It is both shocking and sad when obvious nursing negligence occurs in Maine. For almost every nursing procedure, there is a standard way of performing the procedure that every Maine nurse is expected to know.

Take, for example, the common nursing procedure of placing a feeding tube in a patient’s stomach. If a patient cannot eat, the doctor will often write an order in the hospital chart telling the nursing staff that the patientis to receive nutrition by a tube that goes in through the nose, down the back of the throat and into the stomach.

Placing the tube is a nursing function that takes place on a routine basis. Sometimes the tube goes in easily, other times it can be difficult to pass the tube into the stomach easily due to the patient’s condition or because the tube gives the patient the feeling of gagging during the insertion and causes the patient to thrash. It is important for all Mainers to know that even if placing a tube is “challenging”, there is not a hospital in Maine that is allowed to deviate from the standard of care in nursing as it relates to insertion of a feeding or “enteral” feeding tube. In fact, if placing a tube is especially difficult in a particular case, it is all the more reason for the nurse to be especially careful.

The most serious potential misadventure of a feeding catheter or nasogastric tube is placement in the lung. If not recognized in time, lung collapse and death may result from placement of a feeding tube in the lung.

This x ray shows a feeding tube in the lung of a 64 year old woman recovering from spinal surgery. ( There is also a nasogastric tube properly positioned in the stomach.) This case illustrates the importance of looking at the lung bases where a feeding catheter is seen passing through the bronchial tree of the right lower lobe and extending well into the right pleural space.

There are simple devices that allow nurses to be 100% sure that the tube is in the stomach and not the lungs. One article describes some modern methods of checking for placement as follows:

Enteral feedings are an integral part of care for many hospitalized patients. Accessing the gastrointestinal (GI) tract safely and in a timely manner can be challenging. Various techniques and devices to enhance the safety of bedside feeding tube placement are available for clinicians. Three specific devices are highlighted, including the colorimetric CO(2) detector (CCD), a magnetically guided feeding tube (MGFT), and the electromagnetic tube placement device (ETPD).

The CO(2) detector is applied to detect the presence or absence of CO(2), thus assisting in correct placement of the feeding tube tip into the GI tract vs the lung. The MGFT uses a magnetic device to manipulate the feeding tube through the GI tract into the small intestine.

The ETPD provides real-time visualization of the feeding tube as it progresses into the small intestine. Training and repetition are essential for safe and successful feeding tube placement, and the highlighted devices can contribute to both of these goals.

As a Registered Nurse as well as a medical negligence lawyer, it is especially disheartening to hear when such a basic nursing procedures is carelessly handled.

Briggs & Counsel has successfully litigated numerous cases of medical and nursing malpractice on behalf of patients. Maine has very specialized laws and procedures for handling medical malpractice cases and few Maine law firms handle medical malpractice on a routine basis as we do.

If you or someone close to you has suffered from the careless actions of nurses at a Maine hospital, attorneys from our firm would be willing to meet with family members individually, or as a family group, to begin the process of sorting out what needs to be done to fix what can be fixed, and make up for the problems that can’t be fixed.

Copyright 2009 Briggs & Counsel

You feel terrible.  You feel beyond terrible. You just found out that your parent or grandparent has been neglected, injured, abused, killed in a Maine nursing home.  It happens.  You can take action, right?  Not so fast.  The outgoing adminstration of George Bush quietly inserted language into federal law that pretends that all those nice Maine people who regulate Maine nursing homes are (even though they are not) federal employees who can’t be forced to tell the truth about what they find out about Maine nursing home safety.  Keith Olbermann blasted the law at the end of a recent MSN “Countdown”  piece.   Think it’s outrageous to silence Maine nursing regulators?  So do we. But it isn’t going to stop Briggs & Counsel from prosecuting cases of nursing home negligence.    If your loved one was injured or died from negligent care at a Maine nursing home, call an attorney who specializes in nursing home litigation.  And write to your U.S. Senator (Olympia Snowe or Susan Collins)  to allow State of Maine employees to tell the truth about what they find at Maine nursing homes.

Copyright 2009 Briggs & Counsel

Alison Wholey Mynick, RN, Esq.

Imagine living in a Maine nursing home and having cancer or arthritis so severe that you cannot get out of bed by yourself.  You rely on the nurses to make sure your pain patch is in place, but the nurses don’t check, and the nursing assistants steal your pain medication.  Imagine that no one comes right away when you press your call light to go the bathroom, and no one comes to help you change your position.  Imagine that you fall out of bed and break your arm trying to get to the bathroom on your own.  And imagine that, because you aren’t positioned by nurses on schedule, you develop a large and excruciatingly painful bedsore that grows deep into your flesh and becomes infected.   All of these images are real examples of injuries caused by nursing home negligence in Maine.  Nursing home negligence caused by understaffing, or poorly trained staff, may cause severe injuries and death to Maine’s most vulnerable population- the nursing home bound elderly.

Families need to know that that their elderly mother, father, aunt, uncle or dear, older friend is safe and well cared for.  How do Mainers scratch the surface of a nursing home that appears clean and pleasant on an introductory tour?  One starting point is to look at a nursing home’s “star rating”. 

The federal government has a five-star rating system. A Maine http://www.medicare.gov/NHCompare/Include/DataSection/Questions/HomeSelect.asp nursing home can obtain up to five stars (much above average) in each of five areas: Health Inspections, Nursing Home Staffing, Quality Measures, Fire/Safety. The lowest ranking possible is one star (much below average).

In Maine, the good news is that 26% of our long term care facilities received the government’s best nursing home score.  However, more than 7% of our nursing homes received the lowest “one star” ranking.

According to officials, the five star rating system is meant to be an accompanying tool for consumers to compare nursing homes, but should not take the place of visits and interviews at the actual facility.  Here’s why:

A Nursing Home may receive five stars for staffing, three stars for inspections, three stars for fire safety, but only one star for quality measures, and still have an overall score of three stars.  Even if a nursing home has an overall three star score, would you want your mother or father exposed to a higher risk of injury, including bedsores and urinary tract infections, than they would encounter at a different nursing home only a half mile away?  When a nursing home tells the federal government that it has great staffing, but also has a high percentage of bedsores, urinary tract infections and depressed residents, the facts speak for themselves.  Nursing homes are only as good as the care they deliver. 

Mainers may see the five-star  rating system as a way to challenge nursing homes to improve the care they provide in the 112 facilities across the state. Maine families considering nursing homes for loved ones should weigh many factors when choosing a long term care facility. The number of stars a nursing home is assigned is just the tip of the iceberg.

Copyright 2009 Briggs & Counsel

It is extremely stressful watching our grandparents and parents grow older. With advancing age comes many new concerns about health, long term care, and losing our loved ones. When they are no longer able to live on their own or be cared for by loved ones, many of us turn to an assisted living facility or nursing home to provide thoughtful and conscientious care.

Many of these facilities can provide great care for our loved ones. Unfortunately, there are many as well that do not. Many are often understaffed with underpaid and poorly trained employees. Many nursing homes push the bottom line so far that they endanger the lives of their patients.

Neglected, abused, and threatened, nursing home residents may suffer physically and emotionally. Painful bedsores, broken bones, or even premature death can result from neglectful and outright abusive treatment.

Visible injuries are the type that you will pick up on right away. Examples are broken bones, cuts, scars, and bed sores.

Neglect type injuries are more subtle and more difficult to see. These include insufficient food, water, and bathing opportunities, failure to change the resident’s underclothes in a timely manner if using the toilet is an issue, failure to supply adequate bathing supplies such as shampoo and soap, failure to properly assist the resident who needs help bathing, eating, walking, and verbal abuse.

If your loved one has fallen victim to abuse or neglect in a nursing home setting, you may wish to seek the legal counsel of Briggs and Counsel.  We have a successfully prosecuted nursing homes that have caused injury to residents through neglectful care.