Nursing Homes Abuse Blog - By Jonathan Rosenfeld

No one seems to give much thought to transporting a nursing home patient in a wheelchair throughout the facility or outside on the facilities grounds.  Just push the patient in the chair to where they need to go?  Right?

Well, like most tasks, there really is quite a bit more to it than is originally apparent.  In order for patients to be safely transported in wheelchairs staff need to take precautions to make sure that the patient arrives where they need to be in a safe manner.

Though not a well-publicized topic, injuries resulting from faulty wheelchairs and staff negligence in pushing the wheelchairs, are responsible for a steady stream of needless injuries to especially vulnerable people.  Just recently, I read about a patient at a Minnesota nursing home who broke three toes when a staff member sloppily pushed the wheelchair and knocked her foot into a wall.

While the incident itself may seem like not much of a deal, the fact that that patient was forced to live with a broken bone due to the inattention of a staff member pushing their wheelchair is inexcusable. At facilities where patients are regularly transported via wheelchairs, the facility needs to train staff on the basics of wheelchair use including:

• Securing immobile or spastic patients
• Transferring patients into and out of the wheelchair
• Use of wheel locks
• Wheelchair lifts between floors and on vans
• Loading patients into elevators
• Use of braces and other propping devices for patients who may already have an injury 
• Parking patients in level areas and away from ramps and stairways

As an injury lawyer, who has represented people who have suffered a variety of wheelchair related injuries, I frequently find little attention paid by facilities or staff to this essential--- albeit somewhat mundane task.  As more disabled patients begin to demand to live full and active lives--- not just in the confines of their room--- facilities need to make sure that their facilities and staff are equipped to safely care for patients in wheelchairs.

Related Nursing Homes Abuse Blog Entries:

Investigation Into Nursing Home Resident's Death In Van Accident Begins

Another Example Of Nursing Home Negligence: Disabled Patient Falls Down Unsecured Stairway

Nursing Home Aide Fired After She Forgets To Secure Paralyzed Patient In Wheelchair

Medical Facilities Must Use Wheel-Locks & Supervision To Protect Patients In Wheelchairs

One week after arriving at DFW Nursing & Rehab 23-year-old Even Fleming was dead. 

The young man was admitted to the Texas nursing home for rehabilitation following a car accident that left him with a traumatic brain injury (tbi) and multiple facial fractures.  On September 14th, a CNA called a nurse at the facility after she noticed that Evan was not breathing.

Rather than initiate CPR, the nurse scrambled to locate Evan's medical chart to determine what his families were with respect to resuscitation. 

In fact, seven minutes went by between the time the condition was recognized and chest compressions were initiated-- missing a crucial 5-minute window to initiate CPR.

By the time paramedics got Evan to a nearby hospital, he was dead.

This incident was investigated by The Texas Department Of Aging and Disability Services when it was discovered the facility was in disarray and had many problems that threatened the safety of patients.  Amongst the findings:

• 7 nurses lacked current CPR certifications
• Medical charts of 43 of the facilities patients contained no information regarding resuscitation wishes of the patient
• In other cases where resuscitation wishes were noted on the patient rooms, most of the time they were incorrect
• The facilities 'crash cart' contained inadequate medical equipment such as a missing blood pressure cuff, stethoscope and a working flashlight

Nursing homes need to be aware of their residents wishes-- to be resuscitated-- or not.  Certainly, when CPR is requested, it should be initiated as quickly as feasible by staff that are properly trained in the procedure. 

While I have no idea of this young-man's prognosis at the time he was admitted to this facility, it is tragic that the caregivers who were responsible for caring for him lacked the basic training to at least position him for the best outcome possible.

Related:

'Neglect' cited in death of Fort Worth patient November 15, 2010 Star-Telegram by Darren Barbee

A short delay from out of hospital cardiac arrest to call for ambulance increases survival (PDF) Johan Herlitza*, Johan Engdahla, Leif Svenssonb, Marie Youngc, Karl-Axel A¨ ngquistd, Stig Holmberga, European Heart Journal

Nursing Home Injury Laws: Texas

A shameful story regarding a Pennsylvania assisted living facility / group home recently made headlines after staff left an autistic man in a hot van for five hours following a field trip sponsored by the facility. 

Apparently the man was chaperoned to a local amusement park with staff from the Woods Services.  When the group returned to the facility, one of the staff members escorted some of the other residents back to the living quarters while the other staff member parked the van.  The staff member who parked the van forgot that the autistic man remained in the back seat.

By the time the staff located the autistic man in the van he was dead.  According to the medical examiner, the man died from hyperthermia. The staff involved in the event have been suspended pending the results of the investigation in the incident currently underway by multiple investigative agencies.

Hyperthermia Deaths

Sadly, hyperthermia deaths related to people left in vehicles is more common than you think. Even relatively mild temperatures and bright sunlight can allow temperatures in vehicle to reach dangerous levels with short periods of time.

Hyperthermia can occur when the body is exposed to high temperatures and produces more heat than it can dissipate. The increased heat raises the body temperature disrupting normal body functioning. If not treated quickly after the initial onset, hyperthermia can result in disability and death.

Related:

Hyperthermia Deaths of Children in Vehicles

Autistic man dies at Langhorne center after five hours in parked van, philly.com July 28, 2010

Second suspension in Woods Services death, phillyburbs.com July 28, 2010