"Nursing home fined $75,000 in patient's choking death"
Los Angeles Times
State public health officials say the staff at Anaheim Crest Nursing Center failed to immediately treat the man, who had a history of difficulty with swallowing.
By Rong-Gong Lin II
8:14 PM PDT, March 12, 2009
An Anaheim nursing home was fined $75,000 after its staff allegedly failed to immediately treat a patient who choked on part of a sandwich and died, state public health officials said Thursday.
The patient had dementia and a known history of having difficulty with swallowing, officials said. The patient's care plan at Anaheim Crest Nursing Center said he should only be given pureed food.
The state investigation documented two incidents Sept. 9 when the patient ate solid food. At dinner, he was fed an incorrect meal and given a spoonful of vegetables and rice. After he started coughing, a nursing assistant performed the Heimlich maneuver and a "tomato-like" material was coughed up, the state report says, quoting the hospital staff and the patient's daughter. He was subsequently given the correct pureed meal.
Later that evening, a nursing assistant left a food cart within the reach of the patient, and he was able to grab a sandwich and began to eat it, the report says, citing a hospital investigation.
"He took a bite and squashed the sandwich when the [certified nursing assistant] attempted to retrieve the sandwich . . . then he started choking and turning colors," the state report says, quoting the internal probe.
According to the state, there was no documented evidence that the patient received emergency treatment for choking.
But Kathy Hurst, the nursing home's healthcare operations director, said the staff did attempt the Heimlich maneuver, administered cardiopulmonary resuscitation and called 911.
Hurst said the nursing home is appealing the fine, and said that its investigation is not complete.
"We honestly believe there was not a lack of care or assessment to the resident that caused his death," she said. "We believe this was purely an unfortunate accident."
Hurst said the nursing home's administrators initially believed the death was a result of a heart attack, and that they had not been informed the patient had a choking incident just before his death.
After the coroner determined that the patient had choked on a piece of food found in his larynx, a subsequent internal investigation uncovered the second, and ultimately fatal, choking incident, Hurst said.
When asked if there was a possibility that the nursing home's employees lied to its own investigators, Hurst said there was "no proof of that" but that "it is something we may consider." State health officials Thursday also cited Escondido Care Center in San Diego County with a $90,000 fine after investigators determined that inadequate care led to a resident's death. The care center, which declined comment, has signaled its intention to appeal the fine.