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 woman accused of sneaking into Beaverton's Maryville Nursing Home has been arrested.
Theresa Kim Smith is a certified nursing assistant in the Portland area and someone the police listed as “a person of interest” in a reported theft of Fentanyl pain patches.  The suspect woman posed as an employee at the Maryville Nursing Home on three separate occasions, but no motive was suspected at the time. Tips from the public led police to interview Smith, and the stealing Fentanyl patches from residents could be a possible motive.

Smith, who works at the Care Center East Nursing Home in Portland, is suspected of stealing the pain patches from multiple nursing home locations.  The Oregon State Board of Nursing has been conducting its own investigation into Smith’s reported Fentanyl thefts and has suspended her CNA certification.  Read more about the posing nurse here.

Is the staff turnover at nursing homes so great that the people who actually work at the facilities can not recognize a new face?  Perhaps equally frightening is how lazy these facilities are when it comes to securing such a dangerous drug like Fentanyl.  The authorities should investigate the self-serving Fentanyl incident.

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Recently, I discussed medication errors in nursing homes. Every nursing home resident I have seen is on some type of medication or vitamin supplement. The likelihood of suffering an injury due to a medication error is higher than almost any type of treatment rendered in a nursing home. How can you prevent the medication errors from occurring?

Jeffery Levine, M.D., author of, Medical-Legal Aspects of Long Term Care, has put together a list for preventing medication errors and adverse drug reactions. Dr. Levine provides the necessary information for a family member to evaluate potential errors in the administration of medication. I highly recommend this book. Inspired by Dr. Levine, here is a listing of recommendations applicable to every nursing home and hospital patient.

Review each medication to determine its necessity

• Make sure the list of medications is complete
• Identify the condition for which each medication is prescribed
• Determine the potential for any drug vs. drug interactions
• Determine potential for any drug vs. disease interactions
• Can the drug regimen be simplified?
• Are there any new, safer drugs available to substitute with current medication?
• Is it possible to discontinue any medication? 

New medication tips

• Is the diagnosis correct?
• Can the condition be treated without medication?
• Can a lower dosage be used?
• Could the symptoms be related to another medication?
• Can one drug be used to treat multiple conditions?

Inappropriate medication use

• Don't try to treat every condition. It is impossible to treat every physical condition
• Don't try to treat the side effects of medications
• Try to have one physician prescribe all medications
• Make sure each all physicians involved in a patients treatment are aware of each other

Clearly, the most important preventative measure is to take an active role in the care of your loved one. Making regular, unscheduled visits is suggested. Do not be afraid to ask questions from those who have a role in the dispensing of medications. A clarification may prevent an episode of injury down the road.

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Medication errors are considered to be any preventable event that may cause or lead to inappropriate medication use or harm to a patient. Since 2000, the Food and Drug Administration (FDA) has received more than 95,000 reports of medication errors. FDA reviews reports that come to MedWatch, the agency's adverse event reporting program.  (Source: FDA website)

The FDA relies on a voluntary reporting for incidents involving medication errors.  The actual number of incidents involving errors in the misadministration of medication to be much higher. The term 'medication error' may describe situations involving: physician malpractice, inadequate facility policies and procedures, faulty charting, order miscommunication, inadequate product labeling, faulty packaging, under-staffing and failure of a nursing home or hospital to monitor residents.

The American Hospital Association lists the following as some common types of medication errors:

• incomplete patient information (not knowing about patients' allergies, other medicines they are taking, previous diagnoses, and lab results, for example);
• unavailable drug information (such as lack of up-to-date warnings);
• miscommunication of drug orders, which can involve poor handwriting, confusion between drugs with similar names, misuse of zeroes and decimal points, confusion of metric and other dosing units, and inappropriate abbreviations;
• lack of appropriate labeling as a drug is prepared and repackaged into smaller units; and
• environmental factors, such as lighting, heat, noise, and interruptions, that can distract health professionals from their medical tasks.

Similarly, incidents of medication error may occur when nursing home staff withhold medication or over-medicate residents.  There are incidents where nursing homes intentionally over-medicate a large percentage of their residents in order to keep them complacent and quiet, rather than providing them with the necessary care.

Victims of medication errors have rights.  If you believe a family member or friend has suffered an injury due to a medication error contact the nursing home monitoring authorities in your area.

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