April 2011 Archives

April 25, 2011

Study Finds More Than Half of Those Hospitalized for Medication Errors Are Seniors

As a Philadelphia medical malpractice lawyer, I know medication errors are a major source of medical mistakes for patients of all ages. But I was disappointed to see an April 20 article about federal data showing that the majority of all medication error victims who wind up in the hospital are seniors. The data comes from the federal Agency for Healthcare Research and Quality, part of the Department of Health and Human Services. That agency found that medication errors have grown by 52 percent between 2004 and 2008, the last year it studied. That's 1.9 million people injured badly enough to need hospitalization, up from 1.2 people injured in 2004. Another 838,000 patients were treated in emergency rooms and released, 18 percent of whom were 65 or older.

The medication errors included errors patients made themselves and mistakes by caregivers providing the medicines. Reasons included overdoses, mistakes by pharmacists, bad reactions, mixing incompatible medications and more. The kind of drug that most often sent people to the hospital was corticosteroids, a class of drugs used to treat arthritis, asthma, inflammatory bowel disease and several other conditions. That class of drugs was responsible for 283,700 hospitalizations. Next most common were painkillers (269,400 cases), blood thinners (218,800), cancer and immune-system drugs (234,300) and heart and blood pressure medications (191,300). In emergency rooms, visitors most often didn't specify a drug, but also cited painkillers, antibiotics, tranquilizers and antidepressants, and corticosteroids.

This news concerns me as a Pennsylvania nursing home lawyer because people in nursing homes are likely to have complicated medical needs. Families generally put their loved ones in nursing homes when their needs are too constant or complicated for the families to handle themselves. For the same reasons, nursing home patients are less likely to be able to notice a mistake with medicine or speak up when they do. At the same time, nursing home employees can make mistakes or even intentionally make an unauthorized change in medication. Even the best intentions can fall flat when nursing homes are understaffed, robbing employees of the time they need to make sure details are right. And in some cases, employees have perpetrated Pennsylvania nursing home abuse by stealing painkillers from patients for their own use, intentionally giving inappropriate sedatives or withholding medication to save money. In either case, it's unacceptable for an institution we trust with the care of vulnerable older loved ones. Families who find themselves in this position should talk to a Philadelphia injury lawyer right away.

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April 19, 2011

Study Finds Pennsylvania Nursing Home Patients Can Lose Memory When Hospitalized

As a Philadelphia medical malpractice lawyer, I was interested to see a new study suggesting that hospitalized nursing home patients may need an advocate even more than previously thought. As HealthDay News reported April 18, a new study by Northwestern University has found that older people can suffer short-term memory loss when they go into the hospital. Researchers found a temporary reduction in cognition among one-third of the patients they studied as they were being discharged from the hospital, but a majority of those problems disappeared in a month. They cautioned the public that it's vital for seniors to have a family member or other advocate present on discharge, so vital medical instructions aren't forgotten or lost.

The researchers studied 200 people ages 70 or older who lived alone and didn't have any diagnosis of cognitive problems like dementia. On the day the patients were discharged, the team administered tests measuring their reading and writing skills, orientation, calculation and comprehension. The results showed problems with nearly one-third of the patients. A month later, the researchers administered the tests again. Of those whose earlier test results showed problems, 58 percent no longer had results showing reduced cognition. Lead author Dr. Lee Lindquist said this suggested that some seniors may be better off with help understanding and applying discharge instructions. That kind of help could reduce the need for more hospitalization in the future caused by confusion or missed instructions about things like medication.

As a Pennsylvania nursing home lawyer, I am particularly interested in this as it applies to nursing home care. Patients in nursing homes are supposed to have advocates already on staff -- aides and nurses who are in charge of medication, nutrition and other needs. But all too often, nursing homes fail their patients by mixing up instructions or neglecting important medical needs. To prevent this kind of Pennsylvania nursing home abuse, I believe it's important for families to stay involved -- at all times, but especially when a loved one is hospitalized. By advocating for their disabled relatives at a time when they may not be able to advocate for themselves, families can prevent neglect and abuse leading to more health problems or even death.

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April 11, 2011

Hidden Camera in Philadelphia Nursing Home Catches Employees Abusing Woman

It's fortunately rare that I find a local news story directly relevant to my practice as a Pennsylvania nursing home lawyer. But I'm sorry to say that news reports broke last week of an incident of abuse caught on camera at a nursing home in Haverford, in Delaware County. As the Philadelphia Inquirer reported April 8, three women have been fired from the Quadrangle nursing home and charged with crimes after being caught on tape hitting and tormenting patient Lois McCallister, 78. Samirah Traynham, 22, Tyrina Griffin, 21, and Ayesha Mohammed, 19, are all charged with aggravated assault, criminal conspiracy, harassment, neglect of a care-dependent person and more. The police and the state Department of Public Welfare are both investigating, and McCallister has been removed to the care of her daughter and son-in-law, Mary and Paul Franch.

The Franches planted a hidden camera in McCallister's room at the Quadrangle after McCallister told them she had been hit and slapped, then later showed them bruises. The home told the Franches that McCallister's dementia was likely the reason for the complaints. The camera told a different story. In one video, Traynham slaps and hits McCallister as she struggles to pull a shirt over her head. In another, all three employees mocked McCallister as she stands there, topless, and repeatedly prevent her from leaving the room when she tries. Griffin helps McCallister put her shirt on, but then she and another employee pull and slap at McCallister's ears, which are sensitive because she had hearing aids removed. Griffin shadow boxes at McCallister and Mohammed pokes her in the eye. Five minutes after the more recent video was taken, the Franches showed up for a visit. They said McCallister was agitated and asked "Why do they keep picking on me?"

The video, from ABC News:

As a Philadelphia injury lawyer, I wish I had an answer for Mrs. McCallister. However, it looks like this is not the first regulatory trouble for the Quadrangle. The home was issued a provisional license in May of 2009 after one dementia patient ingested paint and another antibacterial cleaner. The home was cited for failing to keep the hazardous materials out of patients' reach, failing to obtain medical care and failing to report the incidents to the DPW. Its for-profit parent company, Sunrise Senior Living, has had 25 citations from the DPW for its 18 Pennsylvania facilities since 2007. Frequently, this kind of Pennsylvania nursing home abuse and neglect stems from cost-cutting, which stretches staffers thin, encourages fast turnover and encourages the use of inexperienced or less well trained staff -- which may explain why McCallister's caretakers were ages 19 to 22. Saving money is an important part of a for-profit business, but as a Philadelphia medical malpractice lawyer, I know it can also cost the company a lot of money in the long run, when patients whose health and dignity were compromised file successful lawsuits.

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April 5, 2011

More County-Owned Pennsylvania Nursing Homes Under Threat of Privatization

As a Philadelphia injury lawyer, I believe the profit motive in for-profit nursing homes sometimes undermines those homes' commitment to good care. So I was disappointed to see an April 3 article from the Erie Times-News about an apparent trend toward Pennsylvania counties selling their nursing homes to private companies. According to the article, at least fiver Pennsylvania counties -- most in greater Philadelphia -- have sold homes or are exploring the idea. A committee connected to Erie County's County Council has recommended the sale of its county-run facilities as well. However, the idea has met with fierce opposition in Northampton County, where advocates for the Gracedale nursing home in Nazareth are concerned that proposed privatization could harm the elderly and sick residents.

Gracedale, which has 600 employees and 725 beds, is one of the biggest county-run nursing homes in Pennsylvania. County government officials there are soliciting bids from private companies, in part because the 1970s-era building needs $10 million in repairs and improvements. However, county residents are currently petitioning to put the sale to a vote. Nursing home sales in other counties have also generated controversy over issues like number of indigent patients the homes will serve and whether union contracts with the counties will still be honored. Officials in Cambria County said the Laurel Crest home there lost $9.2 million in two years, and the sale removed a financial liability from their budget. Erie County's two Pleasant View Manor homes aren't losing money, their administrator said, but a county committee recommended selling it for financial and competitive reasons.

I oppose this because, as a Philadelphia medical malpractice lawyer, I believe that county governments are better caretakers for the sick and vulnerable than for-profit nursing home companies. Of course, not all companies seeking to make a profit are willing to do it at the expense of patients, but serving the financial bottom line has effects that voters may not realize. For example, homes can save money by cutting staff members, especially skilled staff members. However, when the ratio of staff to patients is too low, and especially when staff members don't have the right training, they may be too busy to give patients the attention they need to handle difficult behavior, dehydration and bedsore prevention. As a result, important patient care can be neglected, eventually causing health problems or even Pennsylvania nursing home abuse. Understaffed, underskilled homes may also use psychiatric drugs instead of behavioral interventions -- a practice that can lead to unnecessary illness or injury. As a Pennsylvania nursing home lawyer, I believe protecting the vulnerable is part of government's job -- not a business to be sold when the budget is tight.

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