State Recommends Changes to Staff Training Due to Multiple Choking Deaths in Connecticut Nursing Homes

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120199_1857.jpgA state agency is recommending changes to nursing home staff training procedures after three residents in separate facilities around Connecticut choked to death in a four-month period earlier this year. At least two of the three patients were clients of the state’s Department of Developmental Services (DDS), which advocates for people with developmental disabilities in care facilities. The state fined each of the nursing homes where the choking deaths occurred.

The first incident occurred on February 3, 2012 at Torrington Health and Rehabilitation Center in Torrington. An elderly patient, who required careful monitoring during meals, reportedly choked on a peanut butter and jelly sandwich. An investigation by the state Department of Public Health (DPH) concluded that staff members improperly left the resident alone with the sandwich, leading to the resident’s death. Out of a maximum possible fine of $3,000, the state fined the nursing home $510 and ordered it to submit a corrective action plan to DPH.

Investigations of Rehabilitation Facility For Brain Injured Patients Raise Questions About Quality Of Care, Proper Licensure

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156461_green_room.jpgAccording to the Centers for Disease Control and Prevention, approximately 1.7 million people suffer from a traumatic brain injury each year. People living with the long-term effects of a traumatic brain injury can suffer from difficulty with memory and speech, emotional problems, problems controlling their movement, and cognitive difficulties, according to the Brain Injury Association of America. Brain injured individuals often require extensive long-term care and rehabilitation after their initial injury. The Brain Injury Association also reports that many Americans with brain injuries have difficulty obtaining the rehabilitation they need because insurance benefits don’t always cover adequate care.

Bloomberg recently reported on multi-state investigations of one of the largest centers for rehabilitation and care for brain injuries in the nation, the Florida Institute for Neurologic Rehabilitation (FINR). According to the Bloomberg article, 20 current and former patients have made complaints against the facility, criminal charges have sometimes been against three former employees, and advocates for the disabled have become involved. Allegations have been made that five patient deaths since 1998–two in less than the last two years–have been due to abuse or neglect. Patients have described being hit repeatedly by staffers, families have alleged that health care plans such as the use of feeding tubes have not been followed, and the aggressive behavior often seen as a symptom in those recovering from a brain injury has allegedly been dealt with harshly by FINR staff.

In addition to investigations in its home state of Florida, FINR was recently investigated by the Connecticut Fatality Review Board for Persons with Disabilities after the death of a patient who had been placed at FINR by the state of Connecticut due to mental illness complications suffered after abuse as a child, rather than a brain injury. According to a report by the Fatality Review Board, FINR had used a technique called Brief Assisted Required Relaxation, where patients were taken down to the floor by FINR staff and restrained, on the Connecticut woman 29 times in her 5 months at FINR. The woman alleged that the FINR staff hit her and called her names, and a Florida sheriff’s report documented physical injuries, although it concluded that she had not been abused.

The Connecticut woman had a history of harming herself, and FINR staff had a plan of care that required two staffers to be watching her closely at all times. However, on February 10th, 2011, employees arriving for the morning shift found her with her hair wrapped around her neck and not breathing. According to the Florida investigations, one of the employees who was supposed to be watching her was asleep and the other had not checked on her in at least 15 minutes.

Florida’s Agency for Health Care Administration is investigating, as FINR’s license doesn’t allow it to treat patients such as the Connecticut woman, who suffered from a mental illness rather than a brain injury. However, James Siemianowski, a spokesman for Connecticut’s Department of Mental Health & Addiction Services considers “FINR to be a safe and effective placement.”

Federal Government and States Work to Reduce Use of Antipsychotic Drugs in Nursing Home Patients

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Wain_cats_6.jpgDementia patients can present particular challenges to nursing home staff, requiring routine care and attention. In some nursing homes around the country, staffers are using antipsychotic medications as a form of “chemical restraint” to treat dementia patients. The U.S. Food and Drug Administration (FDA) recently warned that these medications pose risks of severe complications or death for dementia sufferers.

In order to coordinate efforts to reduce nursing homes’ use of antipsychotics, the Centers for Medicare and Medicaid Services (CMS), the federal agency that administers Medicare and other public assistance programs, announced a partnership with state governments and health care providers. Antipsychotics are still a problem in many nursing home in Connecticut and around the country, and they can be dangerous enough that, in many cases, they can be viewed as a form of nursing home abuse or neglect.

The group of antipsychotic medications includes two subgroups: older drugs known as “typical” antipsychotics, and newer “atypical” antipsychotics. Typical antipsychotics include drugs like Haldol and Thorazine. Atypical antipsychotics include Seroquel, Risperdal, Abilify, and Zyprexa. Their most common approved use is for the treatment of schizophrenia and related disorders. Dementia patients who also suffer from schizophrenia-related conditions may be able to take an antipsychotic medication safely. For other dementia sufferers, however, these medications can have severe, sometimes fatal side effects.

Mother Settles Suit Against Treatment Center for Allegedly Torturing Her Son, then Petitions to End Center’s “Shock Treatment” Policy

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A mother in Massachusetts has settled her lawsuit against a treatment facility that, she alleged, subjected her son to shock treatments that constituted torture. Video of the procedure became widely available on the internet after the judge unsealed it and news of the case spread. Although the mother is reportedly satisfied with the settlement, she has also continued a public campaign to put pressure on the center to stop its use of the shock treatments allegedly used on her son.

Andre McCollins was born with serious disabilities, and as he grew older he experienced difficult behavioral and mental issues. In 2002 his mother, Cheryl McCollins, sent him to the Judge Rotenberg Center (JRC) in Canton, Massachusetts when he was eighteen years old. While Andre was a patient at the JRC, staff subjected him to what is known as “aversive therapy.” The JRC reportedly says that this is used for patients with acute behavioral problems and actions like cutting or other self-mutilation. It is apparently the only facility in the U.S. that uses this treatment. The treatment consists of administering an electric shock to a small area of skin for a few seconds. The Center claims that it obtains permission from both a patient’s parents and a judge before administering the treatment.

The video that Cheryl McCollins obtained, however, shows her son strapped to a table face-down, restrained by staffers, while he screams for help. She claimed that staffers did this as punishment because Andre removed his coat during a class. In the video, Andre’s body goes stiff, then begins to shake when the shocks are administered. On the day the video was recorded, he was reportedly shocked thirty-one times. Several psychologists employed by the JRC were allegedly present for the treatment. Cheryl McCollins reportedly found her son in a “catatonic state” during a visit three days later. She took him to a hospital in Boston, where doctors said he was having an “acute stress response” brought on by the shocks, and that the shocks could have risked his life.

Nursing Home Standards of Care- Not your Average Hospital

Nursing home abuse and neglect of the elderly is hard to tolerate in a society whose very constitutional principles are rooted in protecting those citizens that are most vulnerable. Unfortunately, Nursing Home abuse and neglect does occur in Connecticut and it happens with too much regularity. Nursing Homes and Rehab facilities tend to locate near the population centers, which in our State means concentrations in Hartford, New Haven, New London and Fairfiield Counties.The actionable injury cases in this area may include a wide variety of different bad outcomes which occur more frequently in the presence of physician or nursing staff negligence. These range from Falls producing serious fractures and Death, Bed sores and nutritional neglect to actual physical abuse.

The requirement for a Nursing home facility to plan for and provide for the Health, Safety and well being of its patients is a duty which arises under Federal and Connecticut statute and related regulations.In contrast to other forms of medical care delivery which are largely governed by various specialty boards and norms determined within the community of similarly trained providers, Nursing homes are highly regulated and subject to both Federal and State standards governing their operation and patient care delivery. Connecticut’s legislature has , for example, adopted a patient bill of rights set forth in Conn General Stat. Section 19a-550 which mirrors the Federal regulations which apply to the level and quality of patient care mandated to be delivered by nursing homes

Medication Errors- A Recurrent Problem

Medication Errors of a wide variety and levels of seriousness continue to occur with alarming regularity. This affects patient populations across all spectrums of ages and circumstances. Unfortunately, what it comes down to is that human error and lack of uniform safety and redundant verification procedures. There is a certain statistical frequency that such mistakes re-occur so that in smaller States like Connecticut this effects a smaller number of people versus someone living in New York or New Jersey for example. Such episodes are not confined to the administration of medicines while in Hospitals as the error may be at the phamacy or even a physician’s office. The latter events seem to happen when certain medical offices fail to take account of other medicines that a patient is already taking and sometimes those medicines have in fact been prescribed by a different medical specialty. Reactions to being over medicated or being provided the wrong medicataions can be fatal but more often than not are close calls. Because of the difficulty and expense involved in bringing a medical malpractice claim or a products liability claim, only the more serious injuries tend to make their way into a lawsuit. This does not minimize the impact of the close calls though and if lawsuit avoidance really becomes one of luck in terms of how badly harmed the particular patient is then the problem is obviously not going away as the incentives to be more careful and implement better procedures and technology is lacking.

Nursing Home Abuse And Neglect- A Growing Problem in Connecticut

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September 19, 2009
Posted In: Recent News , Nursing Home Abuse And Neglect , Fractures , Brain Injury , Wrongful Death

By Paul Levin on September 19, 2009 12:18 PM | Permalink
The consequences of Nursing Home abuse and neglect to Connecticut’s elderly and most vulnerable residents does not often make headlines in Connecticut’s newspapers and television broadcasts. Perhaps some of the reason for this is that when an elderly resident of a Nursing Home or rehabilitation facility falls and fractures their hip or sustains a serious head injury the intial reaction is too often a misplaced sense that “these things happen when one gets old.” The same reaction might occur when an elderly person chokes on their food which may actually stem from a diet not sufficiently monitored for reduced mastication function or develops painful bed sores and skin ulcers as a result of an insufficient physcial activity plan and/or inadequate interventions related to periodic position changes while resting in bed. The problem is that these sorts of events while commonplace occurences are not supposed to happen while in the protective custody of a qualified Nursing Home or Rehab facility.