Maryland Nursing Home Lawyer Blog

The Risk of Decubitus Ulcers—Resident Abuse and Negligence in Nursing Homes

November 4, 2009 | Lebowitz & Mzhen

Decubitus ulcers, also known as bedsores or pressure sores, are a serious problem in nursing homes today—a leading cause of nursing home injury that affects nearly one million Americans every year. Decubitus ulcers develop when the blood supply to a resident’s skin is cut off, due to unrelieved pressure on the skin, from staying too long in one position without movement or shifting weight.

All stages of decubitus ulcers are preventable, as long as nursing home residents are provided with appropriate care. Elderly residents in nursing homes who are immobile or confined to wheelchairs are some of the most vulnerable to pressure ulcers, and the frequency of these sores can be seen as an indicator of the quality of care in many nursing home facilities. Many advanced decubitus ulcer cases are often the result of nursing home abuse and neglect, and can end in wrongful death.

According to data from the National Nursing Survey from 2004, one out of ten nursing home residents in this country have pressure sores. Of the study’s 1.5 million nursing home residents evaluated, 159,000, or 11%, had pressure ulcers. Around sixty thousand people die each year from complications of some of the more advanced stages of bedsores.

When residents are left lying or sitting for long periods of time in the same position, their skin begins to break down, and pressure sores can quickly develop. Pressure ulcers commonly develop over bony areas that are close to the skin and are less padded by muscle and fat—like heels, ankles, hips, tailbones, shoulders, elbows, backs, and the back of the head. One small irritation can quickly develop into a crater that is painful, difficult to heal, and can become a life-threatening nursing home injury.

Violence in Nursing Homes—Protecting Elderly Residents from Criminals and the Mentally Ill

October 30, 2009 | Lebowitz & Mzhen

In yesterday’s post, our Maryland Nursing Home Injury Attorneys wrote about the difficulty of maintaining resident safety in nursing homes that take in mentally ill patients and violent criminals. Elderly nursing home residents who are often weak and unable to protect themselves from the violent actions of younger, mentally ill patients.

In the Chicago Tribune’s ongoing reporting on security and safety reform in nursing homes, today’s article recommends a serious overhaul of nursing home operations, to better protect elderly residents in nursing homes from the violence of mentally ill residents and convicted felons.

Nursing homes have become known as “dumping grounds” for young and middle aged individuals with mental illnesses, according to U.S. data and Associated Press interviews. The placement of mentally ill patients into nursing homes in this country has increased by 41% between the years of 2002 and 2008, as well as the incidents of nursing home crime and violence.

The Centers for Medicare and Medicaid Services (CMS), released data earlier this year that nearly 125,000 individuals with mental illnesses like schizophrenia, depression, or bipolar disorder lived in U.S. nursing homes last year—many of whom moved directly into homes from jail cells, shelters and psychiatric wards.

According to the Associated Press, many states are mixing the mentally ill with the elderly because the federal government will help pay for resident care under Medicaid regardless of their age—as long as the nursing home’s mentally ill residents stay under 50%.

Nursing Home Rape Leads to Resident Safety Concerns

October 29, 2009 | Lebowitz & Mzhen

A brutal nursing home assault in Illinois recently shed light on an ongoing problem many nursing homes are facing today—how to maintain resident safety in homes that take in violent mentally ill patients and criminals.

In January of this year, a 69-year old female resident of Maplewood care nursing home in Elgin, Illinois was found crying and terrified in her room, moaning in pain. According to police reports, 21-year old Christopher Shelton, a mentally ill patient from the second floor, had assaulted the woman—raping her, as she begged him to stop.

Although psychiatric patients are not an inherent threat in homes, some residents have criminal records, and if not carefully assessed, treated or monitored, can be a big concern for resident safety. At Maplewood, officials had reserved rooms on the nursing home’s second floor for psychiatric patients—but the separation between floors was not safely protected or monitored.

When Shelton, who suffers from bipolar disorder, moved into the nursing home, he had a violent history including an aggravated battery conviction, as well as other aggression related arrests. According to an article in the Chicago Tribune, Shelton was arrested three times last year for alleged offenses that all included nursing home violence.

Before Shelton entered the home at the end of last year, the facility staff didn’t properly check his criminal background, or listen to the director’s warnings from the previous nursing home on his violent and disturbing behavior. After the resident assault and injury, facility officials told the state investigators that Shelton and the woman had been involved in “consensual” sex—a suggestion that the emergency room staff, the prosecutors as well as the police vehemently rejected.

Unnecessary Drugging in Nursing Homes Threatens Lives of Residents

October 28, 2009 | Lebowitz & Mzhen

As Maryland Nursing Home Injury Attorneys, we have been following the Chicago Tribune article published yesterday about an epidemic of unnecessary and dangerous drugging going on in nursing homes—causing nursing home injury and threatening the lives of elderly residents.

The report details that many vulnerable elderly residents in nursing homes are being given strong psychotropic drugs that they neither need or want—leaving them with dangerous side effects like tremors, severe lethargy, and a high possibility for falls or wrongful death.

This review of more than 40,000 federal and state inspection reports found that a wide variety of nursing homes ranging from high end facilities to run down centers, are in violation for improperly treating patients with psychotropic drugs. The violations included chemical restraint, unnecessary drug administering, dosages exceeding safety standards, and cases where dosages led to nursing home resident falls.

Since 2001, the Tribune identified 1,200 nursing home violations that involved psychotropic medications. These infractions reportedly affected 2,900 residents, although the actual statistics are likely to be far higher, as regulation inspections are only enforced once every 15 months.

Congress passed landmark laws protecting patients from unnecessary drugs in 1987—and since then, it is unlawful for facilities to give psychotropic drugs to patients without a doctor’s orders, patient’s consent and treatment justification.

Family Sues Nursing Home for Neglecting Resident’s Penile Cancer

October 27, 2009 | Lebowitz & Mzhen

In a tragic case that our Maryland-based Nursing Home Abuse and Neglect Lawyers have been following, Everett Care & Rehabilitation Center, a Washington state nursing home, is being sued for abuse and negligence, for failing to care for 97-year old resident Charles Bradley—who suffered from an untreated penile infection that allegedly caused his death.

Bradley entered Everett Care & Rehabilitation when he was 93, in the winter of 2004. He lived in the nursing home until two weeks before his death, in March 2008, when Bradley was suddenly taken to the emergency room. Upon admittance to the hospital, doctors discovered a life threatening penile infection that caused his genitals to disintegrate, leaving nothing but a gaping wound. The court documents claim that Bradley’s wound went untreated for months in the nursing facility, and developed into severe penile cancer. Bradley died 18 days after entering hospital.

The lawsuit, filed this month by Bradley’s son in Snohomish County Superior Court, claims that the nursing home allowed the injury to continue to develop for months, without properly caring for Bradley, or reporting the wound to the doctors or family—violating the center’s promise to care and protect for elderly residents. Bradley’s family trusted that the center would provide him with the best care as promised, but they claim the nursing home neglected Bradley’s basic daily needs.

According to the suit, in November 2007, the staff at the nursing home noticed skin breakdown while changing Bradley’s diaper and reported the problem to a care manager, who failed to alert his doctor. Four months after this report, Bradley’s skin continued to break down in his genital region, and he started to lose large amounts of weight. Two weeks before he was taken to the hospital, the staff allegedly reported the skin breakdown one more time, but the managers again ignored the problem. By the time he reached the hospital on March 13, 2008, he was diagnosed with an infected wound, that doctors later diagnosed as severe penile cancer.

Washington State Department of Social and Health Services (DSHS) began investigating Bradley’s case before his death, and issued a citation to the center for failure to follow the quality of care standards required by law. The DSHS claimed that there was no evidence that the home had ever reported Bradley’s condition to the family, the facility’s doctor, or their social services department—necessary for a life-saving intervention. The center was cited and forced to take corrective action.

Advanced Dementia and Nursing Home Error

October 22, 2009 | Lebowitz & Mzhen

Our attorneys at Lebowitz and Mzhen Personal Injury Lawyers, have recently read a study on nursing home residents with advanced dementia, published in the October 15, 2009, issue of The New England Journal of Medicine. According to the report, dementia is not just a disease of the mind, it is a physical illness as well—a leading cause of death in this country, and should be recognized as a terminal illness that requires high quality palliative care.

The report, led by Dr. Susan L. Mitchell from the Hebrew Senior Life Institute for Aging Research in Boston, studied 323 nursing home residents with advanced dementia and their families, in 22 different homes over a period of 18 months. The goal was to better understand the clinical complications of dementia and the families’ comprehension of the dementia prognosis, in order to make the right decisions in patient placement—reducing pain, suffering and nursing home injury and neglect in the final stages of life.

Patients with advanced dementia experience severe memory loss, have difficulty speaking, are restricted to the bed, and are totally dependent on others for care. The report argues that because dementia is consistently not recognized as a terminal illness, patients with advanced dementia are not being diagnosed as high risk for death, and are receiving poor palliative or nursing home care.

Mitchell argues that families need to clearly understand the prognosis of advanced dementia as a terminal illness, and the complications to expect, so patients can receive proper advanced care—like access to a high quality hospice, or improved skilled nursing home services. The goal, states the report, is to avoid patient suffering and pain, as well as nursing home negligence, due to lack of skilled nursing home services and supervision.

Repeat Offender—Nursing Home Charged With Third Wrongful Death Lawsuit This Year

October 16, 2009 | Lebowitz & Mzhen

Our Maryland Nursing Home Injury Lawyers have been following a recent case in which Ruxton Health, a local nursing facility in Virginia, has been charged with another wrongful death lawsuit—the third nursing home injury lawsuit from this year.

Bob Wiggins filed the civil lawsuit last week on behalf of his mother, Lorina Wiggins, who had been under Ruxton Heath’s care for a year when she was brought to the emergency room in March 2008 with deeply infected bedsores. Wiggins, who was 84 at the time, died a week later from complications of these wounds.

This nursing home injury lawsuit claims that one of the seven bedsores that Wiggins developed over the year that she was cared for at Ruxton Health, had become so deeply infected that in the course of three months it exposed her ankle bone.

Bob Wiggins claims in the suit that he was never informed about his mother’s infected bedsores that advanced to a deadly degree during final few months of her life. When he was unable to visit the facility in person, he claims that when we could call to check on her, he was incorrectly reassured by the Ruxton staff that she was doing “fine” and had “no problems”.

When Lorina Wiggins entered the nursing home, she was at high risk for skin breakdown, and according to the suit needed specific nursing home care to prevent any sores or lesions from developing, which included being physically moved every few hours.

The lawsuit is seeking $35 million from Ruxton Health and former nursing home administrator Sue Myatt.

The Wiggins case is the third nursing home wrongful death lawsuit brought against Ruxton Health this year. The first wrongful death lawsuit was filed on behalf of Lillian Funn—who died from skin ulcers and multiple nursing home bedsores in 2008.

Nursing Home Abuse and Neglect Violations

October 12, 2009 | Lebowitz & Mzhen

As Maryland Nursing Home Abuse and Neglect Lawyers, we support the rights for Maryland residents to receive quality care, and be protected with treatment that is free from criminal acts, abuse, and the kind neglect that often results in injury or wrongful death. Under the Nursing Home Reform Act of 1987, all residents living in nursing homes or long-term care living facilities are entitled to receive this quality of care and attention in an environment that improves and maintains their mental and physical health.

Nursing home abuse and neglect occurs when a facility fails to protect and care for the residents, by paying proper attention to situations that could cause harm or pain. In an effort to educate families and consumers, and protect residents’ rights, the National Consumer Voice for Quality Long-Term Care (NCCNHR) publishes a consumer fact sheet aimed to prevent future nursing home abuse and neglect violations. The NCCNHR reports these common violations:

• Poor positioning of the body, which can lead to bedsores and frozen joints.

• Lack of cleanliness, hygiene, and proper toileting—causing incontinence, falls, bedsores.

• Resident malnutrition and dehydration
• Not assisting residents with walking, which can lead to immobility, and falls
• Abuse from a staff member, visitor, or intruder—which can involve using physical force in feeding, while administering medicine, or while moving a resident

• Ignoring, antagonizing, or depriving a resident of adequate needs, which can lead to emotional and psychological abuse.

• Inappropriate sexual touching or forcing residents into performing sexual acts
Other common nursing home injury violations to be aware of include failure to supervise residents adequately, administer proper medication to each resident, and provide patients who are mentally ill or who have dementia with special attention and care.