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Nursing Homes Abuse Blog

By Jonathan Rosenfeld

Dangers Related To Byetta And Januvia Not New

By Jonathan Rosenfeld on Posted in Defective Products

Pancreas Although the latest warning from the FDA regarding drugs like Byetta and Januvia only came in March 2013, the dangers have been known for many years. The recent information released by the FDA that researchers have found pre-cancerous cells in deceased patients using the drugs came after several previous warnings dating back to 2007. Although the FDA has yet to confirm the link between these drugs and pancreatic cancer, many believe that it is only a matter of time.

Bad News From The Beginning

Byetta still had that new-drug smell when reports began trickling in that patients using the drug were having a higher incidence of pancreatitis.  The FDA approved Byetta in 2005 and by 2007, the first FDA alert was issued that patients using the drug had reported to the FDA that they had pancreatitis. The next year, another alert was issued, with reports of patients dying from the disease.

Januvia had similar results. The drug was approved in 2006 and in 2009 the FDA issued an alert regarding pancreatitis and Januvia as well. Although the alerts were only to advise the public and healthcare personnel of the reported cases, not to recall or blame the drug for these reactions, it was an early warning sign of problems to come.

Dangers Of Pancreatitis

Both these drugs are classified as incretin mimetic drugs that work to spur the pancreas to produce insulin. Byetta mimics the incretin hormone, which causes the cells in the pancreas to release insulin. Januvia works to prevent enzymes from breaking down existing incretin hormones, having a similar affect on insulin levels. It has not become clear on how they are causing inflammation in the pancreas or pancreatitis.

However, the affects of pancreatitis are well known. Pancreatitis is painful and can lead to gall bladder disease and other complications. In addition, those with chronic pancreatitis or necrotizing pancreatitis have a 10-15% mortality rate. There also has been a link between pancreatitis and pancreatic cancer. The UCLA Center For Pancreatic Diseases estimates that those with pancreatitis are five times more likely to get cancer of the pancreas, one of the deadliest forms of cancer. In addition, the newest FDA findings indicated pre-cancerous cells in the pancreas samples taken from deceased diabetes patients previously on incretin drugs.

Unfortunately for diabetes patients, these drugs that seemed to have so much hope have quickly turned out to be wolves in sheep’s clothing. In eight short years they have went from the newest drugs of choice for Type-2 diabetes to high on the FDA radar of possible dangerous drugs. The benefits that they offered are far outweighed by the risks that they bring to already fragile bodies. Sadly, for many others, the damage has already been done and any further warnings or recalls that may come regarding these drugs will be too late.

Do you have questions about litigation related to Januvia and Byetta?

Rosenfeld Injury Lawyers is currently representing people who have developed complications related to Byetta and Januvia use. If you or a loved one has developed complications that you believe are related to this drugs, contact our office for a free case evaluation and discussion of your legal rights.

http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm124713.htm

http://www.drugs.com/history/byetta.html

http://pancreas.ucla.edu/body.cfm?id=36

http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/ucm183764.htm

http://usatoday30.usatoday.com/news/health/medical/story/2011-09-23/Popular-diabetes-drugs-may-raise-pancreatic-cancer-risk-study-suggests/50531776/1

State Attempts to Make Nursing Home Lawsuits More Difficult to Initiate

By Jonathan Rosenfeld on Posted in Litigation

nursing home negligence lawsuitFamily members of nursing home residents offered powerful testimony about neglect and abuse in some facilities, but legislation to limit the impact of a nursing home lawsuit still passed the Florida Senate Rules Committee on April 15. The next stop is the Senate Floor. Although the bill has been stuck in the House, representatives could agree to the Senate version.

Siblings File Lawsuit after Mother’s Rape

One brother and sister related that their mother was subject to rape in 2002 at a Jacksonville Facility when another patient with a history of sexual attacks assaulted her. Although they were awarded a $750,000 judgment in a nursing home lawsuit, they never collected anything after the facility closed.

They think the legislation could mean people will have even more trouble filing lawsuits if it passes. Their motivation in filing the lawsuit was to change the culture, and they were not concerned with the money. The brother questioned the panel as to who would benefit from the legislation. He feels that the nursing homes and administrators are being protected unfairly and that the bill does not look out for the best interests of patients.

Nursing Home Facility Perspective

A representative from the nursing home industry explained they wanted fairness. She added that in some cases, attorneys inflate the cost of court judgments although many cases are settled out of court.

Suggested Changes

Current laws make plaintiffs give evidence of alleged abuse before a trial, but that evidence does not need to be admissible in court. The new legislation would order those who are filing lawsuits to present the evidence to a judge at a pretrial hearing. The judge would determine the validity of the evidence and whether the case would move forward. However, the current laws allow the attorney to look at the amount of money available in the case and then decide if they want to pursue punitive damages.

The state previously ordered that monies from punitive damages must go into a trust fund, but that is not happening. The director for the Florida Justice Association, which helps lawyers who focus on consumer and patient lawsuits, feels that the bill is still a problem for the residents of elderly care facilities.

Nursing Home Negligence Verdict To Stand

By Jonathan Rosenfeld on Posted in ManorCare

A nursing home facility in Kanawha County West Virginia recently lost its appeal to reconsider a sizable verdict awarded in a case that went to trial two years earlier. The lawsuit investigates whether the limits established for medical malpractice apply to nursing homes. It borders on whether the defendant, HCR Manor Care, looked to garner more profits by withholding staff to cut costs.

The Charges against HCR Manor Care

In 2009, a facility owned by HCR Manor Car, LLC took charge for an 87- year old woman. Just 19 days after admittance, the elderly lady died of dehydration. The lawsuit filed by her son claims that there were a number of abuses on his mother during her short stay at the nursing home

The investigation shows not only did the woman fail to receive proper food and water, the general care was lacking, as well. Her body showed sign of head trauma due to several falls. Her mouth had sores that required surgical removal, as well. It was the lack of proper nutrition, however, that contributed to her death.

The Nursing Home Lawsuit

The initial findings by the Kanawha County Circuit judge were in favor of the plaintiff. The elderly victim’s family received an award for 91.5 million dollars. The judgment included 80 million punitive and 11.5 million dollars compensatory payment.

HCR Manor Care appealed the initial verdict claiming that the high judgment against them violated West Virginia’s malpractice caps. If true, the restriction would lower the payout by the company to just 500,000 dollars. The plaintiff’s attorneys countered that medical malpractice caps were designed for physicians, not a broad blanket rule for all medical services.

Court Upholds the Findings

At first, the judgment was sent back to the residing court for review. The reigning judge ruled against the cap motion stating that the nursing home did not fall into the purview of the state law covering health care providers. At the time, the court reviewed the company’s ability to pay such a large judgment, as well. Financial records show the establishment made just 75 million dollars in 2009. In addition, as of 2011, they no longer qualified for Medicare and Medicaid funding because of care violations.
Further review by the West Virginia Supreme Court supported the initial finding by the county judge. Next, the case was heard by the U.S. Supreme Court, which found that the lower judges failed to consider other restrictions such as the Federal Arbitration Act. This sent the case back to West Virginia. After taking another look, the lower court decided the nursing home was not covered by the FAA framework either.

The Advantage of these Rulings

This nursing home lawsuit, though not yet fully decided, does offer some promising implications. With just 500,000 at stake, there is little to keep these institutions honest. A nursing home lawsuit that can cost them millions means they are more likely to follow proper healthcare standards and improve the quality of life for elderly individuals in their care.

Will Privacy Trump a Families’ Right to Protect Their Loved Ones in Nursing Homes?

By Jonathan Rosenfeld on Posted in National Nursing Home Issue & For-Profit Chains

Will Privacy Trump a Families' Right to Protect Their Loved Ones in Nursing Homes?The family members of a 96-year-old woman, who has since passed away, witnessed nursing home abuse from aides of the elderly woman after they caught staff members on camera. The Oklahoma Department of Health reported that the nursing home was supposed to investigate the abuse that happened in April 2012, but the family has not seen the results of that investigation.

Abuse Caught on Camera

The woman’s daughter hid a camera inside her mother’s room because she believed that staff or others at the facility were taking her things. She expressed her surprise at what was happening at the home. In one incident, two staff members shoved rubber gloves into the woman’s mouth, and another aide seemed to push her head.

State Oversight by Government Agencies

One of the daughters expressed her opinion that her mother’s abuse had not been properly investigated. The Oklahoma Department of Health made a statement related to the accusations and said they refused to tolerate any neglect or abuse of nursing home patients. The organization has given out 20 citations to facilities for failing to protect patients from nursing home abuse since May 2009.

The ODH and the Oklahoma State Department of Health revamped regulations in 2007 by ordering all nursing homes to report any suspected crime to the authorities. The facility complied with the requirements and contacted the police. The nursing home also filed a report related to how they addressed the situation with OSDH at the time of the incident. Police decided that the individuals were responsible for their criminal actions. Two staff members were taken into custody; one was convicted and incarcerated.

Between July 2011 and June 2012, the OSDH listed 7,603 violations against elderly care facilities and took action against these facilities 404 times because of violations. As of June 2012, the state oversaw 318 licensed facilities.

Daughters’ Counsel to Others with Relatives in Nursing Homes

The woman’s daughters indicated they believed the problem is more prevalent than previously thought. They think there are more victims than initially reported. They also encouraged people to closely watch for any signs of abuse in loved ones.

Senate Bill Could Modify Privacy Laws for Nursing Homes

Senate Bill 587 in the Oklahoma legislature would permit nursing-home patients to have cameras in their rooms. However, an amendment could punish any unauthorized cameras. The woman’s daughters support the Bill.

Morphine Overdose Kills Nursing Home Patient

By Jonathan Rosenfeld on Posted in Medication Errors

Morphine Overdose Kills Nursing-Home PatientOn April 20, a jury returned a verdict for the plaintiff and against a north St. Louis County nursing home after a mentally ill patient died when he received a fatal dose of morphine. The 45-year-old man had never been prescribed the opiate derivative and passed away at a hospital in 2009. Although his death was originally ruled as a heart attack, a toxicology report revealed a fatal level of morphine in his system. However, it is unknown how the patient ended up with the medication overdose.

Family Files Lawsuit Against Nursing Home

The man’s brother and nephew filed the lawsuit against the care facility. Their attorney insisted that the man was unable to leave the facility and so he must have somehow gotten the drug there or from the staff. Witnesses testified that pain medication was sometimes left out at the nurses’ station and that some patients received morphine shots. The jury awarded the plaintiffs $700,000.

Criminal Charges not Filed

Although law enforcement personnel looked into the man’s death, they concluded that all of the morphine in the facility was accounted for. No charges were filed against the nursing home, and state health authorities observed no violations related to the medication overdose.

The attorney for the nursing home observed that the damages might be lowered because of Missouri laws related to malpractice. She also suggested that they would appeal the decision. She further observed that the employees at the nursing home do their best on a daily bases to provide care for patients with a wide range of challenging health care issues.

Facility Received Citations

The nursing home administrator did not comment on the lawsuit. The facility was rated lower than average at two out of five stars through Medicare, which relates to overall staffing and safety concerns. The home received a citation in December from state officials for health issues related to the excessive weight loss of several patients.

The Missouri Protection and Advocacy Services looks into neglect and abuse charges of individuals who suffer with disabilities. In 2011, they looked into accusations that the nursing home failed to properly care for a 37-year-old patient who was hospitalized due to dehydration, kidney failure and allegations of poor nutrition. They found the facility did not give the proper medical treatment to the patient and planned to inform the state.

 

Time For Nursing Homes To Start Paying More Meaningful Wages To Staff

By Jonathan Rosenfeld on Posted in Nursing Home Staff

Nursing Home Employees Need to Make More MoneyAs the baby boomers age, nursing homes face unprecedented understaffing issues.

Understaffing in Nursing Homes

The current economic climate has made it difficult for many people to find jobs, which makes it even more astounding that there is such a significant shortage of nursing home workers. The bottom line is that nursing home assignments are undesirable, and until that changes, staffing in nursing homes will not improve. In fact, the industry estimates that the situation will get much worse with no end in sight.

Baby Boomers Leading Longer Lives

A factor in this problem is that improved medicine and technology is leading to longer lives. More baby boomers are requiring nursing home care, and they are requiring it for a longer period, than any generation before them. The industry expects the problem to get even worse with future generations.

Undesirable Working Environments

The problem is exacerbated because the pool of nursing home workers isn’t just static but rather shrinking. Industry surveys of people who have worked at a nursing home but no longer do indicate that those people were unsatisfied with it as a long-term career option. Changing that perception then is the key to better staffing in nursing homes.

Wages Too Low

Firstly, much of this dissatisfaction is attributable to the fact that the average rate for nursing home workers is approximately $12 an hour. It may seem like a fair wage, but as minimum wages rise, there are an increasing number of jobs close to that rate that are not nearly as demanding. The obvious solution is to increase wages, but nursing homes are struggling for money as it is. Furthermore, the industry has to be careful not to simply attract people for the wrong reasons. A good nursing home worker is a special kind of person.

Benefits and Long-Term Security Not Enough

Many nursing home jobs ironically lack adequate medical insurance and dental insurance, and perhaps the majority lack a 401k plan or similar mechanism. Working at a nursing home is a tough job, and if you want people to make that kind of commitment, then it is necessary to give them the peace of mind of being secure when they are longer able to perform the job.

Workers Worked Too Hard

The staffing issue in nursing homes is somewhat of a Catch-22. Current nursing home professionals are overworked, and many leave for this exact reason. However, the overworking occurs largely because the nursing homes are undermanned. This has continued so long that it is becoming difficult to return to balance.

High Injury Rates

There is also the issue of high injury rates at nursing homes. We don’t tend to think of nursing homes as dangerous environments, but statistically, nursing homes are up there with other dangerous assignments, including construction. Nursing homes must find a way to be safer and ways to serve their employees better when injury does occur.

Conclusion

The current situation of staffing in nursing homes is nasty one that is continuing to grow. There is no easy solution, and it will require a concerted industry-wide effort to overcome it.

 

Labor Shortage In Nursing Homes Is A Safety Concern

By Jonathan Rosenfeld on Posted in Nursing Home Staff

Labor Shortage In Nursing Homes Is A Safety Concern Nursing homes across the country are having great difficulty finding workers, and the industry expects that the problem will only get worse as the baby boomer generation gets older.

Under-staffing in Nursing Homes

Worker shortage for nursing homes has occurred primarily because the rate of elderly people has increased but the rate of people interested in these positions has not. Based on population growth, one could expect these rates to rise and fall in a similar fashion, but this isn’t simply a matter of population growth. Medicine has improved significantly and lifespans are longer, so people who need nursing homes require them for significantly longer periods than past generations did.

Enticing the Next Generation of Nursing Home Worker

The demand for nursing home care is not going to go away. In fact, the industry estimates that the need will continue to grow substantially and that there is no end to that growth in sight. Therefore, the only way to remedy the situation is to make the positions more enticing to the people who can fill them. It speaks volumes that in an economic crunch, where jobs can be hard to come by, under-staffing in nursing homes is such a prevalent problem that has been associated with neglect of nursing home patients.

Why Nursing Homes Jobs are Undesirable

The biggest issue is that the average nursing home job pays less than $12, which is not significantly higher than the average rate provided by jobs that do not even require a high school education. This is simply not enough pay considering that the work is unpleasant, physically difficult and emotionally draining. Furthermore, the industry has injury rates that are in line with dangerous lines of work, such as construction. Most people don’t think of nursing home work as dangerous, but it is.

A Multifaceted Problem

The simple answer is to increase the wage rates. The big problem with this is that nursing home budgets are very tight, and most simply don’t have any additional funds to spare. The other issue is that simply increasing wage rages tends to attract a type of employee that is there simply because of the additional pay. Nursing homes require a special kind of person, or else the elderly who live there suffer. The solution is going to involve decreased workload, a safer work environment and long-term security.

 

What Does It Take To Make It to The List Of the Worst Nursing Homes?

By Jonathan Rosenfeld on Posted in Nursing Home Abuse

Worst Nursing Homes?A Deer Park, Cleveland nursing home has made it onto a federal watch list due to significant nursing home violations.

East Galbraith Health Care Center

The East Galbraith Health Care Center is a 140-bed nursing home facility in Cleveland, and there was a time not so long ago when the facility was one of the most respected in the area. That all changed in 2012 after three consecutive inspections uncovered significant transgressions as well as an unwillingness to conform to the requirements put forth by the inspector after the first two violation-plagued inspections. The federal watchdog group was aware of the nursing home after the second inspection and put it on the watch list after the third.

What It Takes to Be on a List of Worst Nursing Homes

Making it onto the federal watch list is not easy to do, and it does not occur due to minor violations. The violations at East Galbraith Health Care Center, however, were significant, and the inspector found more deficiencies than the national average and twice as many than the state average. The severest infraction was the centers unwillingness to report a sexual assault by a male patient on a female patient to police.

The Federal Watch List

Most nursing homes that receive Medicaid or Medicare receive an inspection each 12-15 months, but once a home has made it to the list, they receive inspections every six months. In addition, if there is a current complaint for which progress is being tracked, an inspector might come on an even more frequent basis. The goal of the federal watch list is to assist states as well as provide countrywide consistency to a process that has not always been effective.

A Growing Concern

Although better efforts are being made to regulate nursing homes, nursing home violations are still on the rise. In fact, East Galbraith Health Care Center is not even the worst nursing home on the federal watch list. If you are concerned that a family member or friend is being mistreated in a nursing home, there is help available. Contact a nursing home abuse lawyer, and they can help you navigate the process, and if there have been violations, they can help you to sue for damages.

Medical Malpractice Cases Take Work & Time To Settle

By Jonathan Rosenfeld on Posted in Abuse In Chicago Nursing Homes & Other Communities Within Illinois

Medical-Malpractice-Cases-Take-Work-And-Time-To-SettleMedical malpractice lawsuits are some of the most complex types of civil suits and can take years to get to the settlement stage, if they ever get to that point. There is a lot of work involved and special litigation procedures that must be followed. If you are a victim of medical malpractice in Illinois, understand that your case will take time to pursue and get ready to hang in there for the long haul and often to trial.

Illinois Medical Malpractice Cases

Medical malpractice cases are not as cut and dry as headlines often make them seem. While large verdicts of millions of dollars often make the news, what you do not hear about is all the work that went into the case, the time it took and how many other similar cases were lost once they went to trial.

The Jury Verdict Reporter did an analysis on medical malpractice cases over a five-year period, 2002-2007, both in Cook County and throughout the rest of Illinois. The breakdown shows how many cases were won, what the median and average verdict awards were and the amount of the highest award each year. Some interesting numbers from that report:

  • Both Cook County and the rest of Illinois had a similar win rate. In Cook County, 32.4% of medical malpractice trials ended in plaintiff verdicts, while the rest of the state average 30.3% over the 5-year period.
  • In five years, only 41 cases ended in a trial award of $5 million or more in the state of Illinois.
  • The highest medical malpractice award was $32,036,787 in 2004-2005 in Cook County.
  • The average verdict ranged between $2 and $5 million in Cook County, with a median verdict ranging between $975,000 and $2.5 million.

The Settlement Fallacy

For some reason, many people believe that big medical companies rush to settle cases, handing out millions of dollars to stop from going to trial. This is far from reality. In the report on Chicago medical malpractice trials, very few cases had any offer of a settlement when the verdict was handed out. And of those that did, only a handful was above $500,000. In the 5-year period, only 27% of Cook County trials and 17% of the rest of the state’s trials had settlement offers on the table when the jury returned with a verdict. Out of over 700 medical malpractice trials, only 52 had a settlement offer of $500,000 or more.

Of course there are some medical malpractice cases that not make it to trial and do settle out of court. But to assume that these are the majority or that it is a quick process is just not the case. The Jury Verdict Reporter reports about 150 medical malpractice settlements each year in their publication. The important thing to remember is that more cases go to trial than settle and to understand that these types of cases will most likely take time and effort to come to fruition.

 

Hospital Blamed For Patient’s Death In Bed Rails

By Jonathan Rosenfeld on Posted in Bed Rail Injury

Death from bed rail entrapmentIt seems that for every episode involving of complex medical care that goes wrong during an admission to a nursing home or hospital, there are at least a handful of ‘adverse events’ that result simply from the fact that someone at the facility wasn’t doing his or her job properly.

Not all bad outcomes are the result of negligent care

In reviewing hundreds of medical malpractice cases, one of the most difficult parts of the evaluation process is explaining to families how an adverse outcome doesn’t necessary equate to a viable case in a legal sense.  As a party initiating a medical negligence lawsuit, the individual or family bringing the case has the burden of proving their case and must establish not that there was just a bad outcome—but most crucially, the poor outcome existed because of a ‘deviation in the standard of care’ on the part of the treating physician or staff— a much more difficult hurdle to cross than simply demonstrating that someone was injured.

Second guessing medical errors is not always a fair was of assessing blame

While it’s easy to look back at incidents—after the fact—and say how the outcome would have been different had it been for a staff member who may have been a little more attentive or if things would have simply been done in a slightly different way, these critiques may be unfair given the working environment.

My experience that the vast majority of people who work in the medical field are concerned, dedicated people who are genuinely concerned about the patients they care for.  However, when I read about episodes involving a needless injury of a patient while they were admitted to a hospital, I must second guess the judgment of some of these folks—and truly wonder what, if anything was going on?

Blatant errors still exist when it comes to caring for a patient

Case in point, a man recovering from heart surgery at a Pennsylvania hospital died after her became trapped between the mattress and the side rails on the bed. While the design of the bed itself, may not have been ideal, I place a good portion of the blame on the staff at the facility for failing to monitor the patient—or even look to see the fit of the mattress in the bed frame.

While there are new technologies available to help staff monitor patients well being and safety, nothing can ever take the place of old fashioned common sense and continuing care. It seems that the patient’s family feels similarly (and who can blame them?) as they have filed a wrongful death lawsuit against the hospital and the manufacturer of the bed.

While we will await to see how—or if– a jury apportions blame between the facility and the bed manufacturer, I hope that a jury hearing this matter recognizes this case for what it really is— a case of someone not properly doing their job—as opposed to a complex medical situation with an educated judgment gone wrong.

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