Patient Allowed To Wander From Nursing Home Facility; Falls And Suffers Traumatic Facial Fracture

A 70- year-old female was admitted to a nursing home on February 25, 2012. At the time of her admission and thereafter at all times relevant, the patient had dementia, significant memory loss with minimal recall, confusion, and altered mental status. The nursing home staff knew when the patient was admitted to its facility and thereafter at all times relevant that the patient suffered from these cognitive, emotional, and physical conditions, needs, limitations, and vulnerabilities.

At the time of her admission and thereafter at all times relevant, the patient also was a high fall risk because she was weak, a safety concern, required 24 x 7 supervision, needed close supervision and assistance for safety with standing, transfers, and ambulation, experienced episodes of orthostatic hypertension, had distal tremors, required maximum assistance for functional safety, had poor safety awareness, required frequent/maximum redirection and verbal cues due to confusion, had difficulty judging distances, demonstrated poor motor planning, had ataxic gait with instability, and experienced dizziness. The patient also struggled with problem-solving difficulty, poor foot placement, episodic akinesia, fatigue, and instability. She also had impaired personal safety, was agitated, and required verbal cues even to locate her room within the nursing home. The nursing home staff knew when the patient was admitted to the nursing home and thereafter at all times relevant that she suffered from these cognitive, emotional, and physical conditions, needs, limitations, and vulnerabilities.

The nursing home staff knew when the patient was admitted, during her residency at the nursing home, and when the representations were made that patients just like her had been permitted at the nursing home to exit those nursing homes by themselves without the knowledge or supervision of staff and, on many occasions, sustain injury and die. With full knowledge of those events, the nursing home staff admitted the patient to the nursing home on February 25, 2012 and thereby undertook ongoing responsibility for her care, treatment, supervision, and safety, including her safety from wandering events and injuries.

While a patient at the nursing home, she was noted on May 13, 2012 to be confused. She reportedly packed her belongings to go home on two separate occasions that day, walked the halls, wandered like she was lost, required redirection to her room several times, did not recognize family, tried to put shoes on a roommate who had no feet, was noted to have increased anxiety, and exhibited crying spells.

On May 18, 2012, the patient was noted to be at the exit doors of the nursing home trying to get out. On May 24, 2012, her confusion continued, she was repeating questions, walked the halls from 11 pm to 7 am, and gathered her personal belongings to go home. The next day, on May 25, 2012, the patient’s confusion continued, her daughter expressed concern about her fall risk during times when she was left unsupervised and unassisted, and the nursing home’s staff provided assurances that safety rounds were being made to ensure the patient’s safety. On May 26, 2012, the patient was noted to have a urine culture positive for urinary tract infection.

On May 28, 2012, the nursing home staff allowed the patient to walk unsupervised and unassisted up to and through the exit doors of the nursing home and into the parking lot, where she fell. The patient was able to exit the nursing home without a glimmer of recognition or response by the nursing home staff, which, despite the reported use with the patient of a Wanderguard, failed to respond or intervene to protect her.

After the fall, the nursing home staff picked the patient off the parking lot and placed her in a wheelchair. The patient was noted to have lacerations on her chin and right forearm, as well as abrasions to her nose, right hand, left shoulder, and knees. She complained of pain in her chin and both knees. The patient was transferred to the hospital, where x-rays revealed she sustained a displaced comminuted fracture of the right mandibular condyle and neck as a result of the fall. The patient was not a surgical candidate.





As a result of the fall and fall-related injuries, the patient could open her mouth only 2.5 cm and was required to consume liquids and a mechanically softened diet, for which close supervision was required. She also experienced constant pain in both knees and right hip and wrist, which was worse with movement. She also required physical, occupational, and speech therapy and narcotic pain medications, including Lortab.

The family contacted us to pursue claims against the nursing homes and hospital for failing to provide proper supervision and care to prevent her from wandering and from falling. We were able to obtain a settlement award for the patient’s family.