.

"The statute effectively puts substantial limitations on the rights of the poor and middle class to recovery while leaving the right to virtually unlimited recoveries unimpeded for the wealthy," Arrington said. "The disabled manager of a hedge fund, a corporate CEO, an entertainer or such other person whose income is in the tens of millions of dollars has a claim under Georgia law that would dwarf the amount awarded in any case for pain and suffering."

I read an interesting article about getting medical records earlier this week.  The article raised several important points:  1) Its hard to get your own records, but its much harder to get someone else’s; 2) Its hard to get ALL records; 3) Its hard to be sure that the records are accurate.

USA Today specifically points out that its harder to obtain medical records from treating facilities after something has gone wrong.  In fact, the article suggests that one way to avoid just this sort of problem is to routinely request copies of medical records.  This advice, which I think is very good advice, led me to wonder, well, just how often do you request records?  I mean, consider you’re in the hospital having a baby.  Do you request the records on day 2?  Do you request the records upon discharge?  Do you request the records on day 2 and upon discharge? 

The article also points out that under federa law, every patient or designated representative has the right to see and copy the patient’s medical records.  This is aparently not the case in nursing homes.  Nursing homes in this area routinely say that once a patient is discharged, they are no longer a patient, and therefore have no right of access to their records, at least not until those records have been thoroughly reviewed by their corporate attorneys.  Clever, don’t you think? 

Worse than that, try arguing with in-house counsel about whether or not your deceased client’s daughter (who was the Responsible Party for purposes of admission, who likely signed an arbitration clause that the nursing home will try to enforce against her) is a "designated representative" for purposes of reviewing and/or receiving medical records.

The article is worth the read.  And I don’t think its exaggerated.  And its certainly something to think about. 

Inevitably in most of our nrsing home cases, numerous documents that are intended to show the care, treatment, and services provided to the resident are missing, lost, or never done by the staff.  This occurs because the care was not provided or understaffing caused the staff not to have time to document or poorly trained and supervised staff.  Despite the fact that all nurses were taught and accept the axiom that "If it wasn’t documented, it wasn’t done", the insurance companies, nursing home industry, and their defense counsel always say the missing information is not relevant and does not show that the care wasn’t given but rather wasn’t documented.  Hopefully, the new Medicare reimbursement policies will preclude this frivolous argument.

McKnight’s has an article discussing the new Medicare reimbursement policies and the necessity of documentation to prove care provided.  Nursing homes will have a greater role in ensuring accurate documentation of care.    Compliance officers’ experience in billing and coding could be easily transferred to the area of quality-of-care forms.  Physicians and care workers will need to learn the appropriate language from compliance officers to best fill out the claims forms.

WIStv.com had a story by Jack Kuenzie about a resident being neglected in a Prosperity, S.C. nursing home.  The owner of the Southside Residential Care Facility, Roy Lee Bowers, 64, has been arrested and charged with felony neglect of a vulnerable adult, resulting in the death of a patient.   His health care administration license was also suspended Friday by the state.

Investigators started looking into the facility when they found 59-year-old William Sealy malnourished and only weighing 94 pounds.  Sealy had injuries to his legs, bed bugs, a toenail rotted off and a toe beginning to rot off, and his socks had been left on for so long that his skin was pulled off when his sock was removed. They said he also had a scalp disease, appeared as if he hadn’t been bathed in over a week, and was severely malnourished. He weighed 94 pounds and officials said he should have weighed at least 160 pounds.

Sealy died on Saturday, April 12th. Autopsy results show he died of pneumonia and severe infection.   Until he died, Sealy’s family had no idea he was even there. A spokeswoman says the family had been told by his guardian to avoid contact with Sealy for fear of damaging his fragile mental condition.

To those who monitor the state’s system for protecting sealy and others like him, it’s another indication of just how weak that system can be.

William C. Lhotka of the St. louis Post-dispatch wrote an article about a Judge preventing a nursing home from evicting a resident from a nursing home.  Below is an excerpt of his article:

A judge has barred an Ellisville nursing home from discharging a resident in a billing dispute because of the possible traumatic effects of transferring her to another care facility.  The judge found for the family of Barbara H. Lindsay and against Bethesda Long Term Care Inc. which operates Bethesda Meadow.  The ruling means the nursing home cannot move Lindsay to another nursing home when Bethesda alleged Lindsay’s family owed the company past due bills.

Lindsay’s son Douglas contended that the bill was erroneous and that his mother was too fragile to move.   Jacqueline Levey, attorney for the Lindsays, argued before Vincent that "any nursing facility wishing to expel an elderly or disabled resident can simply manufacture a series of grossly inaccurate billing statements."

Bethesda lawyer James W. Erwin had contended that some billing errors by Bethesda didn’t negate the failure of the Lindsay family to make payments.  On the day before the hearing in October, the Lindsay family paid its bill in full. Nonetheless, the nursing home proceeded with the discharge, said Levey, the family’s lawyer.

Vincent cited medical testimony in his order that Barbara Lindsay "is very fragile and has very little strength." The judge said the nursing home provided no evidence that "a safe and orderly discharge could be accomplished."