In July, 2011 Judge Ryan of JAMS
found Lifecare responsible for the injuries to Geraldine McDonald.
He assessed damages of $376,000 against Lifecare of Lynn Massachusetts.
On the evening of June 13, 2008, Geraldine McDonald,
a handicapped wheelchair resident at Lifecare rolled off a curb
outside the facility while the attendant turned and walked away.
She suffered extensive leg fractures. She died 3 weeks later from
Pneumonia.
Prior to the fall she had been stranded outside by Lifecare, unsupervised.
Geraldine's care plan stated requirements needed for her safety:
"proper supervision when going out for a smoke - accompanying
should propel resident's wheelchair while outside facility".
She was a documented safety risk with a "high risk" for
falling.
Geraldine's Condition, History:
Gealdine was totally physically disabled and confined to her wheelchair.
She was completely dependant on Lifecare for her safety She was
incapacitated by extensive rheumatoid arthritis with severe contractures/deformities
of both hands and feet. She had no use of her hands for wheelchair
transport. She was not independent enough to get back inside the
facility by herself. She couldn't open doors.
She was on several psychotropic medicines which Lifecare noted
"affect her abilities to make decisions" and presented
a "high fall risk".
June 13, 2008: Lifecare puts Geraldine in position of danger,
withholds assistance
At approximately 8 PM Instead of returning using the adjacent courtyard
door the receptionist brought Gerry outside the perimeter gate to
go around the long way to the front entrance. The receptionist claims
the door locked her out.
The receptionist left the courtyard and opened the outside gate
directing Geraldine through. Straight ahead lay the nearby curb
which dropped off to a paved parking lot. The receptionist allowed
Gerry to roll down the walkway right off the curb and crash onto
concrete. The aide did nothing to assist her or prevent the fall.
Gerry did not have the ability to stop the wheelchair herself. The
receptionist did not secure the wheel chair brake. Geraldine could
not apply the brake herself.
Geraldine was a "high" safety risk requiring close supervision
Geraldine's Lifecare Assessments continually showed she was a "high"
safety risk Indeed she had burned herself and clothing multiple
times while at the smoking break. Her Care Plan: described her Fall
Risk "problem" as being "at risk for physical injury
from falls related to psychotherapeutic medications and rheumatoid
arthritis". She was classified by Lifecare as a "high
risk for falls" due to severe arthritis, poor balance, and
the use of psychotropic medicines.
Plaintiffs argued Lifecare violated safety regulations:
State regulations regarding patient safety required
(1) "At all times a responsible staff member shall be on duty
and immediately accessible, to whom patients or residents can report
injuries, symptoms of illness, emergencies, other discomfort or
complaint" and
(2) "There shall be a signal system or a hand bell …..
in all patient areas." 105 CMR 150.000.
Federal safety regulation 42 CFR §483.25(h) "Accidents"
requires that
The facility must ensure that -
(1) The resident environment remains as free from accident hazards
as is
possible; and
(2) Each resident receives adequate supervision and assistance devices
to
prevent accidents.
Both the CMS guidelines and the "State Operations Manual"
use the same language to describe this Federal Safety Regulation::
"Identification of Hazards and Risks: All staff (e.g., professional,
administrative, maintenance, etc.) are to be involved in observing
and identifying potential hazards in the environment,
Training of staff, residents, family members and volunteers on the
proper use of assistive devices/equipment(ie wheelchairs etc is
crucial to prevent accidents.
Resident Condition. conditions combined with cognitive impairment
can increase the accident risks of using wheelchairs.
Unsafe behavior, such as failure to lock wheelchair brakes can result
in falls and related injuries;
Any surface that a resident may come in contact with may cause injury,
if the surface is not in good condition and free from sharp edges
or other hazards.
physical plant (e.g., building grounds), hazards include fire doors
that have been propped open, disabled locks or latches, nonfunctioning
alarms, irregular walking surfaces.."
Geraldine suffered for 23 days before she finally succumbed.
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