Medical Abuse and Neglect in a Nursing Home
Learn which problems are routine and which might be medical abuse and neglect in a nursing home when dealing with medical devices, breathing and tubes, medication, and other areas.
Here is a partial list of medical conditions and complications that may or may not be the result of incorrect medical procedures or care. Be aware of the procedures, treatments or medications your loved one is receiving. Do not be afraid to ask questions of the medical staff as to the benefits they hope to derive from providing them, and how they will know if they are working properly.
Problems with Medical Devices
Nursing homes and assisted living facilities have numerous medical aids for the benefit of their patients. Some of these may fail for a variety of reasons, such as inadequate maintenance, improper use, or incorrect installation. Some examples of devices that may stop working and subsequently cause injury to the patient are: bedrails, a Hoyer Lift, oxygen equipment, infusion pumps, wheelchairs, defibrillators, or ventilators. Nursing home abuse may arise when the equipment is used by inexperienced or distracted staff members, causing pain and suffering, or even death on the part of the nursing home resident.
Clogged Breathing Tubes
A breathing tube (endotracheal tube) which becomes obstructed can cause brain injury or even death within minutes. Breathing tubes can become a medical necessity to provide air for a number of different reasons, including assisting the patient in breathing after a difficult surgery or with a person susceptible to choking. A breathing tube is usually used with a ventilator. This allows mucus to be removed from the patient’s lungs.
Although a breathing tube is normally only used for a few days, it does prevent the person from speaking because it passes through the vocal cords. It also stops the person from drinking or eating. Nutrients are supplied through an intravenous connection.
The breathing tube must be suctioned out periodically, and there is a risk of it becoming displaced. To prevent tampering with the breathing tube assembly, the patient may receive a mild sedative and have his or her hands restrained. If the nursing home staff does not properly monitor or respond appropriately in the time of an emergency, they could be facing successful legal action against them. They should be thoroughly trained in the maintenance of breathing tubes and what emergency actions should be taken if a problem develops.
Feeding Tube Injuries
The preferred method of providing nourishment to critically ill patients is the use of feeding tubes. Even though this is considered a safe technique, it does not mean that there are no dangers in using them.
Today, smaller diameter tubes are used, which are softer and present fewer complications when compared to the older, larger feeding tubes. In addition, they are also more comfortable for patients. The use of the newer tubes has moved away from their insertion into a central vein; however, tracheopulmonary injuries are another problem.
A study involving the placement of feeding tubes showed that qualified personnel had placed a number of tubes and were confident that they were correctly inserted. It was only after x-rays were taken that the tubes were discovered to have been improperly placed.
Although incidents of problems with feeding tubes are small, they can still result in major complications, and sometimes even death.
If a nursing home patient is receiving treatment, medication, or nutrients through the use of an intravenous system, the nursing home has a duty to make certain the needle is properly placed and kept functioning correctly. Needle dislodgement is not an uncommon problem involving dialysis, for instance. If a needle becomes dislodged, routine checks by nursing home staff should be able to correct the problem in a timely manner.
MRSA* Staph Infection
Being a resident in a nursing home is a major risk factor for developing the MRSA staph skin infection. This staph infection is resistant to a number of antibiotics. The media commonly refers to this as the flesh-eating bacteria. In a nursing home, MRSA can change into pneumonia or a blood infection. It is very contagious and is spread by direct contact or by sharing personal items such as a razor.
Covering all abrasions, lacerations, and other wounds with dry and clean bandages until they are healed is a good preventative measure. The key to controlling this infection is treating it very quickly.
Signs of the MRSA staph skin infection might include a bump and the infected area could be red, swollen, warm to the touch, filled with a discharge or pus, or it could be painful. It might also be accompanied by a fever. Many of these symptoms could apply to other conditions making an immediate diagnosis difficult. * (Methicillin-Resistant Staphylococcus Aureus)
The most common cause of infection in nursing home settings is known to be pneumonia. As if that is not serious enough, 30-day fatality rates range from 10-30%. Because of this, prevention of pneumonia must carry a high priority and treatment must be aggressive.
One difficulty in managing this problem is that patients 65 years of age or older are less likely to complain about chest pain, fever, or chills compared to more youthful patients, according to one study. Other research found that three or fewer signs or symptoms were present in 80% of patients who actually had pneumonia. This, of course, hinders discovering the infection early.
For prevention, the Center for Disease Control is recommending a pneumococcal vaccination.
Sepsis (septicemia) and Septic Shock
Sepsis is a blood infection, normally caused by bacteria. It is difficult to diagnose and cure. It can develop quickly and present problems throughout the body. Sepsis can begin from nearly any infection, even something as small as an abscessed tooth. If the infection begins to multiply away from the site of the original infection, it can enter the blood stream and sepsis can be the result. Septic shock is the next elevation when sepsis becomes out of control.
Uncontrolled sepsis is a life-threatening issue and must be dealt with immediately. It can cause an organ to completely fail or weaken the heart and reduce the blood pressure. Chemicals released from the infection can initiate an inflammation in the entire body. Blood clots and leaky blood vessels can be the result. Blood flow is then hindered which reduces the nutrients flowing to the organs. This then leads to septic shock which can result in more organs failing and ultimately causing death.
Common sources leading to sepsis are a surgical area infection, MRSA, bed sores, urinary tract infections, and pneumonia. Elderly patients are one of the high risk groups for exposure to sepsis.
According to the CDC, the number of sepsis cases increased almost 100% between 2000 to 2008. They theorize that this increase could be from more chronic diseases developing, more people attaining an older age, higher resistance to antibiotics, an increase in invasive procedures like organ transplants, or better tracking of these cases.
Also, the fatality rate falls between 28% and 50%, which reflects just how dangerous this disease has become. The mortality rate of septic shock is even higher: 40%-70%.
The usual symptoms of sepsis are a fever, an increased rate of respiration and heart rate, having a hard time breathing, disorientation, confusion, and a rash.
The consequences of a recovery from sepsis are not optimistic. Many people suffer permanent damage to an organ. If someone had a problem with their kidneys before sepsis, it is likely that they would suffer kidney failure and be required to undergo dialysis for the remainder of their lives.
Because of the danger level of dealing with sepsis, you need to make certain that your nursing home or assisted living facility is capable of identifying and treating sepsis. Because sepsis is difficult to identify, early treatment often does not occur. If sepsis is diagnosed in a hospital setting, the patient is usually transferred and treated in an Intensive Care Unit. Make certain your nursing home is constantly on the lookout for sepsis and has a good plan for dealing with it. If you suspect your loved one has been a victim of neglect, call our nursing home abuse lawyers immediately for a free, confidential legal consultation.
Errors in administering medication can involve providing the correct medicine, but either in a higher or lower amount than is being prescribed. It could also be the wrong medication or administered at the wrong time – too frequently, or not often enough.
All medical professionals strive to eliminate such errors, however it is impossible to eliminate every one—humans are involved. Tablets and capsules are color coded and labeled to help reduce any such problem, though errors still occur.
One reason for medication errors can be that the caregiver is just not properly trained. It could also be that the person providing the medication is under a very heavy workload and is just under too much stress. Or, it could simply be from carelessness. Keep in mind multiple medications might adversely interact with one another.
Some patients have been on the same medications and dosages for years. If they have gained, or more likely lost a substantial amount of weight, their dosage may need to be adjusted up or downward to keep them from being over or under medicated. Their doctor should take this into account and review and update dosages as necessary. It is possible that the primary physician has not been properly trained in geriatrics and prescribes the wrong medicine or the incorrect amount. Elders could present special considerations from their health history and require a fine-tuning of dosages.
Medical errors are one of the major causes of U.S. deaths. Be familiar with your loved ones medications and treatments and be sure they are being delivered correctly and on schedule. This area is certainly one that should be examined for legal action if a problem develops.
Nasogastric tube dislodgement: a problem on our ICU and Confirmation of nasogastric tube placement in critical care: https://ccforum.biomedcentral.com/track/pdf/10.1186/cc12120?site=ccforum.biomedcentral.com
http://www.nij.gov/topics/crime/elder-abuse/roundtable/Pages/transcript.aspx (medical abuse and neglect)
https://www.ncbi.nlm.nih.gov/pubmed/11952936 (needle dislodgement)
https://www.cdc.gov/mrsa/community (staph infections)