Most Elder Deaths in Nursing Homes are Never Investigated

Deaths occurring among elderly nursing home residents often escape scrutiny. Doctors may classify possibly suspicious deaths as the result of “natural” causes, and as a result cases of abuse and neglect are not investigated. Reporters for ProPublica, in cooperation with PBS’ “Frontline” and other news organizations, conducted a review of coroner and medical examiner records from around the country to examine how often suspicious deaths in nursing homes get swept under the rug. While an accurate total is probably impossible to determine, they identified over three dozen cases in which authorities missed “alleged neglect, abuse, or even murder of seniors.” The resulting article names three systemic problems in elder care that contributes to the problem of under-reporting suspicious deaths: incorrect identification of causes of death, completion of death certificates by doctors who did not examine the body, and infrequent autopsies of elderly decedents.

The authors of the study describe the case of Joseph Shepter, a resident of a California nursing home who passed away in 2007. The chief medical officer stated that his death resulted from heart disease, and the coroner never investigated. Around the time of his death, a staffer at the nursing home reported to state officials that the home was using antipsychotic drugs to “chemically restrain” dementia patients. This led to a fine against the home and an investigation by the state attorney general, including a look at the circumstances of Shepter’s death.

The investigation found widespread abuse and neglect, particularly with regard to Shepter. He had apparently lost nearly twenty percent of his body weight in the three months prior to his death. His cause of death was revised from heart failure to a combination of conditions related to neglect, such as dehydration, sepsis, and pneumonia, all made worse by the use of antipsychotic medications. Two years after Shepter’s death, prosecutors brought criminal charges for homicide against the chief medical officer and two others. His case helps illustrate the three systemic problems identified in the report.

1. Incorrect Causes of Death. States tend to rely on treating physicians to determine whether or not a death is “suspicious” or “natural.” If a treating physicians certifies a death as resulting from natural causes, coroners will not conduct an investigation. The law does not generally consider the possibility that a doctor would incorrectly identify, or even deliberately misstate, the cause of death.

2. Death Certificates, Sight Unseen. Many states allow doctors to complete a death certificate without examining the decedent’s body. Obvious physical signs of abuse or neglect may go entirely unnoticed.

3. Autopsy Ageism. The study found that autopsies are performed on elderly people in ever-decreasing numbers. In one sense, this is rational. The death of an elderly person, while tragic, is neither uncommon nor entirely unexpected, as opposed to the death of a younger person. As a result, elder deaths are often attributed to existing health conditions without much review, leading to physical evidence being overlooked.

Maryland is one of the few states that regularly examines death certificates to determine their reliability. Arkansas passed a law that requires reporting of all elder deaths, regardless of the circumstances. State authorities there have uncovered multiple cases of abuse and neglect that would have gone unnoticed otherwise. Hopefully measures such as these can help identify and hold accountable the facilities that do not provide the quality of care that people expect and that the law requires.

The Maryland nursing home lawyers at Lebowitz and Mzhen represent people who have been injured due to abuse or neglect by staff members. Contact us today online or at (800) 654-1949 for a free and confidential consultation.

More Blog Posts:

Nursing Home Abuse Leads to Fines, Lawsuits in Michigan, Maryland Nursing Home Lawyer Blog, December 27, 2011
Nursing Home Aide Pleads Guilty to Seven Counts of Abuse After Hidden Camera Catches Her, Maryland Nursing Home Lawyer Blog, December 14, 2011
Two Nursing Home Workers Lose Licenses After Alleged Beating of Resident, Maryland Nursing Home Lawyer Blog, December 7, 2011

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