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
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
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
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
(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
(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
(2) Each resident receives adequate supervision and assistance devices
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