Hip implants, which are generally made from metal and plastic, often last for 15 years before they wear out and need to be replaced. Such devices can fail prematurely for a variety of reasons, but the early replacement rate is typically 1 percent after a year, or 5 percent at five years.  However, the New York Times reported that an internal analysis conducted by Johnson & Johnson in 2011 estimated that the all-metal hip implant device would fail within five years in nearly 40 percent of patients who received. The company’s analysis showed that the implant is likely to fail prematurely over the next few years in thousands more patients in addition to those who have already had painful and costly procedures to replace it. “Johnson & Johnson never released those projections for the device, the Articular Surface Replacement, or A.S.R., which the company recalled in mid-2010. But at the same time that the medical products giant was performing that analysis, it was publicly playing down similar findings from a British implant registry about the device’s early failure rate.”

“The episode represents one of the biggest medical device failures in recent decades and the forthcoming trial is expected to shed light on what officials of Johnson & Johnson’s DePuy Orthopaedics division knew about the device’s problem before its recall and the actions they took or did not take.”

“About 93,000 patients worldwide received an A.S.R., about one-third of them in the United States. There are two versions of the A.S.R., one used in standard hip implants and the other used in an alternative replacement procedure known as resurfacing. Only the standard implant was sold in the United States. Both versions of the A.S.R., however, used the same metal hip cup as part of their design.”

 

The Chicago Tribune reported the suspicious death of a resident after a fatal altercation with another resident at Oak Park Healthcare Center.  The nursing home failed to report the altercation to the health department for further investigation. Anibal Calderon, 80, died of head injuries after an alleged fight that took place.  Calderon’s death was ruled a homicide by the Cook County medical examiner’s office. The Illinois Department of Public Health is now investigating.

Under state law, the nursing home should have reported the incident immediately to the health department as well as to the family of the victim and local police. Federal regulations require that nursing home residents involved in violent incidents be removed from the facility if necessary for their safety and the safety of others.  State officials have no record that Oak Park Healthcare notified the health department, said spokeswoman Melaney Arnold.  The for-profit nursing home has 204 beds and an occupancy rate of about 75 percent, according to the state. 

Nursing homes are also required to make available for public inspection the five most recent years of survey materials that would list possible violations, according to the IDPH website. But the Tribune reporter was escorted out of the Oak Park facility after requesting to look at the documents.

 

Kansas City’s KCTV5 reported the lawsuit filed about the alleged crime and cover-up at Brandon Woods at Alvamar.  Predictably, Defendants say there is no merit to the lawsuit, but the allegations in a 32-page court document are detailed and disturbing.  The suit was filed by the family of Jean Allen who was living at Brandon Woods at Alvamar in hospice care with dementia and almost entirely immobile.

The report of a possible sexual assault by a nursing aide was upsetting to the family, but the outrage stems from how the facility responsible for Allen’s care handled that report.

"The lawsuit against the owners and staff says the daughter of Allen’s roommate called the head of nursing on Oct. 21, 2010.  "The telephone message starts out, ‘Something awful may have happened,’" said Skepnek.  Skepnek says the head of nursing, Sharon Mulqueen, did not contact Allen’s family, did not suspend the nursing aide, did not call police and did not send Allen to the hospital. The next day, he says, Mulqueen suspended the aide and sent Allen to Lawrence Memorial Hospital – not for a sexual assault exam, but for a routine Medicare exam."

The nursing home staff refused to file a police report until hospital staff threatened to do so themselves.  In the interim, the nursing home staff had bathed Allen and washed her clothes, destroying whatever DNA evidence might have been available.  As for Allen’s exam, the suit says a specialized sexual assault nurse reported cuts and scrapes that left her with "no doubt" that Allen had been sexually abused.

 

WLTW out of Cincinnati reported the settlement in the case of a former nursing home administrator and the company that owns the home that could end up leading to a dismissal of criminal charges of failure to report suspected sexual abuse of a resident.   Charges were filed on Aug 6, 2010, after The Cabinet for Health and Family Services conducted an inspection in May and said it found several incidents of abuse and neglect that were not reported by the nursing home.

The Lexington Herald-Leader reported that Attorney General Jack Conway’s spokeswoman, Allison Martin told the newspaper that the charges against the administrators have been delayed and is expected to be dismissed within the next six months. She added that if the administrators don’t follow the agreed terms, criminal charges will be filed again.

 

KCBD out of Lubbock, Texas reported the investigation into the death of Willie Joe Byers who froze to death at the Tumbleweed Nursing Home. Police concluded that Byers died after being outside for several hours in freezing temperatures. He was finally found by a nursing home employee in the outdoor courtyard.  The staff is supposed to check on residents every two hours. The Texas Department of Aging and Disability requires that if a facility accepts a new resident that is reported to have dementia and/or a history of wandering, the resident should be closely monitored.

Deion Mitchell, Byer’s Nephew, said that he "found out about his Uncle’s death from a family friend, who knew someone that works at the facility. We had no idea that he was even transferred to the Tumbleweed Nursing Home."

According to Byer’s nephew, "Surveillance cameras show that Willie walked out of the facilities back courtyard door and apparently fell and hit his head while outside, and was found lying next to a shed."

 

 

Chicago Sun Times had an article about Rainbow Beach Nursing Center’s failure to protect a resident with debilitating schizophrenia.  Ingrid Williamson was impregnanted while a resident.  Based on her mental illness, she could not give legal consent to sexual relations..

Ingrid’s family visited often and noticed the obvous changes to her body. “We would visit her every Saturday and think ‘wow her stomach is getting really big,’” her sister recalled of those summer 2003 visits. “We asked [nursing home staff] and they told us ‘oh it’s just the medications that are making her puffy.’ My husband said ‘she’s pregnant.’”

He was right. A home pregnancy test in August and a follow-up visit to the doctor determined she was 5 1/2 months pregnant.  No one knows who the father is but some believe that it is another patient suffering from mental illness or an employee.  No test has confirmed either.

Williamson, now 54, gave birth to a baby boy the following January. Williamson Ofori-Amanfo, who became her sister’s and now-6-year-old nephew’s legal guardian, is suing the nursing home for negligence.  The nursing home has a duty to supervise, protect, and keep resident’s safe.

Williamson asked a nursing home supervisor: “Why are you letting these people have sex?” Staff told her the patients have a "right" to engage in sexual relations. “We [family members] said, “OK, then why don’t you give them birth control?” “They’re allowing them to [have sex] with complete disregard for the consequences.

In addition, the nursing home failed to recognize the pregnancy for 5 months, and didn’t provide pre-natal care and medication.  In fact, the home continued to give her psychotropic drugs to treat the schizophrenia for the next 3 months — even though family asked that staff stop administering for fear it could hurt the fetus.  Today, the boy suffers from autism and is developmentally delayed.

“She shouldn’t have gotten pregnant in the first place,” Gravlin said, placing the blame squarely on the nursing home. “Now she’s got a son who’s got to be provided for.”  Taxpayers are going to end up paying for the child unless the nursing home is held accountable.
 

Lexington Herald-Leader have been running a series of great articles on the failure of authorities to investigate complaints or for the facilities to report complaints and incidents.  See also article from WLWT.  The article uses the death of Ruby Goode as an example of lack of reporting, investigating, and prosecuting neglect and abuse of vulnerable adults.

The death of Ruby Ethel Goode in a nursing home was one of more than 100 incidents over three years in which Kentucky nursing homes were cited for violating state regulations. Few of those cases were prosecuted as crimes. When Brenda Goode Woitke learned that her 93-year-old mother had died in the Calvert City Convalescent Center, she assumed that she had died of natural causes.  But the death of Ruby Ethel Goode was far from natural or peaceful. She was found on the floor with her head stuck between the side rail of the bed and the mattress, her neck unnaturally stretched.

Not only did officials at the Western Kentucky nursing facility fail to tell Woitke how her mother died, but they intentionally hid the facts. A nurse told others "not to talk about this to anyone because they would all get in trouble," according to a state citation issued to the nursing home after Goode died.  "There was no evidence the family, the physician, the administrator, or the director of nursing were immediately notified" of how Goode, known as Ethel, died, according to a Type A citation, which is issued by state regulators when there is an immediate threat of death or injury to a nursing home resident.

Goode’s own doctor said that if he had been told about the circumstances of his patient’s death he would have contacted the coroner himself.  After a local newspaper reported how her mother had died, she walked into the office of Paducah lawyer Richard Walter and said: "I just want to know what really happened."

The civil lawsuit that was filed as a result has been settled for an undisclosed amount. Through the civil process, Woitke learned that the facility had not thoroughly assessed whether her mother — who had memory problems, was at a high risk of falls and frequently slid to the bottom of her bed — should be left alone with her bed rails up.

"It’s not about the money," Woitke said. "The truth of the way my mother died was withheld from me deliberately. I don’t want this to happen to another family."

But when prosecutors reviewed Goode’s case, they said there was not enough evidence to charge anyone with a crime — even though regulators said the nursing home failed to adequately assess whether Goode should be placed in a bed with side rails. The citation even said that might have prevented her death.

A Herald-Leader examination of 107 Type A citations issued over a three-year period by the Kentucky Cabinet for Health and Family Services Office of Inspector General found a number of gaps in the system that mean few nursing home deaths are ever prosecuted as neglect or abuse. They include:

■ Police and coroners are rarely notified of nursing home deaths or serious injuries.

■ Although the state sends all of the most serious nursing home regulatory violations to the attorney general’s office, that office can only prosecute with the permission of local prosecutors. And local prosecutors say they seldom hear about the cases.

■ The attorney general’s office misplaced or never received at least five citations issued by the cabinet from December 2006 through 2009.

The responsibility for criminal prosecutions involving long-term care facilities is spread over several agencies, with no single authority as overseer. That results in confusion and finger pointing among officials who do not want their offices blamed for not protecting the elderly.

The inspector general says it’s the attorney general’s responsibility to review nursing home citations and determine whether a crime was committed. The attorney general says that the inspector general or Adult Protective Services office can notify local police or prosecutors when criminal activity is suspected.

The 107 citations involved 18 deaths and 30 hospitalizations. Seven of the type A citations resulted in criminal charges. Eight cases are still open.

Cases where no charges were filed included those at facilities where a man wandered away and froze to death; a patient who was not monitored lost 87 pounds in 19 days and was later hospitalized; and a patient who fell and broke her hip but did not receive medical attention for seven hours.

The examination also found that nursing home employees who are prosecuted seldom serve jail time.

Much of the problem, experts said, can be attributed to the lack of a central authority to oversee investigations and prosecutions of incidents at nursing homes.   Advocates for the elderly, family members and attorneys say that nursing home deaths and injuries are not often scrutinized as potential crimes because the victims are elderly and often have serious illnesses.

If many of the same things happened to children, there would be a public outrage, said Kathleen Quinn, the director of the National Adult Protective Services Association, a trade group for adult protection workers.

Most nursing home incidents "are not investigated at all," said Dr. Barbara Weakley-Jones, Jefferson County coroner and a former state medical examiner who first noted Kentucky’s lack of attention to nursing home deaths in a 1991 study. "Unfortunately some nursing homes try to cover up what happened," she said.

Experts say criminal prosecutions in nursing home cases are difficult. Even if it seems clear that a crime was committed, it may not be certain which staff member or members did it. And elderly residents often cannot tell what happened.

Consider the case of Aden Owens, a construction worker who suffered a closed head injury at age 61 when a concrete slab collapsed. He entered Sunrise Manor Healthcare and Rehabilitation in Somerset in 1999. But his family became concerned about bruises he received — 114 injuries of unknown origin over seven years, the family alleged in a civil lawsuit.

Stephen O’Brien III, a Lexington attorney who represents Owens’ son Bryan, said Owens’ worker’s compensation carrier required him to be at Sunrise Manor. The family spent several hours a day at the nursing home and in 2006 placed a hidden camera in his room.The videotape showed a nursing assistant pulling Owens’ hair, twisting his fingers and striking his hands.  Another nurse’s aide is seen striking him, jerking him by his neck and placing a knee on his chest while changing his diaper.   After Owens fell out of bed, an aide left him on the floor while changing his bed, the videotape shows.

Bryan Owens said he couldn’t understand why his father’s case wasn’t prosecuted, while in another case, three nurse’s aides caught on a hidden camera abusing an elderly woman at Madison Manor nursing home near Richmond in 2008 were prosecuted and convicted.

In the Madison Manor case, one aide was found guilty of abuse after she roughly handled 84-year-old Armeda Thomas. Another was convicted after she ate Thomas’ food and said in records that Thomas ate it.

One key difference between the cases — Thomas’ case received widespread media coverage. Owens’ didn’t.

 

Read More →

The Winston-Salem Journal had an article about Clemmons Nursing and Rehab Center possibly losing the ability to be reimbursed by Medicaid and Medicare for failing to follow OBRA regulations and other standards of care.  Clemmons is facing federal and state claims that it isn’t properly caring for residents after investigators found that employees injured a patient by carelessly picking her up out of a wheelchair and throwing her onto her bed.  The state’s investigation cited concerns about residents’ physical and mental health and said the nursing home failed to comply with its policies and procedures, such as filing timely reports on incidents.  The center also was cited by the state for not properly observing residents’ medication regimens and not properly cleaning some female residents’ genitals.

Medicare may no longer make payments to the center for new inpatient services, and would only make payments for up to 30 days for patients admitted before June 19.  However, federal and state agencies have in the past extended the compliance deadline, depending primarily on whether the facility shows initiative in addressing deficiencies.

Clemmons is operated by Forsyth Health Investors LLC. The center has 120 beds and 71 residents.  The center also received a notice, dated June 1, that its state certification was in immediate jeopardy. 

The state agency recommended to Medicare that the center be fined a civil penalty of $10,000 for each incident.  A survey by the federal Medicare and Medicaid agency, released in December, gave the center two out of five stars, with five being the highest. The rankings focus on three categories — health inspections, staffing and quality measures.

See full report here.

BakersfieldNow had an article about the neglect suffered by Anita Ramirez after spending less than two weeks at LifeHouse Parkview nursing home.  The family discovered that Ramirez ended up with serious burns during her brief stay. Ramirez was sent to the nursing home to resolve a bedsore from a recent hospitalization

"She needed to be turned every two hours," Dias (daughter) said. "And she was on an I.V. antibiotic, and they felt this was the best course of action."

The family soon had concerns about Ramirez’ care.  Another daughter, Amanda Ayala, was very worried and she called police to help get Ramirez transferred to the hospital.  "The same nurse that saw her two weeks or three weeks prior, saw her — and said, What happened to you?" Dias said. "One of the nurses that bathed her cried, and said nobody deserves this."

The doctors then ordered Ramirez to be transferred to the burn center at San Joaquin Hospital. 

"Once they did an evaluation, they came to realize that these were severe burns all over her body," Dias said. The family has photos showing badly damaged and darkened skin. "She literally has no skin left on parts of her body," Dias said.

The article states that Eyewitness News contacted the California Department of Public Health, and spokesman Ralph Montano said the agency "can confirm an on-going investigation regarding Parkview Health Center." He could not say if that relates to the complaints regarding Ramirez.

Checking the state Health Department website, two complaints are currently on file regarding the LifeHouse Parkview facility on Real Road, but one is from mid-March and the other was started in mid-January.

 

The Lexington Herald-Leader had an article about a recent lawsuit filed against a nursing home with a history of neglect and violations.  The facts behind the lawsuit suggest that the nursing home’s failure to assess the respiratory condition of a 54-year-old man led to his death after a six-day stay.   The Winchester Centre for Health and Rehabilitation has faced numerous state and federal sanctions in the past two years and was threatened with the loss of Medicare and Medicaid funding.

On Jan. 25, 2008, William Baker was admitted to the nursing home.  The facility failed to assess and monitor Baker’s respiratory condition or to suction him. Baker developed breathing problems and was transferred to a Lexington hospital where he died on Jan. 31, 2008.  "The lack of care and attention caused Mr. Baker to suffer in a most traumatic fashion and ultimately die," the lawsuit said.  The lawsuit also the said the facility "established staffing levels that created recklessly high nurse/resident ratios."

The lawsuit is the latest in a series of problems for the facility, which in 2008 received two type A citations — the most serious the state can give. One, in August, was for not calling a doctor when a man lost more than 87 pounds in 19 days. At the end of the 19 days, the man was found unresponsive and was taken to the hospital, according to the citation from the Kentucky Cabinet for Health and Family Services

A second type A citation was issued Jan. 12 after a patient received the wrong dose of an anti-seizure medication for 40 days in November and December, an error that wasn’t discovered until the patient suffered a seizure.  The facility didn’t have a system to make sure that medications were administered properly, according to the Jan. 12 citation.