IDPH has cited and fined Assisi Health Care Center at Clare Oaks nursing home in Bartlett after a resident suffered a broken neck in a fall from a wheelchair.
Wheelchairs are like every other piece of equipment in a nursing home setting – usually safe, helpful, and beneficial if well-maintained and used properly. For a wheelchair, this includes things such as having the wheels working properly, functioning wheel locks, a properly fitting seat cushion, and foot rests in place. Without all of those things being true, something as simple as a wheelchair can add an extra level of hazard for a nursing home resident.
The resident at issue here was wheelchair bound, but was able to eat independently, and needed only limited assistance with her activities of daily living. She was able to wheel herself about the facility, something which gave her some degree of independence and added to the quality of her life.
On the day of this nursing home fall, the resident was being wheeled out of the shower. The aide pushing the wheelchair had noticed that the seat cushion was too long for the seat. The foot rests were also not being used. As the resident was being pushed forward, the resident slid forward out of the seat onto the floor. There was immediate bleeding, and the aide left to get a nurse.
The resident was brought to the hospital where she was diagnosed with a fracture of the C2 vertbera (the second one from the base of the skull). She successfully underwent cervical fusion surgery to stabilize and repair the fracture and returned the to the nursing home. However, where she was able to feed herself, wheel herself about the facility, and needed only minimal assistance with her activities of daily living, now she is a total assist with everything.
There were two notable shortcomings in the care that this resident received. First, she was being wheeled about in a chair with a cushion that was too large. How the too-large cushion got there was not addressed in the citation, but the fact is that it was recognized as such before the resident was taken from the shower. Having an ill-fitting cushion leads to an unstable seating surface which creates the potential for this kind of accident to occur. Second, the resident was being pushed without the foot rests in place. Use of footrests would have helped stabilize the resident in the wheelchair and likely prevented the fall. It is also impossible based on the contents of the citation to exclude the possibility that the resident’s feet dropped to the floor, resulting in her being propelled forward out of the chair. Lack of footrests is far more dangerous than would appear at first glance.
The failure to recognize the danger which was which being created here is an indication of a poorly trained staff. Having a poorly trained staff shows a lack of investment in the personnel working at the nursing home. Sadly, this is consistent with the nursing home business model. One of our core beliefs is that nursing homes are built to fail due to the business model they follow and that unnecessary accidental injuries and wrongful deaths of nursing home residents are the inevitable result. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.
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