By Walter F. Roche Jr.
A dementia patient in a state veterans home was severely injured when he drank highly toxic drain cleaner that had been left unattended in a hallway by a maintenance worker at the facility.
According to a report from the state Health Department, the resident at the Southwest Veterans Center in Pittsburgh, drank from a bottle of Drain Rocket that had been left on a maintenance cart in the hallway of the home's dementia unit.
"The facility failed to make certain that residents were protected from an unsafe chemical," the report states.
The resident was taken to the Veterans Hospital on Feb. 26 where he had to be placed in a chemically induced coma and intubated. He was still in the hospital when the March 5 health department report was written.
The chlorinated drain cleaner was highly toxic, the state surveyors reported.
The patient, who had been diagnosed with non-Alzheimers dementia and depression, had been admitted to the 236-bed facility on Nov. 27, 2018 and had a long history of taking food from other patients' trays and stuffing it in his underwear and shoes.
"Resident is not able to be redirected or deterred from this behavior," the report states citing nursing home records.
"Resident becomes incredibly aggressive and agitated if staff members attempt to assist him to rid his clothing and chair of these collected items," according to report.
"Resident had several episodes of aggression towards staff," the report continues.
Using surveillance footage the state surveyors were able to see the patient take the drain cleaner from the cart.
At 2:44 p.m., the report states, the patient took the bottle and drank from it. He immediately yelled for help and spat on the floor and later began to vomit.
He was taken to the Veterans Administration hospital where he was placed in a coma.
According to the report the maintainence employee later acknowledged leaving the drain cleaner unsecured on his cart while he went into a patient's room.
Following the incident, employees of the nursing home made a sweep of the facility to find any other unsecured chemicals and maintenance carts were checked to make sure they were equipped with locked compartments where drain cleaner and other toxic chemicals could be secured, the report states.
In its plan of correction, the nursing home officials said a re-education program was instituted. A private firm, Affinity Health, was hired to conduct the training, according to the report.
Official of the state Department of Military and Veterans Affairs, which runs the state veterans homes, said patient confidentiality rules barred them from disclosing whether the injured veteran recovered.
Joan Nissley, an agency spokeswoman, said the corrective action plan had been fully implemented.
Contact: wfrochejr999@gmail.com
Monday, April 26, 2021
Monday, April 19, 2021
Reading Fireman Dies After Hour + Wait for MD
By Walter F. Roche Jr.
A veteran Reading, PA fireman, in highly critical condition from Covid-19, was kept waiting for over an hour before an emergency physician arrived at his bedside, but it was too late.
The victim, Mark Kulp, 52, died Jan. 5 at Penn State Health - Saint Joseph just as a chest tube was finally being inserted.
"The cardio-thoracic physician failed to arrive in a timely manner," states a report from the state Department of Health.
Though the state report only refers to Mark Kulp as MR1, Wanda Kulp, said the patient was her late husband, who had been admitted in late December and tested positive for Covid-19.
Wanda Kulp said that neither the state or Penn State Health had informed her of the report's completion or release.
She said the family was kept "waiting and waiting."
In fact the report was completed in early March and posted on the state Health Department web site last week. The department generally does not make such reports public until 41 days after their completion.
Penn State Health - Saint Joseph officials did not respond to questions about the report including whether any action was taken against the physician who arrived one hour and 23 minutes after an anesthetist had reported to the scene.
The report states that just as a breathing tube was being inserted, Kulp coded. "The medical staff failed to provide timely medical care to a patient in respiratory distress," according to the report.
The anesthetist had arrived at 5:25 a.m. The unamed cardio-thoracic physician arrived at 6:45 a.m., according to the report.
The tube placement began at 7:22 a.m., the time of Kulp's death.
In its plan of correction, which the state accepted, hospital officials said new policies and procedures were put in place to insure against any recurrence.
"On March 4, 2021, the determination was made that the hospital took sufficient action to ensure hospital staff had a mechanism to follow when a physician did not report in a timely manner to provide emergent patient care," the Health Department report states.
The call for emergency help came early on Jan. 5 when Kulp experienced worsening breathing problems. An intensive care physician ordered an X-Ray which showed a collapsed lung.
"The virtual ICU physician ordered intubation and placement of a chest tube," the report states.
The longtime fireman, Kulp had also worked as an EMT and had transported patients who were diagnosed with Covid-19. His death prompted a large procession from the hospital to a local funeral home with his wife riding on Engine 7, her husband's engine.
In addition to his wife, Kulp was survived by his mother, Louise Kulp, a daughter, Alyssa Luft, a brother, two sisters and two grandchildren.
Contact: wfrochejr999@gmail.com
A veteran Reading, PA fireman, in highly critical condition from Covid-19, was kept waiting for over an hour before an emergency physician arrived at his bedside, but it was too late.
The victim, Mark Kulp, 52, died Jan. 5 at Penn State Health - Saint Joseph just as a chest tube was finally being inserted.
"The cardio-thoracic physician failed to arrive in a timely manner," states a report from the state Department of Health.
Though the state report only refers to Mark Kulp as MR1, Wanda Kulp, said the patient was her late husband, who had been admitted in late December and tested positive for Covid-19.
Wanda Kulp said that neither the state or Penn State Health had informed her of the report's completion or release.
She said the family was kept "waiting and waiting."
In fact the report was completed in early March and posted on the state Health Department web site last week. The department generally does not make such reports public until 41 days after their completion.
Penn State Health - Saint Joseph officials did not respond to questions about the report including whether any action was taken against the physician who arrived one hour and 23 minutes after an anesthetist had reported to the scene.
The report states that just as a breathing tube was being inserted, Kulp coded. "The medical staff failed to provide timely medical care to a patient in respiratory distress," according to the report.
The anesthetist had arrived at 5:25 a.m. The unamed cardio-thoracic physician arrived at 6:45 a.m., according to the report.
The tube placement began at 7:22 a.m., the time of Kulp's death.
In its plan of correction, which the state accepted, hospital officials said new policies and procedures were put in place to insure against any recurrence.
"On March 4, 2021, the determination was made that the hospital took sufficient action to ensure hospital staff had a mechanism to follow when a physician did not report in a timely manner to provide emergent patient care," the Health Department report states.
The call for emergency help came early on Jan. 5 when Kulp experienced worsening breathing problems. An intensive care physician ordered an X-Ray which showed a collapsed lung.
"The virtual ICU physician ordered intubation and placement of a chest tube," the report states.
The longtime fireman, Kulp had also worked as an EMT and had transported patients who were diagnosed with Covid-19. His death prompted a large procession from the hospital to a local funeral home with his wife riding on Engine 7, her husband's engine.
In addition to his wife, Kulp was survived by his mother, Louise Kulp, a daughter, Alyssa Luft, a brother, two sisters and two grandchildren.
Contact: wfrochejr999@gmail.com
Thursday, April 15, 2021
331 Vaccinated PA Patients Get Covid
By Walter F. Roche Jr.
Pennsylvania health officials say that there have been 331 so-called breakthrough cases of Covid-19, cases in which the patient tests positive for the coronavirus even after being vaccinated against the virus.
State Health Department spokeswoman Maggi Barton said the state has reported the 331 cases to the U.S. Centers for Disease Control and Prevention.
She said the 331 tested positive for the virus more than two weeks after being fully vaccinated.
Though complete data from all states is not available, Pennsylvania's appears to be among the highest if not the highest in the country. Michigan has reported 246 cases, while South Carolina has reported 155 and Washington 102. "Breakthrough cases are normal with any vaccine," Barton wrote in an email response to questions.
Nationally the CDC reported there have been some 5,800 breakthrough cases out of 66,000 who have been vaccinated.
The CDC reported that 7 percent or 396 of the breakthrough patients had to be hospitalized and one percent or 74 died.
In Pennsylvania 6,736,568 residents have been vaccinated against the coronavirus., according to the Health Department.
"We know that the more people are vaccinated, and the fewer chances for exposure and infection there are, the less likely we are to see breakthrough cases," Barton said.
Contact:wfrochejr999@gmail.com
Pennsylvania health officials say that there have been 331 so-called breakthrough cases of Covid-19, cases in which the patient tests positive for the coronavirus even after being vaccinated against the virus.
State Health Department spokeswoman Maggi Barton said the state has reported the 331 cases to the U.S. Centers for Disease Control and Prevention.
She said the 331 tested positive for the virus more than two weeks after being fully vaccinated.
Though complete data from all states is not available, Pennsylvania's appears to be among the highest if not the highest in the country. Michigan has reported 246 cases, while South Carolina has reported 155 and Washington 102. "Breakthrough cases are normal with any vaccine," Barton wrote in an email response to questions.
Nationally the CDC reported there have been some 5,800 breakthrough cases out of 66,000 who have been vaccinated.
The CDC reported that 7 percent or 396 of the breakthrough patients had to be hospitalized and one percent or 74 died.
In Pennsylvania 6,736,568 residents have been vaccinated against the coronavirus., according to the Health Department.
"We know that the more people are vaccinated, and the fewer chances for exposure and infection there are, the less likely we are to see breakthrough cases," Barton said.
Contact:wfrochejr999@gmail.com
Wednesday, April 14, 2021
Discharged Behavioral Patient Jumps on Interstate
By Walter F. Roche Jr.
A Pennsylvania hospital with a history of regulatory infractions has been cited for dozens of deficiencies in handling suicidal patients including one who was discharged only to run to a nearby bridge and jump on to an interstate highway.
In a highly critical report on the 249-bed Lehigh Valley Hospital -Pocono, dozens of lapses in the care of behavioral patients were enumerated in detail.
They included several cases in which the hospital failed to assign workers to provide a physician ordered one-on-one watch for suicidal patients, in some cases with dire consequences.
In fact in six of six cases reviewed watchers were not promptly provided for patients considered at high risk for suicide.
"There was a concern serious harm was likely to occur as a result of staff not providing constant direct observation," the report states.
In one case a patient at high risk for suicide who was placed on a one-on-one watch was discovered by chance by a nurse with an EKG cord and oxygen tubing around the neck in a suicide attempt. No watcher had been assigned.
The report by surveyors from the state Health Department said the facility demonstrated "systemic non-compliance" with its duty to "promote and protect each patient's rights."
Another case cited was that of a patient who was brought back to the East Stroudsburg hospital after jumping off a nearby bridge and landing on the interstate highway below.
"It was intentional," the report says of the jump.
So rampant were the infractions that the state surveyors twice during the on-site survey declared a state of immediate jeopardy, forcing the facility to take immediate corrective action.
In a plan of correction hospital officials said staff were re-educated but they acknowledged staffing was limited due to the pandemic. They also attributed the increased patient load in the unit to the pandemic.
Hospital officials did not respond to a series of questions about the report.
In addition to failing to assign watchers, the hospital repeatedly failed to perform initial and periodic assessments of behavioral patients, the surveyors reported.
In another case of faulty discharge planning a patient who was not provided pre-discharge services was returned the same day suffering from an overdose.
Contact: wfrochejr999@gmail.com
A Pennsylvania hospital with a history of regulatory infractions has been cited for dozens of deficiencies in handling suicidal patients including one who was discharged only to run to a nearby bridge and jump on to an interstate highway.
In a highly critical report on the 249-bed Lehigh Valley Hospital -Pocono, dozens of lapses in the care of behavioral patients were enumerated in detail.
They included several cases in which the hospital failed to assign workers to provide a physician ordered one-on-one watch for suicidal patients, in some cases with dire consequences.
In fact in six of six cases reviewed watchers were not promptly provided for patients considered at high risk for suicide.
"There was a concern serious harm was likely to occur as a result of staff not providing constant direct observation," the report states.
In one case a patient at high risk for suicide who was placed on a one-on-one watch was discovered by chance by a nurse with an EKG cord and oxygen tubing around the neck in a suicide attempt. No watcher had been assigned.
The report by surveyors from the state Health Department said the facility demonstrated "systemic non-compliance" with its duty to "promote and protect each patient's rights."
Another case cited was that of a patient who was brought back to the East Stroudsburg hospital after jumping off a nearby bridge and landing on the interstate highway below.
"It was intentional," the report says of the jump.
So rampant were the infractions that the state surveyors twice during the on-site survey declared a state of immediate jeopardy, forcing the facility to take immediate corrective action.
In a plan of correction hospital officials said staff were re-educated but they acknowledged staffing was limited due to the pandemic. They also attributed the increased patient load in the unit to the pandemic.
Hospital officials did not respond to a series of questions about the report.
In addition to failing to assign watchers, the hospital repeatedly failed to perform initial and periodic assessments of behavioral patients, the surveyors reported.
In another case of faulty discharge planning a patient who was not provided pre-discharge services was returned the same day suffering from an overdose.
Contact: wfrochejr999@gmail.com
Subscribe to:
Posts (Atom)