Bed Alarms In Nursing Homes: Is Staff Indifference Resulting In Episodes Of Delayed Response To Emergency Situations?

Various alarms devises are frequently used by nursing homes and hospitals to help keep staff updated as to changes in a resident’s condition or notified in circumstances where a patient may be at risk for harming themselves.

For example, in the case of patients who may be at risk for falling, an alarm on a patient’s bed or chair may alert staff that the patient has moved and staff should address the situation before a patient sustains a fall.

Similarly, in the case of patients on a ventilator, an alarm may be used to notify staff when there is a problem with the machine or when a patient’s oxygen level has dropped.

Theoretically, the use of alarms to notify staff in a change in a patient’s condition allows the staff to react and implement necessary care before the issue becomes a problem or results in an injury to a patient.

A recent article the Boston Globe by Liz Kowalczyk, “FDA working to trim hospital ‘alarm fatigue’” highlights a situation behind many medical malpractice and nursing home negligence cases when staff fail to timely respond to various alarms commonly used at facilities.

The Globe article discusses how medical staff at some facilities have become desensitized to the audio and visual cues provided by alarms to the point where patients suffer and injury or death due to a response delay--- or complete response failure by facility staff. 

In response to a widely recognized problem in the healthcare industry, the FDA is looking in alarm devises that provide more detailed information or even alarms that multitask and can take the place of several alarms used at facilities--- all with the intention of providing staff with devices to more accurately respond to patient needs.

As a lawyer who has worked on cases involving circumstances where patients have suffered a serious fall-related injuries due to a delay in responding to a bed alarm and other cases where patients have literally suffocated to death due to malfunctions with ventilators that were never responded to, I truly hope the FDA’s inquest helps bring better medical devices to the market.

Unfortunately, my experience leads me to believe that facilities need to continue to give staff the essential tools necessary to performing their jobs by both teaching staff the significance of treating each alarm as an important situation and by providing sufficient staffing levels at facilities to assure that there is enough staff available to properly respond to such calls. As in the case of most medical care, technology is only as effective as the people whom are using it.

Related Nursing Homes Abuse Blog Entries:

Nursing Home's Failure To Implement Fall Precautions Results In Death Of Patient

Nursing Homes Failure To Implement Use Of Bed-Alarm Blamed For Death Of Elderly Patient

Nursing Home Sued After Resident Fractures Both Hips In Separate Falls

Nursing Home's Conduct In Wrongful Death Case Angers Jury---- To The Tune Of $200 Million

Communication Is Crucial To Prevent Short-Term Nursing Home Admissions From Turning Into Long Term Nightmares

For many people, a short term admission to a nursing home to recover from an illness or provide a break to a caregiver sounds like a reasonable proposition.  While many of these people are not inclined to use the services of a nursing home for their long-term care needs, there appears to be more of a willingness to use nursing homes for a fixed period. 

After all, how much could possibly go wrong during a short term admission of just a few days or weeks?

Despite the short time horizon, without the nursing home's understanding of patient needs and an understanding from the family concerning the type of care that nursing homes are capable of providing, short term admissions—of any duration-- can lead to patient injury and even death.

I was reminded of just how dangerous short-term nursing home admissions can be after I  began to review the records in a case involving a woman who suffered a disabling hip fracture in a fall at a facility.  What makes this case a bit unusual is that the woman wasn’t even officially a patient at the facility! 

The woman fell in a supervised ‘waiting room’ at the nursing home as her family was in the process of completing admission paperwork in a nearby office.  As it turns out, the nursing home was recommended by physical therapists who were working with the woman during rehab exercises following a hip replacement at a nearby hospital.

Barely ten minutes in the waiting area—with a staff member nearby--- the woman fell out of a chair (that she theoretically should never have been placed in) and fell onto her ‘good hip’ (the hip that she did not have surgery on)—suffering a fracture.

The nature of the fall resulted in a dangerous hip fracture that required surgery and implantation of hardware.

In evaluating the liability of this case, it appears as though both the hospital and the nursing home may be partially to blame for this nightmare as poor communication resulted in the absence of discharge orders from her treating physician--- which would have indicated that she was a fall risk and she should be should not have been placed into a chair and full fall precautions were to be put into place.

While the above circumstance may be alarmingly extreme, I find that many facilities fail to address some of the most basic care related needs for patients when they know that they are only at the facility for a short period.  From a medical and legal perspective, this hands off approach to evaluating short term patients’ care related needs is simply unacceptable. 

Regardless of the duration of the nursing home admission--- be it for a few days or for an extended period—nursing homes have a duty to care for the patients that they admit to their facilities.

From the perspective of a family or patient, it is important to treat short-term nursing home admissions as you would any admission to a medical facility and incorporate the following measures:

  • Clearly articulate any special needs or requests to staff members
  • Provide staff with information and contact numbers for treating physicians
  • Make all medications and dosages known
  • Convey special medical needs to staff
  • Bring relevant medical records
  • If coming directly from a hospital, bring discharge orders
  • Provide emergency contact information

Related Nursing Homes Abuse Blog Entries:

Nursing Homes Faces Wrongful Death Lawsuit After Patient Falls & Fractures Hip

Short-Term Nursing Home Admission Proves Too Much For Elder Advocate

Respite Care: A Welcome Break For Caregivers Or Exposing A Loved One To Unnecessary Harm?

Hours After Admission To Illinois Nursing Home For 'Respite Care', Resident Fractures Hip

Study Concludes Nursing Home Patients With Dementia Are Far More Likely To Suffer An Injurious Fall When Taking Common Antidepressants

elderly lady with caneIt's no secret that falls in the elderly nursing home population remain one of the largest threats to patients safety and overall well-being.  Recognizing this threat, nursing homes must assess each patient for their potential fall-risk and create a plan of care to reduce the incidence of falls during their stay at the facility. 

While fall precautions may including common sense precautions such as: staff assistance, walkers or modification of bed heights--- new research suggests that nursing homes need to begin evaluate patient's use of common antidepressants known as selective serotonin reuptake inhibitors (SSRI's) which dramatically increase a patient's risk of falling.

A recently published study in the British Journal of Pharmacology conducted by clinicians in the Netherlands followed a group of 248 nursing home patients diagnosed with dementia over a two-year period. 

While nearly all of the patients experienced some type of fall during the course of the study, the study concluded that patients taking SSRI's had a notably higher incidence of falls compared with their peers who were not taking the drug.  Even more alarming, was that fact that researchers determined that patients taking SSRi's (common drugs include: Paxil, Zoloft and Prozac) were three time more likely to suffer a fall-related injury such as a hip fracture, leg fracture, bruise or wound.

Though not the primary focus of the study, an incidental finding was that patients taking SSRI's combined with sedatives and hypnotic drugs-- commonly given to patients to aid with sleep--- resulted in an ever further elevated rate of fall-related injuries.

While the this similar studies will no doubt need to be completed on a broader scale, mounting evidence suggests that all medications prescribed to nursing home patients should be evaluated to determine their necessity.  Further, given the suggestive data from this recent SSRI study, nursing homes need to heighten their focus on patients' medications when tailoring a fall-prevention protocol.

Related:

Study Links Medication Use With Falls

Half Of Nursing Home Residents Wrongly Drugged

Antidepressants may raise fall risk in nursing homes USA Today

Falls in older people: epidemiology, risk factors and strategies for prevention (PDF) LAURENCE Z. RUBENSTEIN Age and Ageing 2006; 35-S2: ii37–ii41 doi:10.1093/ageing/afl084

Nursing Homes Faces Wrongful Death Lawsuit After Patient Falls & Fractures Hip

senior falling.jpgFalls in nursing homes are one of the biggest safety threats encountered by patients. Statistics tell use that more than one-third of all adults over age 65 fall unintentionally every year.  

A sizable percentage of these falls result in severe injury or death predominately due to complications from head injury or hip fractures.

Recognizing the severity of the problem, federal regulations require nursing homes to conduct a fall-risk assessment of all newly admitted patients both at the time of their admission and conduct similar follow up on a quarterly basis or when the patients health care needs dictate.

Care plans for patients who may be at risk for falling may include precautions such as:

  • Bed alarms / chair alarms to alert staff when a patient is in the process of moving about
  • Use of staff to assist patients get around
  • Assistive devices such as wheelchairs, walkers or canes
  • Monitoring patients blood pressure to avoid any sharp swings that may put the patient at risk
  • Keeping the facility de-cluttered and free environmental fall risks

When facilities fail to adhere to the care plan prescribed and patients suffer fall-related injuries they expose themselves to potential liability claims.  Just recently, the family of a deceased nursing home paitnet in West Virginia filed a wrongful death lawsuit against the facility for failing to attend to the needs of a woman who was at risk for falling.  The lawsuit alleges that the negligence of both Teays Valley Center and parent company Genesis Healthcare Corporation was responsible for the woman's repeated falls, hip fracture and eventual death.

While the nexus between a fall-related hip fracture and death may appear to be little more than a coincidence, given the invasive nature of hip replacement surgeries frequently required to treat the hip fracture--- they usually is indeed a correlation.  As a nursing home lawyer, I frequently seek out the testimony of a treating physician to establish this relationship.  Further, many jurisdictions recognize separate claims for the injuries an individual sustains as a result of a fall and those which the deceased persons estate may pursue for wrongful death.

Given the complexities involved in nursing home fall cases, it is important to carefully examine cases with an eye on both the liability aspects as well as establishing a causal relationship for ensuing damages.

Here are some interesting--- or perhaps more accurately, disturbing-- statistics related to falls involving seniors from the CDC:

  • One out of three adults age 65 and older falls each year1,2 but less than half talk to their healthcare providers about it.
  • Among older adults (those 65 or older), falls are the leading cause of injury death.
  • They are also the most common cause of nonfatal injuries and hospital admissions for trauma.
  • In 2008, over 19,700 older adults died from unintentional fall injuries.
  • In 2009, 2.2 million nonfatal fall injuries among older adults were treated in emergency departments and more than 581,000 of these patients were hospitalized.
  • In 2000, direct medical costs of falls totaled a little over $19 billion—$179 million for fatal falls and $19 billion for nonfatal fall injuries.5 This equals $28.2 billion in 2010 dollars.

Related:

Man blames nursing home for mother's death, The West Virginia Record, October 13, 2011

State Doesn't Buy Claim That Patient's Leg Spontaneously Broke

Some Medical Conditions Virtually Guarantee Elderly Of Falls In Nursing Homes

Determining The Type Of Fracture A Person Has Sustained Can Reveal If Nursing Home Abuse Is Responsible

Quality of life related to fear of falling and hip fracture in older women: a time trade off study BMJ 320 : 341 doi: 10.1136/bmj.320.7231.341 (Published 5 February 2000)

Defective DePuy Hip Replacements To Be Preserved As Evidence In Pending Lawsuits

As the number of DePuy Hip replacement lawsuits continues to expand, a recurring issue in many of the pending cases, centers around who shall control the defective hips and surrounding tissues when they are removed during replacement surgeries.  The removed material and orthopedic hardware is considered valuable evidence in pending product liability cases against DePuy.

According to a report on the DePuy litigation appearing on Bloomberg, DePuy spokesperson Mindy Tinsley, conclusively stated that the removed hip devices-- known as explants-- are indeed the property of the patient and patient's surgeon's, "should take appropriate steps to preserve them."

With that understanding in place, lawyers representing individuals who were given defective DePuy products and lawyers representing Johnson& Johnson, the parent company of DePuy Orthopedics, are arranging for a standardized protocol to arrange for the shipment of the removed devices to be shipped to a centralized location so testing can be conducted.

For thousands of people impacted by the defective DePuy products, this is an important development as the independent testing may provide valuable evidence in pending product liability claims and lawsuits against Johnson & Johnson and DePuy Orthopedics.

Status of DePuy Litigation

More than 37,000 people are believed to have received potentially defective DePuy hip replacement devices known as ASR XL Acetabular System.  In August, 2010 DePuy acknowledged the serious problems associated with their products and initiated a recall of the product. 

At issue is the high failure rate of the device that commonly necessitates a second revisionist surgery far sooner than most anticipated.  In addition to replacement surgeries, other patients experienced serious problems such as: fractures, infection, and pain due to shards of cobalt and chromium that break away from the hip and implant into the surrounding tissues.

Presently, DePuy has hired Broadspire Service Inc., as a third-party claim administrator to oversee voluntary payments made by Johnson & Johnson to implant recipients.  Despite, the community outreach by Johnson & Johnson, many individuals have elected to retain lawyers to represent their personal interests.

Currently, Rosenfeld Injury Lawyers is reviewing a number of DePuy hip implant cases and is working with medical experts other lawyers involved in the litigation to help secure the best possible outcome for each client.  If you received a DePuy hip implant, you may have legal rights for compensation.  We encourage you to discuss your case with our DePuy hip recall lawyers, for a free, no obligation consultation today. (888) 424-5757

Related:

Defects With DePuy Hip Replacement Hardware May Give Rise To Lawsuits Against Manufacturer

Questions Persist With Problems Related To DePuy Hip Replacement Products

New Lawsuits Filed Against DePuy Orthopedics Related To Defective Hip Replacement Products

New Lawsuits Filed Against DePuy Orthopedics Related To Defective Hip Replacement Products

ABC 7 News reported on recent lawsuits filed by five Chicago-area patients who received defective DePuy hip replacement products.  The Chicagoland lawsuits are similar to other lawsuits filed against the medical device manufacturer by patients across the country.

At the heart of the issue is DePuy's negligent design of hip replacement products that release bits of metal into the patients bodies causing severe pain and potential blood poisoning. Though DePuy moved to recall the hip replacement products in 2010, there is mounting evidence that they were aware of problems with the devices significantly earlier.

The pain and medical complications associated with the DePuy products has resulted in some patients requiring additional hip replacement procedures as well as ongoing medical monitoring of the devices.

Rosenfeld Injury Lawyers are actively involved in the investigation and prosecution of defective hip replacement products manufactured by DePuy Orthopedics.  If you have a DePuy hip replacement product, we invite you to speak to our lawyers regarding your legal rights or use our contact form and we will contact you to schedule a consultation. (888) 424-5757

Related Nursing Homes Abuse Blog Entries Related To DePuy:

Defects With DePuy Hip Replacement Hardware May Give Rise To Lawsuits Against Manufacturer

Questions Persist With Problems Related To DePuy Hip Replacement Products

As If Living With The Pain From A Defective DePuy Hip Replacement Device Was Not Enough, Now Some Patients Are Having A Difficult Time Getting The Company To Pay For Corrective Medical Treatment

As If Living With The Pain From A Defective DePuy Hip Replacement Device Was Not Enough, Now Some Patients Are Having A Difficult Time Getting The Company To Pay For Corrective Medical Treatment

Despite assurances from DePuy that they would take care of necessary expenses related to the medical costs incurred due to the replacement of various hip replacement models.   A recent NBC 5 Chicago, news story seems to indicate the company is not doing everything it claims it will do on its website.  

The result?  More pain for patients with DePuy products who can not afford to have the painful hardware surgically removed.

The offers to pay for necessary medical treatment related to the defective hip replacement products is made on the DePuy website after a widely accepted study of particular DePuy products estimated a high failure rate.

Lawsuits and claims for damages against DePuy

If you or a loved one was the recipient of a DePuy replacement product over the past several years, you likely have received correspondence from the company and/or your physician notifying you of the product recall.  

Despite invitations from DePuy to obtain related medical bills and records for you-- there is no obligation to do so.  Completing medical authorizations provided by DePuy is completely voluntary and is not necessary to pursue a claim against them. 

Given the limited medical studies that have examined the long-term effects of DePuy hip replacement products, we invite all recipients-- regardless of if you have are currently having difficulty with the product or not-- of DePuy products since 2003 to contact our medical device attorneys for a free case examination where we can advise you of your potential legal rights. (888) 424-5757

Related:

Defects With DePuy Hip Replacement Hardware May Give Rise To Lawsuits Against Manufacturer

Questions Persist With Problems Related To DePuy Hip Replacement Products

Questions Persist With Problems Related To DePuy Hip Replacement Products

hip.jpgWe received numerous inquiries from perspective clients who were frankly concerned and angry when they became aware that the hip replacement product that they had put their trust in might now be defective.

As we discussed recently, DePuy Orthopedics issued a voluntary recall of its DePuy ASR XL Acetabular Hip System and DePuy ASR Hip Resurfacing System in August, 2010.

The recall of DePuy hip replacement devices comes after hundreds of reports of problems from patients who received DePuy hip replacement devices over the past several years.

In addition to a large number of consumer complaints, a medical study completed by The National Joint Registry of England and Whale (2010) demonstrated a failure rate of DePuy products of more than 12%.

Due to the fact that many of the affected products have only been in use since 2005, the number of complications related to DePuy hip replacement products may actually be even higher than originally believed.

Many of the people who originally received defective DePuy products originally complained of pain in the hip where the hardware is located. An examination of the DePuy product itself indicates that the problems may orginate from the design of the product and the metal-on-metal contact that the device employs.

In addition to pain, people with DePuy hip replacement products have also reported the following:

  • Swelling
  • Hip dislocation
  • Detachment of the product from the bone
  • Dislocation of the hip replacement hardware
  • Fracture of the bone(s) surrounding the implant
  • Splintering of the metals used in the devices

By now, most patients who have received a related DePuy hip replacement product will likely have received notice from their physician or medical center where the procedure was performed. If you have relocated or are unsure if you received a DePuy product, you should contact your physician to inquire further.

In addition to removing the product from the market, DePuy has also established a system to field questions and concerns from people who have received an impacted hip replacement product who offers to provide payment for additional medical treatment.

Nonetheless, if you received a DePuy hip product since 2005, you may have legal rights related to both your past and future medical care and disability. Currently, this medical device litigation is in the primary stages and the real long-term impact of DePuy hip replacement problems may still be unknown.

Consequently, it is our belief that all recipients of DePuy-afflicted products may have a claim for future medical monitoring that should be paid for by the company.

We are committed to the investigation, litigation and compensation of all potential DePuy-related cases. Please fill out the contact form and our medical device lawyers will contact you to discuss your legal options with you.

Defects With DePuy Hip Replacement Hardware May Give Rise To Lawsuits Against Manufacturer

DePuyEvery year, almost 200,000 hip replacement surgeries are performed in the United States for a variety of reasons including trauma and arthritic conditions.  

For many of the hip-replacement patients, a hip replacement surgery is particularly difficult due to the invasive nature of the procedure and the lengthy recovery time. 

As a lawyer who frequently works with the elderly, I have witnessed how a hip replacement procedure can really negatively impact the quality of life.  Sadly, hip replacement surgeries in many elderly people results in a rapid downward spiral in their physical and psychological well-being.  Some studies suggest that more than 25% of patients over 65-years-old will die within a year of the procedure.

What if the hip replacement only resulted in additional pain? 

Or what if the procedure needed to be repeated?

Unfortunately, many hip replacement patients who received artificial hips and various parts manufactured by DePuy, a division of Johnson and Johnson, their original hip replacement may have resulted in both additional pain and the need for a revisionist surgery.

On August 26, 2010, DePuy issued a product recall for their: DePuy ASR XL Acetabular System and the DePuy ASR Hip Resurfacing System.  The product recall came after numerous medical studies confirmed that the DePuy products failed to perform as they were intended-- and marketed to the public.

For some patients who received these defective products, a second or third revisionist hip replacement surgery was necessary due to various defects medical experts relate to metal-on-metal contact that is used in DePuy products.  The design of the DePuy devices has resulted in high product failure rates and splintering of the metal into the patients body.

Given the severe problems associated with DePuy hip replacement products, people who have received DePuy have legal rights related to their pain, disability and medical expenses.  Currently, no class action has been formed and injured individuals can pursue their claim directly against DePuy.  If you have questions as to weather you are a recipient of a DePuy device, you can obtain that information from your surgeon or medical center.

If you have suffered an injury due to a defective hip replacement product or have questions regarding your legal rights.  Please fill out our contact form or call and speak to a medical device lawyer today.  (888) 424-5757.

Related:

Johnson & Johnson Unit Recalls 2 Hip Replacement Systems, Medscape Today by Robert Lowes

Johnson & Johnson Recalls Hip Implants, New York Times, Natash Singer, August 26, 2010

Nursing Homes Abuse Blog: Questions Persist With Problems Related To DePuy Hip Replacement Products

Nursing Home Patients With Osteopenia May Suffer More Severe Injuries During Falls

Bone health is a serious concern for older adults. As you age, your bones get weaker as they lose their internal support structures. Older, weaker bones are more susceptible to serious bone breaks (fractures) because they have lower levels of important minerals including calcium and phosphorous. 

Osteopenia is a lower than normal peak bone mineral density (BMD). While not as severe as osteoporosis, it does increase your risk for osteoporosis. Bone mineral density is an indicator for how strong and healthy your bones are. BMD peaks in your late 20s to early 30s, after which it starts to decline. If your BMD is between 1.0 and 2.49 standard deviations below the average peak BMD, you suffer from ostenpenia. 

Women have a lower peak BMD than men and menopause causes hormone changes that speed up the loss of bone mass, which increases their risk of developing osteoporosis and osteopenia. In the United States, about 30% of Caucasian postmenopausal women in the United States have osteoporosis, and 54% have osteopenia.

For older adults, proper bone health is not just a matter of maintaining overall health; proper bone health can also affect mobility and independence. It is never too late to take steps to improve or maintain good bone health in order to prevent dangerous fractures. These lifestyle changes include:

  • Receiving proper levels of calcium in your diet (maybe including a calcium supplement combined with vitamin D)
  • Not using tobacco products (they can weaken bones)
  • Not consuming excessive amounts of alcohol
  • Exercising and remaining active (bone forms in response to stress, so weight-bearing exercises are good choices)
  • Taking caution to avoid dangerous bone breaks
  • Getting early treatment for eating disorders (low body weight can increase the risk of hip fracture)

Osteopenia does not have any symptoms, but doctors can diagnose low BMD with a bone density scan. This can help you and your doctor decide if bone strengthening drugs are an appropriate treatment option. Many women who have menopause also have osteopenia. 

Some doctors recommend osteoporosis medicine including Fosamax, Boniva, or hormone therapy right away to prevent further bone loss. However, as with any medication, these drugs have side effects and associated risks. Other doctors recommend that you exercise and take calcium. And, some researchers caution that many younger postmenopausal women are taking drugs that they don’t need because osteopenia is just a risk marker for osteoporosis. 

The World Health Organization developed a tool that helps predict a person’s overall risk of major fracture over the next 10 years by factoring in a variety of risk factors including: age, bone mineral density test results, family history of osteoporosis, use of oral steroids, whether or not you have rheumatoid arthritis, and whether or not you smoke. And, the National Osteoporosis Foundation revised its treatment guidelines as follows: drugs should be considered for postmenopausal women and men age 50 and older who have a 10-year probability of a major osteoporosis-related fracture ≥ 20% or a 10-year probability of hip fracture of ≥ 3%. 

If you or a family member is a nursing home resident it is important to ensure that you are receiving adequate calcium in your diet and proper activity and exercise to promote bone formation. Also, if you have risk factors for osteoporosis, you should have a bone mineral density test performed in order to determine your chances of developing osteoporosis and suffering dangerous bone breaks. Your bones are an important factor in maintaining independence and mobility, and nursing homes should ensure that you maintain proper bone health. If you are worried that a family member not receiving proper nutrition or BMD testing, it is important to talk with the nursing home staff as soon as possible to address the problem. 


Sources:

WebMD: Osteoporosis Health Center - Osteopenia

University of Washington: Department of Radiology – Osteopenia

U.S. News: Health – Grappling with a diagnosis of Osteopenia

Better Bones: Rethinking Osteoporosis

Pub Med: Vitamin K deficiency and osteopenia in elderly women with Alzheimer’s disease

JAMA: Osteopenia and Preventing Fractures

Study Links Commonly Prescribed Osteoporosis Drugs To An Increase In Hip Fractures

A recently presented study at the annual conference of American Academy of Orthopedic Surgeons conclusively demonstrates that post-menopausal women who take a drugs to slow bone loss --- osteoporosis-- may be at a heightened risk for hip fractures.  Bisphosphonates, as the group of drugs is commonly known, include brand name medications such as: Actonel, Boniva, Fosomax and Reclast.

While the drugs are commonly prescribed to maintain bone strength in older women, the study demonstrated that when the drugs are taken for more than 5 years, the incidence of hip fractures begins to increase in the group of women who take the drugs compared with women who were not taking the drugs.

"These drugs are good drugs.  They strengthen bone and protect you from fractures for a while.  But in some people that can become deleterious after a period of time," according to Melvin Rosenwasser, chief of orthopedic trauma surgery at Columbia Medical Center in New York.

At this point, the FDA has not reviewed the studies nor has the agency issued any recalls with respect to the drugs involved in the study.  Rather, if you are taking any of the aforementioned drugs, you should discuss the use with your doctor and make a determination as to what works best for your situation.

Read more about the study linking osteoporosis drugs with hip fractures here.

Hip Fractures In The Elderly

As a nursing home lawyer, I have worked on many cases involving hip fractures as a consequence of falls.  Unfortunately, hip fractures typically require surgical repair in order for the patient to regain any quality of life post-fracture.  An estimated 300,000 people undergo surgery for hip fractures every year.

Most hip fractures fall into two categories:

Femoral Neck Fracture

A femoral neck fracture occurs when the ball of the ball-and-socket hip joint is fractured off the femur. Treatment of a femoral neck fracture depends on the age of the patient and the amount of displacement of the fracture.  A partial of full hip replacement may be necessary in patients who sustain a femoral neck fracture because of diminished blood flow makes healing of the area affected by the fracture unlikely.

Intertrochanteric Hip Fracture

An intertrochanteric hip fracture occurs just below the femoral neck. These fractures are amenable to repair more often than femoral neck fractures. The usual surgical treatment involves placement of a plate and screws to stabilize the fracture as opposed to a partial or complete hip replacement.

Hip fracture surgery complications

The good news is that modern medicine is capable of treating many types of hip fractures.  However, data has shown us that many elderly people have an incredibly difficult time recovering from hip fracture procedures.  In fact, an estimated 30%+ of people over 60 will die in the year following their procedure. 

All this means that nursing homes and other care facilities should take all possible efforts to implement fall prevention programs to reduce the risk of falls in their patients.

Related Nursing Homes Abuse Blog Entries:

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

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

Nursing Home Patients Have More Post-Surgical Complications Than Their Peers

A Video Diagram Of A Hip Replacement Surgery

Nursing Home Spotlight: Westside Rehab & Care Center

In the past year, Westside Rehab & Care Center has had 21 total health deficiencies, which is 13 more than the average number of health deficiencies in Illinois and the United States. This was actually an improvement from the total number of health deficiencies in the previous year, when the facility had a shocking 34 health deficiencies. Not surprisingly, Medicare gave this 96-bed nursing home facility located in Frankfurt, IL an overall rating of one-star, which is a much below average rating.

On August 10, 2009, a female resident suffered a leg fracture (broken bone) after falling during a transfer. The nursing home staff did not update her pain assessment in response to this injury, leaving the resident in unnecessary pain for an extended period of time.

During a complaint investigation, the resident told the investigator, “I am hurting! Can’t you help me?” The investigator reported this to the nurse, who then administered pain medication. This same resident was also noted to have dried blood on her face, neck and right arm and hands, with active bleeding on her right wrist. The resident was feeding herself with her fingers that were soiled with dried blood. The facility failed to prevent unnecessary pain and suffering for this resident, which means that the facility did not ensure that this resident maintained the highest level of physical, mental, and psychosocial well-being.

During the same complaint investigation, the investigator determined that the facility failed to ensure that each resident received adequate supervision and assistance to prevent accidents by failing to implement interventions to prevent staff from leaving a total care resident on the toilet alone. This failure resulted in the resident suffering two falls from the toilet.

The first fall occurred in February 2009, when the resident fell from the toilet and had to go the emergency room for evaluation of hip pain. After this fall, the facility should have implemented staff interventions in order to prevent additional falls. However, the facility failed to do so, and the resident fell from the toilet for a second time in June 2009. Falls are particularly dangerous for older adults who have older, weaker bones that are more susceptible to breaks (fractures). Therefore, it is very important that facility’s implement fall precautions in order to prevent resident injury.

Another complaint investigation revealed that the facility staff had knowledge that one resident suffered bruising after being physically restrained for a blood test and another resident was verbally abused. However, the staff did not implement preventative measures or report the potential for abuse to the administration in order to protect these residents and the other 52 residents from actual or potential physical or verbal abuse.

The resident who suffered physical harm was an 85 year old man with diabetes, who displayed behavioral symptoms of resisting care. The nurse woke up the resident in order to perform a blood test. The resident resisted and told the nurse that he didn’t want his blood drawn. The nurse then tried holding down the resident by placing her knee across his abdomen, even after the resident told her to stop. The nurse then called in two certified nurse aides (CNAs) for help in restraining the resident so that she could draw blood.

This incident was viewed by the resident’s roommate, who was awakened by his roommate’s screams. The roommate said that his roommate was shouting, kicking, and screaming for the nurse to stop. As a result, the resident suffered bruising across his abdomen. The nurse was counseled for “inappropriate behavior” and suspended for three days; however, the facility never performed an abuse investigation, as required. Also, the CNAs who were called into the room to help restrain the resident failed to report the mistreatment that they observed firsthand as is required by the internal reporting requirements.

Further investigation revealed that the nurse involved in the above incident was also verbally abusive to another resident. The resident reported that the nurse would yell at her to “move your a—“ and “stop being a baby” when the resident asked for pain medication. The nurse also used the “F” word at the resident. The resident and her roommate told the investigator that they didn’t report the nurse’s behavior because they didn’t want any problems. However, the resident did say that the nurse’s language “hurt her feelings.” Other facility staff members were also aware of the nurse’s verbal abuse and again failed to report the potential for abuse to the administrator in order to prevent abuse and mistreatment.

These incidents of abuse and mistreatment call into question whether Westside Rehab & Care Center can provide adequate and appropriate care for its residents, many of whom rely on the facility’s nurses and staff for activities of daily living. No resident should have to suffer physical mistreatment or verbal abuse such as the incidents reported at the facility. Although the facility has taken steps to improve staff training and intervention, it remains to be seen whether the residents will actually see an improvement in their treatment.

We represent victims of nursing home abuse and neglect.  For a free consultation, contact us (toll free) 888-424-5757.  We are here to help.

Sources:
IDPH: Westside Rehab & Care Center

Medicare: Westside Rehab & Care Center

Chicago Tribune: Compromised Care: West Side nursing home probed after death

Reflex Sympathetic Dystrophy (RSD) In The Elderly: A Real Cause For Concern Or More 'Funny Medicine'?

Several years ago my office represented an elderly woman who suffered a broken arm related to a fall at an assisted living facility.  The severity of the fracture required the application of a cast to align the bones.  A round of physical therapy also ensued after removal of the cast.  Despite the efforts of the doctors and physical therapists, pain originally thought to originate from the fracture continued on long after the bones had healed.  As it turned out, our client was suffered from a relatively little known medical condition known as reflex sympathetic dystrophy (RSD), also referred to as complex pain syndrome.

During the course of litigation, I learned a fair amount of information regarding RSD, but ultimately I was left with the impression that this disabling condition is grossly misunderstood amongst many in both the medical and legal communities.

What is Reflex Sympathetic Dystrophy?

Reflex Sympathetic Dystrophy Syndrome is a chronic pain condition that usually affects your arm or leg and displays a group of typical symptoms including pain (intense burning or aching pain), tenderness, swelling, discoloration, and altered temperature. Type 1 occurs after an injury or illness that does not directly damage the nerves in the affected limb; whereas, Type 2 (causalgia) occurs after a distinct nerve injury. Oftentimes, the pain is disproportionate to the severity of the injury.

What are the causes of RSD?

The cause of RSDS is still poorly understood. It usually follows a trauma-related injury, but again, it is not well understood why injuries can trigger this condition. Theories include irritation and abnormal excitation of nervous tissues which leads to abnormal impulses along the nerves affecting blood vessels and skin.

What are the symptoms of RSD?

RSDS can display a gradual or rapid onset of symptoms, and it may not display all typical symptoms. The symptoms may change over time and will vary from person to person. Typical symptoms include:

  • Burning pain
  • Increased skin sensitivity (allodynia)
  • Changes in skin temperature, color, and texture
  • Changes in hair and nail growth
  • Joint stiffness, swelling, and damage
  • Muscle spasms, weakness, and loss (atrophy)
  • Decreased ability to move the affected body part

RSDS often starts with swelling, redness, changes in temperature, hypersensitivity.  In many RSD patients the symptoms may worsen over time, the involved limb may become cold and pale, displaying skin and nail changes, and suffering muscle spasms and tightening.  Like most medical conditions, the symptoms associated with RSD differ from person to person.

What are the treatments for RSD?

There is no cure for RSDS. Instead, most treatment options seek to relieve the painful symptoms of the disease. Treatment for RSDS is most effective when started early. Usually, once the limb becomes cold and pale and the limb has muscle spasms and tightening, the condition is often irreversible.

A doctor will usually perform a physical exam and collect your medical history. Sometimes bone scans, x-rays, and MRIs (magnetic resonance imaging) can provide important clues in diagnosing RSDS. These tests can show increased circulation to affected joints, loss of minerals from your bones, and tissue changes.

The treatment for RSDS is specifically tailored for each case. Treatment options include various medications and therapies. Doctors might prescribe over-the-counter nonsteroidal anti-inflammatory drugs (aspirin, ibuprofen, and Aleve) to ease pain and inflammation, antidepressants to treat pain from damaged nerves, corticosteroids (prednisone) to reduce inflammation, and bone-loss medications (Fosamax and Miacalcin) to help treat symptoms.

Your doctor might also recommend various therapies to help treat and improve symptoms. These therapies can include: applying hot and cold compresses, topical analgesics to reduce hypersensitivity, physical therapy to help improve range of motion, spinal cord stimulation for pain relief, electrical nerve stimulation to help ease chronic pain, and sympathetic nerve-blocking medication to block pain fibers in the affected nerves. Most medications and therapies merely help treat the pain and inflammation caused by the disease.

Complications associated with RSD

If RSDS is not properly diagnosed and treated at an early stage (within a few months of your first symptoms), the disease can progress into more severe symptoms including muscle wasting (atrophy) and contracture (tightening of your muscles which can leave your limb contracted in a fixed position).

RSDS can also occasionally spread from its source to another area of your body. The symptoms can travel from the initial site of the pain to a nearby area, or spread to an opposite limb, or even leap to a distant part of your body.

RSD & Nursing Home Patients

The mystery surrounding the cause and treatments for RSD leaves many nursing homes ill-equipped to adequately treat patients who suffer from this condition. When a resident is suffering from Reflex Sympathetic Dystrophy Syndrome (RSDS), the resident might experience pain that is more severe than one would expect with the sort of injury or trauma that they sustained.

Many times, nursing home staff do not properly diagnose the condition, leaving the resident in horrible and unnecessary pain as the condition worsens. This is because residents with RSDS often have pain and disability that cannot be explained on the basis of objective physical findings. For this reason, it is important to ensure that a nursing home facility takes your pain seriously.

It is imperative that nursing home facilities properly train their staff to recognize symptoms of RSDS because early treatment is so important in preventing the continuing progression of the disease. Facility staff should monitor residents’ pain and notify a doctor if the resident experiences constant, severe pain in a limb especially when moving the affected limb.

Elderly nursing home residents have an increased risk for dangerous slips and falls. These falls can result in broken hips, which often require surgery, bone fractures, bruising, head injuries, and other injuries. These injuries, which often affect the limbs, can be a source of trauma that puts them at increased risk to develop RSDS. If the nursing home facility does not properly monitor the resident’s pain and recovery following an injury, the resident might not be properly diagnosed with RSDS, which can lead to additional and often irreversible damage to the limb.

Many nursing home residents are often unable to communicate with nursing home staff members because of disease or mental illness. The facility staff might notice the resident crying out in pain for no apparent reason, but this pain, especially if constant and severe, can be an indicator of RSDS. Many nursing homes have large resident populations, which increases the likelihood of a resident’s pain being ignored or concern over constant pain being minimized.

If you or a family member experiences constant and ongoing pain, it is important to notify the nursing home facility and ensure that the pain is properly managed and treated. There is no excuse for nursing home facilities to ignore a resident’s pain, even if there is no apparent source. This pain could be an indicator of Reflex Sympathetic Dystrophy Syndrome or other underlying medical conditions.

Thank you to Heather Keil, J.D. for her assistance with this Nursing Homes Abuse Blog entry

Resources:

Medicine Net: Reflex Sympathetic Dystrophy Syndrome (RSDS)

Mayo Clinic: Complex Regional Pain Syndrome

National Institute of Neurological Disorders and Stroke: Complex Regional Pain Syndrome Information 

Grimes & Teich: Reflex Sympathetic Dystrophy (RSD)

Indiana University: Reflex Sympathetic Dystrophy (RSD) After Blunt Trauma: A Survey of Recent Literature

Nursing Home Patients Have More Post-Surgical Complications Than Their Peers

In the ever mounting pile of problems facing nursing home patients, we can now add another-- nursing home patients are more likely to die following gastrointestinal (GI) operations than their peers living independently.  A study compared the mortality rates for nursing home patients who underwent six types of GI operations including: bleeding GDU's, benign colon disease, colon cancer, cholecystitis and appendicitis.

After evaluating data from 30,721 nursing home patients and 1.18 million Medicare beneficiaries, the studies authors determined that nursing home patients are more than three times more likely to die following the surgical procedures than those living in the community.

The dramatic differences in the surgical outcomes are believed to be the result of a variety of factors that the study was unable to assess including poor conditioning and malnourishment.  

Despite the obviously disappointing data, surgeons are still convinced that GI surgery is necessary for some nursing home patients as that many of these conditions have almost certain mortality when left untreated. 

Now that the medical community knows that this problem exists, they must work to develop a plan to minimize some of these health known problems.  "If we can tease these things out, that's when we can try to design interventions that would optimize outcomes in terms of preparing these patients for surgery and developing pathways and interventions postoperatively," said senior author Emily Finlayson, MD, MS, an assistant professor of surgery at the University of California, San Francisco.

Though I would never hold myself out as an expert post-surgical care, my experience has been that orthopedic injuries such as hip fractures and limb fractures that require surgery are particularly devastating for nursing home patients.  Sadly, I see many of these people deteriorate physically and emotionally after this trauma.  Perhaps this research would be useful for orthopedic patients as well?

Resource:

Nursing Home Patients Suffer Higher Post-op Mortality Rates, General Surgery News, March, 2010

Nursing Home Operators May Be Responsible For Injuries Due To The Negligent Removal Of Snow & Ice

As winter weather sets in, the city is often covered in a blanket of snow and ice. While the slippery weather conditions present a danger to all of us, snow and ice are particularly dangerous for older adults who are already more likely to suffer from a fall and also more likely to suffer bone breaks and injuries.

Nursing home residents rely on the nursing home property owners (nursing home operators and manager) to provide a facility free of dangers that might cause dangerous falls or accidents. This responsibility includes the removal of snow and ice, which creates a serious risk of falling.

In Illinois, according to the Premises Liability Act (740 ILCS 130), owners or occupiers of land owe invitees and licensees a duty of “reasonable care under the circumstances regarding the state of the premises or acts done or omitted on them.” An owner or lessee must provide a reasonably safe means of access to its business. If you bring a premises liability claim, you, the plaintiff, have the burden of proving that your injuries were caused by a condition on the property that was not reasonably safe that the owner knew or should have known of by the exercise of reasonable care.

However, this duty of reasonable care is different in the case of snow and ice on property. In Illinois, absent a contractual obligation, if you are walking down the street and happen to slip and fall on a snow or ice covered sidewalk or parking lot, the property owner owes you no duty to remove the natural accumulation of snow, water, or ice. (Illinois Snow and Ice Removal Act – 745 ILCS 75).

The Act states that it is undesirable for any person to be liable for damages due to his snow removal efforts, unless his actions amount to “clear wrongdoing.” Illinois follows the natural accumulation rule, where a property owner is only liable for a snow or ice related accident only if their alleged misconduct was willful and wanton or there was an unnatural accumulation of snow or ice or a natural condition that is aggravated by the owner. (McBride v. Taxman Corp., 327 Ill.App.3d 992 (1st Dist.2002); Ziencina v. County of Cook, 188 Ill. 2d 1 (1999)).

Natural accumulation is the result of natural weather conditions; whether accumulation is natural or not is oftentimes a difficult factual question. Examples of natural accumulation are: a sidewalk that has not been shoveled, puddles of water inside buildings from melting snow, ice formed by snow being packed down by pedestrians. Unnatural accumulation would be any actions by the property owner that cause snow or ice to accumulate in a specific location. One exception to the natural accumulation rule is if there is a contractual obligation to remove snow or ice; for example, if the property owner or manager has a provision in a lease providing that the owner agrees to remove snow or ice. If this is the case, the owner may be held liable.

Nursing home facilities must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of its residents. Part of this responsibility is ensuring that “the resident environment remains as free of accident hazards as is possible” (Requirements for States and Long Term Care Facilities – 42 CFR 483).

Therefore, nursing home operators owe residents a higher level of duty than a regular invitee or licensee, which under premises liability would only require them to exercise ordinary or reasonable care in maintaining the premises in a reasonably safe manner. Nursing home residents are more vulnerable than the regular invitee or licensee, and the degree of care owed is greater in recognition of that vulnerability.

Absent any dangerous winter weather conditions, nursing home residents are already more vulnerable to dangerous slips and falls, which can lead to serious injuries such as broken hips and head injuries. Even minor falls can be dangerous because elderly people are more susceptible to bone fractures than younger people because as bones age, they lose the ability to resist the formation and growth of cracks which can lead to bone breaks. The federal code regulating nursing homes is sensitive to nursing home residents’ vulnerability to falls, even specifying a standard for flooring; “the facility must have floors that have a resilient, nonabrasive, and slip-resistant surface.”

Therefore, nursing home operators must take extra precautions to make the nursing home facility premises safe for elderly residents. This includes installing slip-resistant flooring and removing dangerous snow and ice. Nursing home operators have a contractual duty to make the premises free of accident hazards, including hazards posed by snow and ice.  

Unnatural Accumulation Of Snow & Ice

If the nursing home operator removes snow or ice in a negligent manner or creates an unnatural accumulation of snow or ice, they may be liable for the resident’s injuries.  Similarly, if you are visiting a family member at the nursing home and happen to slip and fall on snow or ice, you may bring an action against the nursing home even though you are not a party to the contract because you are a foreseeable user of the premises.  

If you or a member of your family has suffered a dangerous fall because of dangerous snow or ice accumulation at a nursing home, you have the right to hold the nursing home owner or operator responsible for those injuries. The nursing home is obligated to provide a safe environment for all residents, and that includes an environment free of dangerous snow and ice.

Thanks to Heather Keil, J.D. for her assistance with this Nursing Homes Abuse Blog Entry

Resources:

Illinois General Assembly – Nursing Home Care Act 210 ILCS 45
Illinois General Assembly – Premises Liability Act, 740 ILCS 130
Illinois General Assembly – Snow and Ice Removal Act, 745 ILCS 75

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New Technology Promises To Reduce Falls In The Elderly Population

There's no doubt about it, falls in the elderly population are a major cause of injury and even death.  The New York Times, ran an encouraging article that by incorporating relatively simple (and inexpensive technology) the number of falls can be reduced.

Using wireless sensors on clothes and strategically placed within rooms, scientists can monitor many different aspects that may be responsible for causing falls including: cardiovascular weakness, changes in medication, early stages of dementia and muscle degeneration.

The data from the sensors can be sent to a person's doctor to help in monitoring overall health and their likelihood of falling with the goal of taking interventional steps before a fall occurs.

The technology seems to work.  According to a recent study sponsored by the Technology Research for Independent Living, fall rates in a sample group of 60 to 94-year-olds were reduced by 30% when doctors used the sensor data to customize a rehabilitation and medication plan in accordance following data analysis.

With an annual cost of more than $75 billion per year, this fall-sensor technology may be a great investment for insurance companies and long-term care facilities because each unit costs less than $200-- certainly less than a trip to the emergency room or surgically repairing a hip fracture.

Obviously, more research needs to be done, but this technology seems to be very encouraging from both a quality of life and economic standpoint. 

Facts About Nursing Home Falls

  • About 1800 people die each year due to falls in nursing homes
  • 10 to 20% of nursing home falls result in serious injury
  • 2 - 6% of falls result in fractured bones
  • 3 out of 4 people living in a nursing home will fall this year
  • Most people are 'repetitive fallers'- After a first fall, there is a substantial likelihood that you will fall again
  • Most falls go unreported

Rosenfeld Injury Lawyers represents individuals and families in claims and lawsuits against nursing homes and long-term care facilities across the country.   If your loved one has suffered an injury or died in a fall, we are always available to discuss your legal options. (888) 424-5757

Related:

Fall In Nursing Home Claims The Life Patient-- Less Than 24-Hours After Admission

Even Common Falls Put Elderly At Risk For Developing Subdural Hematomas

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

What Is Hypostatic Blood Pressure & Why Is There An Associated 'Fall Risk'?

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

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

Nursing Home Sued After Resident Fractures Both Hips In Separate Falls

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

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

Falls are a common problem facing elderly people in and out of nursing homes.  By some accounts, every elderly person in America will fall at least one time over the course of the next year.  Many of these falls will cause injury and some will even cause death.

In the case of falls occurring in the nursing home setting, many clients and their families focus their attention on tying a specific number of falls to a facilities responsibility.  Truth be told, there really is no magic number when it comes to identifying a specific number of falls after which a nursing home or hospital becomes responsible.

Rather, in determining a nursing home's fall related liability, it is important to determine not just the actual number of falls that occurred prior to the injury causing fall, but to look at the situation as a whole.  Taking a look at the residents 'fall-risk assessment' completed by the facility on admission should help determine what safeguards should have been in place to prevent falls.  In the case of multiple falls, it is important to look to see if a new assessment was completed after each fall.  Put another way, there is no magic number of falls for imputing responsibility on the part of a facility.

While in the fall mode, I came across this article regarding a lawsuit filed against a nursing home for failing to take precautions before a resident fell and died from her injuries.  The lawsuit alleges that Windsor Chico Creek Care and Rehabilitation Centers failed to implement fall precautions for a woman who was admitted to the facility following a back injury that made her susceptible to falls.

 

The woman's husband filed a nursing home lawsuit claiming that the facilities negligent conduct resulted in the woman falling from her bed and fracturing her hip. The woman subsequently underwent surgery for the hip fracture and contracted aspiration pneumonia during her recovery that ultimately caused her death.

The lawsuit alleges that despite the facilities own orders for safety precautions, Windsor Chico Creek Care and Rehabilitation Center failed take the following precautionary measures to prevent the woman's fall from occurring:

  • Failed to use guardrails on the bed
  • Failed to use an alarm system to alert staff if the woman fell from her bed
  • Failed to used a lowered bed style to minimize the risk of falling from an elevated height
  • Failed to hire an adequate number of staff to provide assistance

In this case, should the allegations proved to be true, this facility faces liability even though no prior falls took occurred.  The lawsuit also names Helios Healthcare LLC, the owner of Windsor Chico Creek as a co-defendant in the case.

Related Nursing Homes Abuse Blog Posts

Nursing Home Sued Following Death Of Resident In Fall

Woman Dies From Brain Bleed Following Unsupervised Fall

Study Links Medication Use With Falls

A Video Diagram Of A Hip Replacement Surgery

Hip fractures are one of the most common problems affecting nursing home residents.  As we age our bones thin and become more brittle increasing the likelihood of a sustaining a hip fracture due to a fall or being dropped by nursing home staff. Most hip fractures require surgical repair when the hip joint is actually replaced with hardware. Here is a useful step-by-step explanation of how a hip replacement surgery is done.

Prevention of falls should be a priority in all nursing homes.  To minimize the risk of falls the following fall prevention measures should be taken.

  • Remove clutter from floor
  • Remove improperly fitting slippers and other clothing
  • Keep bed rails up when patients are sleeping
  • Provide adequate staff and equipment when transferring into and out of bed
  • Install handrails in areas where patients need stability
  • Keep call lights within reach of residents in bed at all times.  Residents can request assistance easily.
  • Lock wheels on wheelchairs and beds when transferring patients
  • Monitor patients with low blood pressure

If a loved one sustained a fractured hip or femur during a stay at a nursing home, it may be due to the negligence of the facility.  Our office can work with you and determine if you have a viable cause of action.  Speak to an experienced nursing home attorney anytime. (888) 424-5757

Past Nursing Home Abuse Blog Articles on falls:

Never Event #1: Hospital falls & Trauma

Improper Transfer Leads To Fall & Untimely Death of Rehab Patient

Study Links Medication Use With Falls

Why Bother With Hip Pads?

Following my recent post on the frequency of hip fractures in nursing homes, I received several responses from blog readers who asked me about the effectiveness of hip pads in preventing injury and hip fractures to nursing home residents.  For those that don't know, hip pads are usually similar to underwear with built in plastic and foam pads.  The overwhelming evidence suggests that hip pads do little to prevent hip fractures amongst the elderly.  In fact, a recent study of 1,000 nursing home residents was terminated because the hip pads were so ineffective in preventing fracture.

According to the study's author, Dr. Douglas Kiel, of Harvard Medical School, 'In the United States, nearly 340,000 hip fractures occur per year, more than 90 percet of which are assiciated with falls, and the number of hip fractures may double or triple by the middle of this century.' Further, 'The highest incidence rates of hip fractures have been reported in nursing home residents, where 50 percent of residents fall each year.' 

So the question remains, why do nursing homes and facities use hip pads in the first place?  I really con not think of any reason other than the fact that some nursing homes would rather use a device to take the place of staff involvement and supervision of their residents.  The only effective way to prevent nursing home falls is to identify people who may be prone to falls and to provide adequate assistance to residents throughout their daily living activites.

Read more about hip pads in nursing homes here.

Hip Fractures And Some Unsettling Statistics

Hip fractures are a frequent result of falls in nursing homes.   In fact, an elderly person living in a nursing home is more likely to sustain a hip fracture while at the facility than they would living independently.  Most hip fractures require surgery.  The type of surgery required depends on where the break is and how bad it is. Your doctor may put metal screws, a metal plate, or a rod in your hip to fix the break. Or you may need to have all or part of your hip replaced.

The outcome for nursing home residents who sustain a hip fracture are disappointing:

  • 17% to 33% mortality rate for the year following the fall
  • 25% to 33% of residents are unable to walk following surgery and physical therapy
  • Up to 15% of hip fracture patients suffer from pressure sores

Nursing homes must take the risk of falls and hip fractures seriously.  The best prevention of a hip fracture is for a nursing home to identify residents who may be at risk of falling and to have adequate staff in the facility to provide assistance to residents. 

If you or a loved one has suffered a fall in a nursing home and sustained a hip fracture, the facility is responsible for damages from the initial fall, all subsequent medical care and decay in physical conditions.

About Jonathan Rosenfeld

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Jonathan Rosenfeld is a lawyer who represents people injured in nursing homes and long-term care facilities.   Jonathan has represented...

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