March 21, 2019

By: Mass. Lawyers Weekly Staff

The decedent, a 53-year-old man, received assistance from the defendant behavioral health clinic, which included safety checks twice daily and medication management, as his mental health issues prevented him from functioning normally in society. The decedent also had a history of medication noncompliance.

The defendant developed a crisis intervention plan, which included that the decedent would be visited twice daily and that his medications were to be kept in a lock box. The plan created procedures if the decedent could not be contacted, and mandated that staff was to have access to a spare key to the decedent’s apartment at all times in case of an emergency.

The defendant transferred the decedent’s care to the defendant visiting nurse agency for the home visits. The clinic continued to assure the decedent’s sister, who was his health care proxy, that the decedent was well taken care of and receiving visits twice daily.

Meanwhile, the visiting nurse agency reduced visits to the decedent to once daily and had the decedent self-administer his evening medications. Neither his health care proxy nor his legal guardian was informed of that significant change.

During a Saturday morning safety visit, the visiting nurse noted concern about the decedent’s state of health and recommended an “as needed” evening wellness visit. That evening, another visiting nurse documented four calls and two in-person visits to the decedent’s apartment with no answer.

On Sunday, another nurse made three attempts to contact the decedent, but he was not home. There was no attempt to implement the steps to be taken in the event that in-person contact with the decedent was not made, pursuant to the crisis intervention plan. Nobody contacted the health care proxy or legal guardian.

Fifty-three hours since the decedent last had been seen, the visiting nurse again could not gain entry to the decedent’s apartment. The nurse called the police. Upon entry, police and fire personnel found the decedent in a chair, alive but unresponsive. There was blood underneath him, which turned out to be rectal bleeding. He had labored breathing.

The decedent was transported to the hospital, where he was diagnosed with sepsis. Further, he had necrotic pressure ulcers on his buttocks. He also had hypovolemia, acute renal failure, respiratory failure, lower GI hemorrhage, metabolic acidosis and decubitus ulceration, indicating that he had been sitting in his lounge chair for hours to days.

Emergency ICU interventions were given, but the decedent died two days later from (a) septic shock due to (b) acute renal failure due to (c) superficial pressure necrosis of gluteal skin with infection due to (d) hypovolemic shock secondary to gastrointestinal bleeding.

A wrongful death lawsuit was filed on behalf of the estate of the decedent. The suit alleged poor management of the decedent, failure to perform wellness checks for 53 hours, and failure to communicate.

Action: Negligence and tort

Injuries alleged: Death

Case name: Withheld

Court/case no.: Withheld

Jury and/or judge: N/A (settled)

Amount: $1 million

Date: Feb. 6, 2019

Attorney: David J. Hoey of Law Offices of David J. Hoey, North Reading (for the plaintiff)

 

Original article: https://masslawyersweekly.com/2019/03/21/man-with-mental-health-issues-found-unresponsive-at-home/