WRONGFUL DEATH

A middle aged male with esophageal cancer was admitted to a hospital for insertion of a jejunostomy tube in the small intestine for nutrition, medication administration and hydration. The surgeon, in order to prevent anyone from inflating the balloon of the Foley catheter used for this purpose, cut the insertion port and instructed all of the nursing staff at the hospital on the proper care of the jejunostomy tube. He tells them that inflating the balloon would result in perforation of the small intestine and possibly the patient’s death.

The patient was later transferred to a sub acute rehabilitation facility where he was to work on strengthening prior to going home. The admitting RN notes the feeding tube as a gastrostomy tube and gets orders accordingly. Later that week, there was a problem with the tube, the patient reported a “pop” and was subsequently transferred to the ER where he later died. Based on the CLNC’s initial screening of the case, the nursing home, the admitting nurse and the LPN are sued for wrongful death of the patient. The hospital is also named a defendant for lack of instruction to the nursing home on care of the J-tube, which resulted in his death. The family was awarded $25 million for malpractice issues resulting in wrongful death.

TAMPERING AND FRAUD

An elderly nursing home resident with severe dementia, CHF, Diabetes, Chronic Renal Failure, and COPD was totally dependant on staff for care, including bathing, dressing, toileting, transfers, eating and bed mobility. A new nursing assistant notices a dark bruise on the resident’s body and alerts the nurse. Later that day the resident died.

An autopsy was done and indicated the resident fell within hours of the death, and the family sued the facility. Review of the medical records revealed no documentation about the bruise or the fall. The nursing home and nurses were found guilty of tampering with the medical record and for the wrongful death. The administrators are serving 10-year prison sentences.

RESPIRATORY FAILURE

A young home care patient was confined to the home, and on continuous oxygen via a tracheostomy for Pickwickian syndrome, a multi-system disease process where there is an excessive amount of fatty tissue, especially around the respiratory system. The home care Case Manager noted the client’s pathways were clear, and there was no clutter from room to room.

The person coughed hard and expeled the trach tube while home alone. Following the instruction received in the hospital years before, he tried to replace the trach tube, like he’s done before. Unfortunately, he runs into trouble and calls 9-1-1. When the fire department arrives, they find him pulseless and non-breathing on the floor, and initiate CPR. The CLNC’s initial screening and research in Pickwickian syndrome showed no merit for proceeding with court because the scenario is a common result for people with the unfortunate disease process.