IDPH has cited and fined Alden Valley Ridge Nursing Home in Bloomingdale after a resident there had to be hospitalized after experiencing grand mal seizures brought on by a failure to give prescribed anti-seizure medications.
The resident at issue had a history of epilepsy with seizures. When he was discharged from the hospital to the nursing home, there were orders in place and prescriptions written for at least three anti-seizure medications which were to be given twice per day: dilantin, onfi, and keepra. When the resident arrived at the facility, these medications were not on hand and had to be obtained from the pharmacy. These medications were not obtained during the first 36 hours of the resident’s admission to the facility, and as a result, he did not receive his anti-seizure medications.
As a result, the resident experienced two grand mail seizures. The doctor was not notified about the first, and as a result, was not sent to the hospital. After the second occurred, the doctor was notified and the resident was sent to the hospital where labs showed that he had critically low levels of dilantin. He was admitted to to the hospital for several days to stabilize his condition.
Before a resident is accepted for admission to a nursing home, the facility receives a package of materials about the resident which includes a medication list. This is so that the nursing home can determine whether it can meet the care needs of the resident and if they decide to accept the resident, they can order necessary medications. Well-run nursing homes have processes in place to ensure that routine items such as this get handled properly so that critical medications such as this are on hand when the resident arrives. Past that, when there is a critical medication like an anti-seizure medication that is unavailable for a resident, there are processes in place to ensure that the medication is delivered in a timely fashion.
Past that, there were events during this admission which required physician notification. The first of these was the fact that there was a medication error because these was no medication available and that there were multiple missed doses of medication. Had the doctor been notified, the doctor would have had the option of ordering other medications or taking other steps to help the resident maintain his dilantin levels to prevent the seizures. The second of these was the occurrence of the first seziure. When a resident experiences a significant event like that, it requires care regardless. It is also an indication that the missed doses of the anti-seziure medication are having adverse effects on the health and well-being of the resident.
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Other blog posts of interest:
Catastrophic brain injury from medication error at Alden Town Manor
Grove of Elmhurst resident dies due to delay in physician notification
Sharon Health Care Elms in Peoria fails to give anti-seizure medications
Hillside Rehab resident suffers brain bleed due to failure to obtain lab work
Failure to obtain anti-seizure medication at Gilman Healthcare Center
Failure to notify resident physician leads to death at Alden Estate of Barrington
Failure to give anti-seizure medication at Lexington of Orland Park
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