The New York State Department of Health (DOH) issued a citation against the Baptist Health Nursing and Rehabilitation Center, a 262-bed facility in Scotia, New York, for failing to provide adequate and timely treatment for a resident’s broken ankle. Due to the facility’s negligence, the elderly woman’s right leg had to be amputated below the knee. According to DOH inspectors, the resident was diagnosed with spinal stenosis, diabetes and peripheral vascular disease. Because the resident was taking multiple medications and was diagnosed with gait and balance problems, the resident’s care plan indicated that she was at risk of falling.
On February 24, 2014, the resident fell while attempting to use the bathroom unsupervised. When the resident complained that her ankle hurt, a physician ordered an X-ray, which revealed that the patient’s right ankle was severely fractured. The next day, the patient was taken to see an orthopedic specialist, who noted that the bones in the patient’s foot were severely separated. The orthopedist ordered that the patient be taken to the hospital, where doctors manipulated the woman’s broken ankle in an attempt to bring the separated broken bones closer together.
The patient was released from the hospital the same day, and the hospital’s care plan indicated that the resident be given pain medication, elevate her leg which had been placed in a splint, and make a follow up appointment with the orthopedist, which was scheduled for March 3, 2014. In the interim, the resident repeatedly told staff members that she was in severe pain. On February 28, 2014, nursing notes indicated that the patient was screaming in pain throughout the day. DOH investigators discovered that staff members failed to inform a physician about the woman’s increased pain and also failed to adequately assess the woman’s broken ankle.
When the resident visited the orthopedist a few days later, the doctor stated that she would need to undergo surgery. On March 7, 2014, the surgeon determined that much of the tissue on the elderly woman’s ankle had died, a condition known as necrosis. The surgeon noted that a large hole in the woman’s ankle exposed a piece of bone. As a result, the doctor needed to amputate the woman’s leg below the knee. A nursing home physician told DOH investigators that he should have been informed sooner about the patient’s increased pain.
Another incident uncovered by the DOH revealed that the nursing home failed to address another resident’s severe pain. Had staff members taken the resident’s complaints seriously, they would have discovered that the woman had a broken hip that was untreated for three days. On March 12, 2014, a dementia patient who fell reported that her hip hurt. However, a physician who reviewed the patient’s X-ray determined that her hip was not broken. For three days, the woman cried out in pain whenever staff members attempted to move her. The physician finally agreed to send the patient to the hospital, where doctors determined that the woman’s hip was broken.