Articles Posted in Infections in Nursing Homes

Claims against nursing homes can arise in a variety of circumstances, including abuse, neglect, and failures to properly treat patients in their care. As a result, many of the claims against nursing homes and other long-term care facilities allege the facility was negligent in some way. As in any negligence claim, in a nursing home claim alleging negligence, a plaintiff must establish that the defendant owed a duty to the plaintiff, the defendant breached that duty, the breach caused the plaintiff’s injury, and the plaintiff sustained damages.

In nursing home claims, after a plaintiff proves that a nursing home owed a duty to the resident, the next issue is whether the defendant’s conduct fell below the standard of care. This is the standard that a defendant is expected to meet under the circumstances present in the particular situation. In some cases, a nursing home resident may die at a nursing home, but the home may not be at fault. Thus, in order to establish liability, a plaintiff has to show that the facility did not properly care for the resident, and this conduct led to the resident’s injuries. A recent case shows the type of evidence necessary to succeed in a nursing home negligence lawsuit.

Jury Awards Family $450,000 After Resident Dies from Infection

A jury recently found a rehabilitation center was negligent in its care of a blind, diabetic resident,
and it awarded the man’s family $450,000 in damages. According to one news source, the man, a 79-year-old retired tractor mechanic, died in November 2014, just a month after he was admitted to the center. The evidence presented at trial showed that the man was on dialysis and developed an infection in his big toe that turned gangrenous and that led to his right leg being amputated and ultimately to his death.

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Late last month, an article by Newsmax Health conducted an investigation into a frightening statistic that the superbug MRSA can be found in roughly 25% of all U.S. nursing homes. According to the report, the largest contributing cause to the transmission of this antibiotic-resistant bug is contaminated gloves.

The article, working off a study conducted by Infection Control & Hospital Epidemiology, notes that there is a gap in education among nursing home employees regarding the transmission and seriousness of MRSA.

The study, which took place in Maryland and Michigan nursing homes, showed that in 28% of nursing homes the MRSA bacteria was present at some level. The largest contributors were glove- and gown-contamination, with glove-contamination being more prevalent. The study explains that washing hands and changing gloves between residents is crucial to stop the spread of the deadly disease.

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A recent review of norovirus outbreaks in nursing homes found a correlation between outbreaks and higher rates of both hospitalizations and mortality among residents. While the correlation does not necessarily mean that the norovirus directly causes a greater number of hospitalizations or deaths, the data obtained by the study could prove useful in identifying risks faced by nursing home residents during outbreaks of communicable disease. This can in turn help nursing home administrators enact policies to protect and preserve their residents’ health and safety.

The norovirus is a highly contagious virus commonly associated with the stomach flu. It can affect anyone, regardless of age or general health condition, with symptoms ranging from stomach pain and nausea to acute gastroenteritis. People can contract an infection from other infected people, contact with contaminated surfaces, or ingestion of contaminated food or water. According to the Centers for Disease Control and Prevention (CDC), the norovirus sickens around 21 million people in the U.S. annually, and it is responsible for as many as seventy thousand hospitalizations and eight hundred fatalities per year.

The study, “Hospitalizations and Mortality Associated With Norovirus Outbreaks in Nursing Homes, 2009-2010,” was published in the October 24/31, 2012 online edition of the Journal of the American Medical Association. The researchers reviewed records from Medicare and the CDC for a period from January 2009 through December 2010 from three states: Oregon, Pennsylvania, and Wisconsin. Their review covered 308 nursing homes, with a combined total of 407 reported outbreaks of norovirus. The norovirus outbreaks lasted a median of thirteen days. Twenty-nine percent of the total number of reported hospitalizations and seven percent of the reported deaths occurred during reported outbreaks.

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Healthcare-associated infections (HAIs), generally defined as bacterial, viral, or fungal infections contracted by patients while receiving medical treatment, are a potentially major hazard for residents of nursing homes and other long-term care facilities (LTCFs). As many as 2.8 million LTCF patients may contract HAIs, some of them fatal, every year. A group of epidemiologists recently revised the definitions used in the surveillance of HAIs, providing new tools to document and track infections. The Centers for Disease Control and Prevention (CDC) has also issued new guidelines to help LTCF’s monitor HAIs. These new tools will hopefully help reduce the development and spread of infections among nursing home residents.

HAI Surveillance Definitions

In the October 2012 issue of the Society for Healthcare Epidemiology of America’s (SHEA) journal, Infection Control and Hospital Epidemiology, a panel of experts present a new set of definitions for use in monitoring LTCF infections. The existing set of definitions, known as the McGeer criteria, date back to 1991.

A group of experts led by Allison McGeer published a set of definitions in the February 1991 issue of the American Journal of Infection Control. The purpose of the McGeer criteria was to establish a uniform set of guidelines to monitor infections in nursing homes, such as standards for identifying newly-contracted or worsened acute infections that require monitoring.

According to the paper containing the revised definitions, the McGeer criteria work well in nursing homes providing non-acute care to older residents, but they do not necessarily address concerns faced in LCTFs providing acute care and care to younger patients. New types of nonhospital treatment facilities have appeared since 1991, so newer criteria for identifying and tracking HAIs is necessary.

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A study has identified a link between increasing rates of influenza vaccination among nursing home staff and decreasing rate of flu infection among patients. The study, which looked at 75 New Mexico nursing homes, found an 87% decrease in the likelihood of a flu outbreak in facilities where 51% to 75% of direct care workers received vaccinations. This supports earlier findings from the Centers for Disease Control and Prevention, which has encouraged healthcare workers to get vaccinated against the flu.

Interestingly, the study also found that high rates of vaccinations among nursing home patients led to higher odds of a flu outbreak in that home. Researchers suggest that this is due to lower rates of vaccination among staff in nursing homes with high rates of patient vaccinations. This finding would further support the conclusion that high rates of staff vaccination keeps outbreak rates low.

The Centers for Disease Control and Prevention (the “CDC”) currently recommends that healthcare workers obtain annual vaccinations against the flu. Their research found that only 13% of healthcare workers reported a requirement of vaccination from their employers. At the same time, a substantial majority of healthcare workers reported vaccinations being available at work, often at no charge.

Outbreaks of disease in the nursing home environment are a persistent concern. Officials at a nursing home in Turtle Creek, Pennsylvania are currently fighting an outbreak of Legionnaire’s disease that has sickened eight people so far. A 2009 study in Ontario, Canada found that, of the 83 disease outbreaks reviewed, 91% of them occurred in long-term care facilities. A 2003 study published in the journal Clinical Infectious Diseases found that one-third of the reports of infectious diseases from nursing homes involved sudden disease outbreaks. The study examined reports of respiratory infections, including influenza, tuberculosis, and pneumonia; gastrointestinal illnesses such as E. coli, salmonella and viral agents; skin infections; and antibiotic-resistant bacteria. The study concluded that the environment of nursing homes allows easy transmission of disease outbreaks, largely due to close living conditions, lack of proper diagnostic equipment, and the already-diminished health condition of many nursing home residents. Recommendations included greater management plans and surveillance of symptoms in patients to try to recognize diseases before they reach outbreak status.

Vaccinating nursing home staff against known contagions is an important step in this process. Nursing homes must also commit to maintaining a clean environment for its residents. Many infectious diseases can reach outbreak status in a nursing home simply due to a lapse in cleaning. Respiratory illnesses such as influenza are commonly transmitted directly from one person to another, but germs can also persist on various surfaces. An elderly individual, practically one with an already-suppressed immune system, who comes into contact with a contaminated surface risks infection.

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A fourth nursing home abuse and negligence lawsuit has been filed this week against the owners of a Kentucky nursing home complex, after a resident allegedly suffered from inadequate care when her healthcare rights and safety were reportedly threatened.

According to a news development from the Richmond Register that our Maryland nursing home attorneys have been watching, Viola Fields was a resident of Kenwood Health and Rehabilitation Center from the end of October until the beginning of December in 2010. James Rutherford, Fields’ guardian, claimed that Fields, who is incapacitated and not of a sound mind, did not receive the minimum standard of healthcare that should have been available to her as a vulnerable nursing home resident. Rutherford claims that the home violated her nursing home rights as a long-term care resident.

The lawsuit accuses Kenwood of nursing home negligence for failing to provide Fields with timely and accurate nursing home healthcare and medication assessments, proper resident supervision, necessary medical intervention, and from failing to prevent accidental injury. Kenwood is also being accused of medical and corporate negligence.

Rutherford claims that the nursing home’s wrongful conduct caused the rapid deterioration of Fields’ health and physical condition, and led to the direct development untreated pressure ulcers, wound infections, sepsis, pneumonia, urinary tract infections and weight loss. The lawsuit accuses the home of acting with fraud, malice, gross negligence and reckless disregard for the health and safety of Fields and her rights as a nursing home resident. Rutherford claims that because of these injuries, Fields experienced physical impairment, and suffered embarrassment, along with incurring significant medical expenses.

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In a recent Anne Arundel County nursing home blog, our attorneys reported on the problem of pressure ulcers in nursing homes, and the importance of detecting and treating bedsores before they develop into serious infections that could be life threatening.

Bedsores, or decubitus ulcers, affect nearly one million people in the U.S. causing around 60,000 deaths due to complications from the advanced development of the ulcers, like osteomyelitis or sepsis.

As reported in a related Baltimore nursing home injury lawyer blog, pressure sores often form due to nursing home negligence, when immobile residents, or residents who have difficulty moving, are confined to their wheelchairs or beds, restricting the blood flow on certain areas of the body where there is prolonged pressure, causing a lack of circulation and skin breakdown.

Pressure sores often develop in four stages:

• Stage I: When the skin on an area of the body starts to break down, it becomes discolored and red. This is an important stage for healthcare practitioners to identify bedsores, especially with at-risk residents, as pressure sores can be prevented and reversed if caught in the early stages.
• Stage II: The discolored area of a developing bedsore turns into a blister or scrape that forms a sore, resulting from the skin’s breakdown. If the sore does not receive immediate treatment, the skin will continue to deteriorate.
• Stage III: If the pressure sore is not cared for properly, the skin will continue to break down, causing significant loss of the soft tissue beneath the skin’s surface, forming a crater.
• Stage IV: The crater beneath the skin’s surface deepens, in many cases as large as a grapefruit or fist, where the muscle and bone along with tendons and joints, become severely damaged. Residents who suffer from Stage IV pressure sores often experience severe pain and frequent depression, and the massive ulcers can lead to illnesses like sepsis or osteomyelitis that can lead to wrongful death.

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In recent news that our Maryland nursing home neglect lawyers have been following, a Convalescent Center is being sued by the family of a resident, after alleged nursing home negligence led to the decline of health of the resident’s health.

According to the lawsuit, Helen Hammes became sick after receiving improper care while she resided at the care facility. The lawsuit claims that the home failed to develop a care plan that was comprehensive, failed to transfer Hammes to another nursing facility, and neglected to monitor her bowel movement after showing signs of polyuria, a problem with the overproduction of urine. The home is also being accused of failing to follow the physician’s orders by performing a rectal exam, and failing to discontinue diuretic therapy even after the patient experienced dehydration.

The lawsuit claims several violations of the state Nursing Home Care Act, and claims that Hammes suffered physical pain and developed sepsis as a result of the improper care.

As our lawyers have reported in a previous Maryland nursing home blog post, sepsis is a deadly blood disease that develops when an infection in the body spreads quickly—causing blood poisoning, tissue damage and often organ failure. It is reported that every year, over 200,000 people die from different forms of sepsis. Sepsis is dangerous with nursing home residents, as their immune systems are often weak.

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Our Frederick County nursing home negligence lawyers have been following the recent announcement that a New York State jury has awarded over $5 million in monetary damages in a negligence case, after a patient at the Staten Island University Hospital and the Golden Gate Rehabilitation and Health Care Center reportedly developed severe and untreated bedsores that caused great suffering while staying at both facilities.

According to the lawsuit, Robert Messina. 63, was staying at the hospital and rehabilitation center after a brain dysfunction caused him to collapse in August of 2006. While a resident of both facilities, Messina reportedly developed pressure sores, or bedsores, that caused him to lose the ability to walk and led to a hip infection.

Messina claims in the lawsuit that the bedsores went untreated and developed into massive ulcers affecting his buttocks, genitals, mouth and ankles, leading to a spinal ulcer and a bone infection, or osteomyelitis.

In a related Baltimore nursing home injury lawyer blog, our attorneys discussed the danger of bedsores in nursing homes, and the importance of detecting and treating pressure ulcers early, to prevent the life-threatening infections that can stem from the advanced stages of bed sores like sepsis, a blood infection, and osteomyelitis, a bacterial infection of the bone.

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In a recent Maryland nursing home lawyer blog, our attorneys discussed a nursing home negligence lawsuit filed by the widow of a resident—who claims in the suit that while her husband was staying in the Madison Manor nursing home, his foot infection was not properly cared for, leading to the amputation of his leg, and wrongful death.

In a related report, the same Madison Manor nursing home has been sued again by the son of a former resident who says the home failed to properly care for his mother, leading to nursing home negligence and wrongful death.

In this second lawsuit, filed just a month after the home was sued for negligence, David Drury claims that the nursing home owners, operators and staff knew that the facility could not provide the minimum standard of healthcare that was promised to his mother, Lena McKinney, causing her to suffer an accelerated deterioration of health and physical condition that was far beyond what is caused by the normal process of aging.

Drury claims that while his mother was a resident of the home from December of 2008 to July of 2009, she experienced nursing home negligence that led to fluid imbalance and malnutrition, weight loss, poor hygiene, nursing home falls, and infections including urinary tract infections and sepsis that led to acute renal failure. As our Baltimore nursing home lawyer blog has reported in the past, sepsis is a serious blood infection in the body resulting in blood poisoning, and can be a lethal condition if it progresses rapidly, leading to organ failure.

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