Nursing home fined $80K after patient death

DOWNEY - Downey Care Center, a nursing home at 13007 Paramount Blvd., was fined $80,000 by the state for inadequate care that led to the death of a patient, public health officials announced Tuesday.According to a report by the state Department of Public Health, a patient at Downey Care Center went into a diabetic coma after the facility failed to check the patient's glucose level, despite being aware of her history of diabetes. The patient - identified only as a female - had been admitted to Downey Care Center on four previous occasions starting in 2009, and each time a physician had ordered blood sugar monitoring or insulin dosages. The patient was readmitted in 2010 due to recurrent urinary tract infection with nausea, vomiting and dehydration, according to the report. But the admitting documents did not include medications for diabetes or orders to monitor blood glucose levels. The woman suffered from memory loss and was "moderately impaired" in cognitive skills for daily decision-making, health officials said. After 29 days without blood glucose monitoring, her breathing became shallow and nurses could not obtain vital signs. The nursing home called 911 and paramedics transported her to a local hospital. Doctors said the woman was "deeply comatose clinically consistent with brain death." Family members decided to remove her breathing tube and she was pronounced dead. The cause of death was listed as septic shock, urosepsis, diabetic ketoacidocis and diabetes mellitus type II. Nursing home staff told investigators they did not check the woman's insulin levels because they did not have a doctor's order, the report states. Her blood sugar was checked the day she was transferred to a hospital "because it was an emergency." State health officials are authorized to fine nursing homes up to $100,000. The fine amount is determined by the significance and severity of substantiated violations.

********** Published: February 23, 2012 - Volume 10 - Issue 45