Nurses Charged in Deaths of 12 Nursing Home Residents
Three nurses have been charged with manslaughter and tampering with evidence in the deaths of 12 nursing home residents. The charges come after a 2 year criminal investigation and more arrests are expected.
On Monday, August 26, 2019, three nurses turned themselves in on arrest warrants for the heat-related deaths of 12 nursing home residents. Eight people died on September 13, 2017, at the Rehabilitation Center at Hollywood Hills, after power-outages following Hurricane Irma caused temperatures to soar inside the facility. Several other residents died in the following weeks. The nursing home’s administrator was also charged. All four individuals are charged with manslaughter and tampering with evidence.
The Details
Hurricane Irma hit south Florida on Sunday, September 10, 2017, and caused extensive damage. A transformer, powering the facility’s air conditioning system, blew when a tree fell. The nursing home’s residents were moved to halls, next to fans and spot coolers in response to rising temperatures inside the facility. There were calls made between nursing home employees, state authorities and Florida Power and Light about the air conditioning failure. According to a report from then Gov. Rick Scott’s office, the state advised facility managers multiple times to call 911 if a situation placing a resident in danger arose. However, it was not until after the nursing home’s first 911 call reporting a person in cardiac arrest, three days later, that assistance arrived.
Timeline
The Sun-Sentinel published an article providing a timeline of events on Wednesday, September 13, based on multiple sources. Victims ranged in age from 57 to 99 years old.
3:00 am- 911 call patient in cardiac arrest
4:00 am- 911 called patient in respiratory distress
4:00 am- Patient with breathing problems taken to hospital
4:20 am- 911 called patient in cardiac arrest
4:30 am to 4:45 am- 911 called, patient in cardiac arrest, with 911 still onsite two more patients go into cardiac arrest
5:00 am- hospital employee checks on nursing home and 3 residents found dead
6:30 am - All residents evacuated
It was determined the deaths of 12 patients was caused by heat exposure. The victims ranged in age from 57 to 99 years old.
No Back-up Generator
The rehabilitation center had previously been cited for failing to maintain an emergency generator. The generator was still not in working order when the hurricane hit. Although fans and portable A/C units were used, an engineering expert testified in a deposition that the A/C units were insufficient and actually made the conditions worse. Temperatures on the second floor possibly reached between 100 F and 110 F degrees, far above the 81 F state law limit. When paramedics arrived, many patients were suffering from fever as high as 109 F, or a heat stroke.
Extensive Investigation
The criminal investigation, spanning two years, continues with additional arrests expected in the future. More than 500 people were interviewed and 1,000 pieces of evidence collected, along with 55 computers. Police also collected and reviewed more than 400 hours of video. Other factors contributing to the tragedy include:
Nursing home staff failed to evacuate residents despite being across the street from a fully-functioning hospital.
The facility was not on the “high priority” list with Florida Power and Light for unknown reasons
Temperatures of residents were not routinely assessed and monitored.
Crime scene photos show hand-held gauges recording temperatures inside the facility at 95 and 96 degrees.
Video from inside the facility validated a lack of patient assessment and monitoring.
The facility reported into a statewide monitoring database 17 times since September 7th, however never requested assistance or report the need for evacuations.
Facility advised by the Department of Public Health on Monday, September 10th, to call 911 if they had any reason to believe residents were not safe.
Nurse Behavior
Police officials stated, when announcing the criminal charges, the deaths were all avoidable and due to the behavior and inactivity of facility employees. Officials have also said documentation had been falsified with late added entries to give a false depiction of what actually happened. Questions have also been raised around the employees' preparation for responding during an emergency situation.
Nurse One worked at the facility for less than 3 months but had only worked a total of ten days
Nurse Two was only scheduled periodically
Charge Nurse (in charge of building) had been on the job for about a week
Attorneys for the nursing home reported to the Sun-Sentinel that the facility was fully staffed before and after the hurricane with experienced employees.
A Case of “Waiting on the Cavalry”?
More details will emerge as the criminal investigation continues. Do you think the employees were doing all they could, hanging on until the transformer was repaired? Also, do you think the facility’s administrations lack of preparation contributed to the delayed notification of 911 emergency services?
Most normal people and minimally competent people would call 911 BEFORE their patients cooked to death.
So we criminally prosecute the 4 nurses who were working that day with a patient nurse ratio of at least 35:1 ???? There are a lot of people who "should" have done something but the ones that finally called 911 are the ones we ARE prosecuting!
I'd really like to know what the administrators are being charged with. I firmly believe that they should be bearing the brunt of this. An inexperienced, skeletal staff would in no way be equipped to handle a disaster of this magnitude especially without a plan in place. Off-loading to the hospital across the street was not necessarily a viable option. Just because it was operational doesn't mean they weren't experiencing their own disaster and transferring 140 patients to them even under the best of circumstances likely would have crippled them. I'm reserving judgment on the nurses until I have more details about what they did or did not do.
As a nurse, this is tough. Yes the nurses, no matter how long they were there, had a responsibility to care for the patients and advocate for them. It seems they were not really given the proper things to carry out proper care for the patients. But that doesn’t absolve them from calling 911 when the temperatures started to rise too high. They had a duty to closely monitor the patients vitals often as time progressed and things weren’t getting fixed. But I don’t think the nurses should be the only ones on the hook. Administrators should be right next to them. I would think they would be the most responsible for this. And the chart late entries makes the nurses look bad. Just making a problem worse.
You cannot just transfer even for one patient with just the body of the elderly to the hospital. The hospital won't accept them. They need the history and physical, recent lab works, medication lists, progress notes, allergy list etc that something they can be directed to the care of each patients individually. Considering that all of these patients were transferred to the nearby hospital as soon as the nurses learned about whats going on to the elderly and everyone were given the diagnosis of dehydration and heat exhaustion because the generator didn't work at the facility. Will the hospital can provide the exact treatment plan and intervention just by this information alone. What about that these patients were corrected with their present condition with bolus of NS IV but then some of them might have an underlying condition of CHF. But with bolus of NS is very much contraindicated for patients with CHF. They corrected the present complaints but the patient eventually died because of overloading. So therefore, let alone that transferring all 140 patient to the hospital won't provide solution to the problem if the magnitude of the disaster sets in. It needs a least a one to one level of care before hand as in as an ICU level of care because time is of the essence as in this case where in the elderly were dying so fast. Did the facility were able to provide such staffing at that time instead of 1:35 nurse to patient? This is just one of the factors that we need to consider before charging the heroic deeds of the nurses in the facility where they worked for with the dead beat of the disaster over the roof.
The whole scenario was just the worst case with small amount of resources available to the nurses with quick deterioration of the patients in just a nick of time, 12 patients would have to lose their lives. In addition, the nurses didn't pull the trigger to have this kind of series of events, it was the natural disaster that started it all that the domino effects came about which were beyond their control.
There were 140 patients and only 3 nurses. How closely do you think they could have monitored them.
I don’t think they could have monitored them alone. I made an assumption (could be completely wrong) that they weren’t the only 3 working, rather 3 nurses were charged.
Ordinarily, working as a nurse in the nursing home set up, you would expect that all the patient will be stable and if there are some instances, only one or two patients would be required much needed medical interventions from the hospital so they can be transferred asap. But not this typical day after the calamity, wherein everybody of 140 patients will be critical and needed to be ship out to the hospital. Then eventually, 8 or 9 patients died so quickly that constrained the 4 nurse's ability to take care overwhelmingly without much needed support from other people when the assistance matter the most. This is suppose to be a community effort so that lives could have been saved from unexpected deaths to the vulnerable.
Specializes in Surgical Specialty Clinic - Ambulatory Care.
Oh my god! The charge nurse had been there less than a week and the other two nurses had minimal experience at the facility ????????!!!!!!!!!
This so reminds me of my first year as a nurse and I showed up to work 9 months in on a post op cardiac floor to find myself charge nurse (never trained as charge, didn’t have a damn clue what the responsibilities were), the other two nurses were travelers on their first day on the floor and I was suppose to precept the new nurse. Talk about a ‘what the ***’ kind of day! And I did it because I wasn’t made to feel like I had any option.
I’m sorry to all those people out there who feel like nurses have power to draw a line. I really feel like that power takes 2-5 years to develop and we are often put in litigious situations due to short staffing (and budget monitoring low census days) far sooner than one is developed enough skills and back bone to say no.
So much necessary information missing from this for me to make an honest call on this. But my initial gut is to say it is WAAAYYYY out of line to charge these nurses with murder. Now if it was the CEO of the facility being charged I would feel that is appropriate. Plenty of documentation in this article proving that those at the top running the show weren’t making sure the basics were being managed appropriately WAY before the power went out. Which is really what lead to these deaths. My initial read of this is to pin metals of honor on these nurses for even showing up for duty in such *** conditions. I mean really if they hadn’t been at work how many more would have died? Or would they have had their licenses taken away for not showing up for duty during a disaster? So seems the direction our judgemental butts are going as a profession.
After reading about the after effects of Katrina and the slaughter of many good nurses who had to choose between poop sandwiches and douche bags and then were raked over the coals for doing all they could at the time, I will never come in for a disaster. There is no such thing as Good Samaritan any more, either you be a Perfect Good Samaritan or you shouldn’t even try. No attempt at a good deed will go un punished, especially when someone who has been sitting behind a desk for a decade can read a report about it later and see how you could have done better.
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So we criminally prosecute the 4 nurses who were working that day with a patient nurse ratio of at least 35:1 ???? There are a lot of people who "should" have done something but the ones that finally called 911 are the ones we ARE prosecuting!