Jonathan Rosenfeld's Nursing Homes Abuse Blog : Jonathan Rosenfeld's Nursing Homes Abuse Blog | Lawyer & Attorney : Strellis & Field Law Firm | Bed Sores, Senior Neglect, Elder Abuse, Sexual Abuse: Chicago, Illinois

A news story regarding a 12-hour delay in obtaining medical treatment for an injured patient caught my attention-- not necessarily due to the horrible injuries the patient sustained-- but due to the staffs' sluggish response to the injured patient with two broken legs and a fractured shoulder.

The 76-year-old patient fell and sustained her injuries while workers at Ridgeland Nursing and Rehabilitation Center were changing her bed at approximately 5 a.m.  A call for emergency assistance was not placed until 4:42 p.m.-- 12 hours later.

In situations like this, it obviously represents a complete failure in the system intended to protect these elderly people from harm.  Federal law requires nursing homes to treat and relieve pain.

According to Federal Regulations, F-Tag 309 (Quality of Care) requires nursing homes to provide 'necessary care and services to attain or maintain the highest practical physical, mental and psychological well being, in accordance with the comprehensive assessment and plan of care.'

As a nursing home lawyer, its easy for me to point the finger at the facilities errors when it comes to following protocols and federal regulations. From a human point of view, it truly is tragic to see medical professionals ignore a person in pain.

Unfortunately, the 'wait and see' reaction to injuries is becoming more common in nursing home injury cases.  We can only guess what transpired at the nursing home during the 12-hours the staff waited to get medical attention. It certainly would be interesting to get a 'call log' from the facility.  Do you think the staff placed a call to their attorneys during the 12-hours this patient sat in pain related to her fractures?

Related Entries:

Study Reveals Nursing Home Patients Chronic Pain Is Not Adequately Controlled

Nursing Home Patient With Broken Hip Sits In Pain. Why Federal Law Requires Staff To Administer Pain Medication

Bone Fractures In The Elderly Require Special Attention To Improve Recovery & Prevent Complications

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In times of need, locating necessary information regarding the legal rights and resources for nursing home patients can be difficult and imposing.  In this respect, we are proud to introduce a new resource for patients, families and practitioners looking for a concise compilation of information regarding nursing home laws.  Nursing Home Injury Laws, provides every states':

• Nursing Home Laws
• Medical Malpractice Laws
• State Resources
• Applicable State Code

Additionally, we will be posting regular updates regarding important developments relevant to nursing home care within each state.  Here is a link to Nursing Home Injury Laws.

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Many elderly people suffer broken bones during admissions to nursing homes due to; falls, being dropped, or perhaps improper care from staff.  Regardless how the fracture occurred, a fractured bone in the elderly must be timely identified and treated.

What is a fracture?

A fracture is a broken bone that requires medical attention. Fifty percent of women over age fifty and twenty-five percent of men over age fifty will suffer from an age-related bone fracture sometime in their lifetime.

Elderly people are particularly susceptible to broken bones because as bones age, they lose the ability to resist the formation and growth of cracks that can lead to bone breaks because they cannot withstand as much pressure as younger bones.  Unfortunately, as we age, our bodies ability to heal fractures is compromised.

Nursing home staff can take steps to help maintain bone health in elderly nursing home residents:

• Regular exercise
• Adequate amounts of calcium
• Adequate amounts of vitamin D (essential for calcium absorption)

Osteoporatic Nursing Home Patients and fractures

Elderly nursing home residents who have osteoporosis (porous weak bones) or other conditions that lead to weakened bones or decreased bone density are at risk for bone fractures. Weak bones have low levels of calcium, phosphorous, and other minerals in the bones, which makes people more susceptible to fractures because the bones are more brittle. 

Women suffering from osteoporosis are twice as likely to suffer from bone fractures than men with osteoporosis.  Fractures from osteoporosis are most common in the spine and hips (bones that directly support your weight), and the wrists from bracing. Therefore, nursing home staff should take extra precautions to prevent falls and provide adequate nutrition to maintain the well-being of residents.

Diabetic Nursing Home Patients and fractures

Many nursing home residents also suffer from diabetes. A recent study suggests that there is an association between a drug introduced in the 1990s to help treat type 2 diabetes (thiazolidinediones) and bone fracture. The increased risk of fracture increased as the duration of the drug treatment increased and was observed in both men and women. Therefore, nursing home residents who have been treated with this drug also might have a further increased risk of bone fractures. 

Medical treatment for fractures in the elderly

Treatment for bone fractures depends on the location of the break. For most fractures occurring in the arms, legs, hands, and feet, the initial treatment is splinting the injured limb and immobilizing the joints above and below an injury to prevent movement at the fracture site. Then, the splint is removed and replaced by a cast. 

Some breaks might also require surgery in order to properly align bone fragments, increase stability, and ensure that bones will heal properly. Some fractures might also require metal hardware (pins, plates, or rods) to hold the bones in place. Older adults heal slower than younger people, which can cause additional complications and mobility issues for nursing home residents. 

How we can help

Depending on the circumstances regarding the fractured bones, the medical facility may be responsible for the damages relating to the fracture.  In many cases, we have successfully recovered damages for our clients', medical bills, medical equipment, pain and disability.  If you believe that a nursing home is responsible for your broken bone, we would be honored to speak with you to discuss your legal rights. (888) 424-5757

Resources:

Mayo Clinic: Fractures

Lawrence Berkeley National Laboratory: Why Older People Suffer More Bone Fractures

Science Daily: Risk of Bone Fractures Associated with Use of Diabetes Drug

Related Nursing Homes Abuse Blog Entries:

Nursing Home Staff Must Take Precautions While Moving & Transferring Disabled Patients To Minimize Risk Of Dropping

Fall In Stairwell Results In Paralysis-- And Ultimately Death Of Chicago Nursing Home Resident

Nursing Home Sued After Resident Fractures Both Hips In Separate Falls

Nursing Home Cited For Mistreatment Of Resident Following Investigation Of Resident's Fractured Neck

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The most dangerous part of the day for many nursing home patients may be getting out of bed in the morning.  When staff fail to supervise or provide proper assistance to nursing home patients during transfers, patients are at risk for falls or being dropped by staff.

Disabled nursing home patients and those with physical limitations must be carefully monitored to avoid injuries while being transferred from one device to another.  Some of the commonly encountered situations where patients are injured include:

• Bathing: facilities failing to provide assistance or provide specialized bathing equipment including chairs, stands and grips
• Transfer into and out of bed
• Failing to take extra-precautions with patients who may have uncontrolled muscle movement: many times these patients require special restraints during transfers
• Failing to take patient medications into the equation: some commonly prescribed medications can make patients dizzy or cause blood pressure spike or drops when patients are moved
• Failing to engage locks on wheelchairs
• Allowing patients to wear socks or improper footwear during transfers
• Failing to monitor patients with walkers

Although facilities like to claim that these incidents are isolated events, a dropped patient is usually indicative of poor staff training and chronic under-staffing.  Most of these transfer-related incidents occur due to:

• Poorly trained staff: Some facilities do not properly train staff in how to use equipment
• Under-staffing: Facilities sometimes to not have enough man power to safely perform transfers as they were intended
• Wrong equipment: facilities must have the proper equipment for the job
• Faulty equipment: facilities must keep equipment in proper repair.  This includes getting replacement parts from the manufacturer
• Failing to provide timely assistance to patients who request it

Cases involving injury or death during transfer are particularly important to investigate as quickly as feasible after the incident in order to preserve the condition of equipment and to obtain statements from witnesses others who may have knowledge of the event.  

If your loved one suffered an injury or died as a result of a fall or being 'dropped' by staff, we would honor the opportunity to speak with you.  Our nursing home litigation team is always available for consultation. (888) 424-5757

Related Nursing Homes Abuse Blog Entries:

Nursing Home Waits 19 Hours To Provide Medical Treatment To Resident Who Fractured Her Hip During Sabina Lift Transfer

Nursing Home Cited For Mistreatment Of Resident Following Investigation Of Resident's Fractured Neck

Faulty Handicapped Lift Blamed For Nursing Home Death

Improper Transfer Leads To Fall & Ultimately Death Of Rehab Patient

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I guess when it comes to elder care, many problems encountered by residents in U.S. nursing homes sadly seem to make their way across the border to our friends in Canada. The recent news report of an elderly Canadian nursing home resident who fell and fractured her hip-- yet sat for days without medical attention or adequate pain medication is an unfortunate story unnecessarily repeated on a daily basis at nursing homes across the world.

In the U.S., upon learning of a fall or other injury, the nursing home staff must conduct an assessment to ensure no injury was sustained.  In cases where there is an apparent injury, the staff physician should alerted immediately as to the incident.

Once a physical assessment has been completed, federal law requires nursing homes to provide pain medication to the resident as soon as feasible.  As recipients of Medicare funding (the overwhelming majority of nursing homes) must comply with F-Tag 309 pertaining to Quality of Care:

Each resident must receive and the facility shall provide the necessary care and services to attain or maintain the highest practiceable physical, mental and psychological well-being, in accordance with the comprehensive assessment and plan of care.

Although the above language can be generally interpreted to included pain management for nursing home patients, CMS has proposed interpretative guidelines that undeniably require nursing homes to provide sufficient pain management:

Recognition and Management of Pain

In order to help a resident attain or maintain his highest practiceable level of well-being and to prevent or manage pain, to the extent possible, the facility:

• Recognizes when the resident is experiencing pain and identified circumstances when pain can be anticipated;
• Evaluates the existing pain and cause, to the extent possible; and
• Manages or prevent pain to the extent possible, consistent with eh resident's goals, the comprehensive assessment and plan of care and current clinical standards of practice.

Unfortunately, many nursing home residents needlessly suffer from acute (falls) and chronic medical conditions (pressure sores) due to facilities failure to properly follow CMS regulations.  On the surface, this omission may simply be a violation-- but when a resident sits without medical attention with a broken hip or open wound these violations represent a complete lack of compassion and destruction of the quality of life.

Related Nursing Homes Abuse Articles

How Many Falls Is Enough To Impose Responsibility On Nursing Home?

Study Links Medication Use With Falls

Nursing Homes Curtail Use Of Physical Restraints With Residents

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A nursing home negligence lawsuit has been filed against Stearns Nursing and Rehabilitation Center after a 95-year-old resident fell on multiple occasions and suffered hip fractures. The lawsuit alleges that the facility failed to implement fall precautions despite the fact the facility knew the resident suffered from Alzheimer's, was generally confused and considered to be a 'high fall risk'.

The lawsuit claims, Stearns suffered multiple falls resulting in injuries during her admission from May 25th through July 7, 2007. In particular, the lawsuit alleges the following specific incidents:

• On May 27, the resident wandered the hallways, unattended, and fell fracturing her left hip.
• On June 6, while left unattended in a wheelchair and with a shut-off personal alarm, she fell out of the wheelchair.
• On June 15, the resident pulled herself out of her wheelchair and roamed the hallways un-assisted and fell, fracturing her right hip

The lawsuit is pending in Madison County Circuit Court.  Read more about this lawsuit against Stearns Nursing and Rehabilitation Center here.

Nursing Home Falls

More than 1,800 people die each year in nursing home falls.  All health care professionals in the nursing home setting must work together to help encourage nursing home safety.  Nursing homes are required to conduct a fall-risk assessment for every resident to determine who may be at risk for falls.  This puts the staff on notice as to who may need special attention and sets forth what accommodations should be in place for each resident.

Additionally, staff should always be on the lookout for residents who may require assistance getting about.  If residents have a history of falls, the facility should consider using alarms on chairs or beds to notify the staff when the person attempts to walk on their own.

Falls in nursing homes occur for a variety of reasons.  Some of the more common causes for falls  are:

• Muscle weakness and walking or gait problems
• Hazards in the nursing home- wet floors, poor lighting, improper be heights, improperly maintained wheelchairs, equipment left out of place
• Medications-  Drugs that effect the central nervous system, such as sedatives and anti-anxiety drugs (psychoactive drugs)
• Improperly fitting shoes or incorrect walking aids
• Frequent use of restraints
• Inadequate staffing levels that fail to provide sufficient assistance to residents

If your loved one sustained a fall during a nursing home admission, our nursing home litigation team will provide a free case analysis to determine if a lawsuit against the facility is warranted.  Why not put our experience advocating on behalf of the elderly to work for you today?

Related Nursing Homes Abuse Blog Entries

How Many Falls Is Enough To Impose Responsibility On Nursing Home?

Nursing Home Cited For Mistreatment Of Resident Following Investigation Of Resident's Fractured Neck

Falls Amongst The Elderly Can't Be Ignored

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