Cook Community Hospital Cook Complaint Findings for Neglect – Failure to Monitor Insulin Levels
In a report concluded on April 5, 2012, the Minnesota Department of Health cites Cook Community Hospital Cook for neglect of health care.
The allegation is neglect based on the following: false readings for several diabetic Residents #1, #2, #3, #4, #5, #6, and #7 were recorded in the medication administration record by alleged perpetrator (AP#1) and (AP#2). This resulted in some residents not receiving insulin. Resident #2’s blood sugar was noted to be below 80.
Substantiated Complaint Against Cook Community Hospital After Errors With Insulin
According to aafp.org, insulin therapy is recommended for patients with type 2 diabetes mellitus and an initial A1C level greater than 9 percent, or if diabetes is uncontrolled despite optimal oral glycemic therapy. Insulin therapy may be initiated as augmentation, starting at 0.3 unit per kg, or as replacement, starting at 0.6 to 1.0 unit per kg. When using replacement therapy, 50 percent of the total daily insulin dose is given as basal, and 50 percent as bolus, divided up before breakfast, lunch, and dinner. Augmentation therapy can include basal or bolus insulin. Replacement therapy includes basal-bolus insulin and correction or premixed insulin. Glucose control, adverse effects, cost, adherence, and quality of life need to be considered when choosing therapy. Metformin should be continued if possible because it is proven to reduce all-cause mortality and cardiovascular events in overweight patients with diabetes. In a study comparing premixed, bolus, and basal insulin, hypoglycemia was more common with premixed and bolus insulin, and weight gain was more common with bolus insulin. Titration of insulin over time is critical to improving glycemic control and preventing diabetes-related complications. (Am Fam Physician. 2011;84(2):183-190.
For more information from the Minnesota Department of Health, Office of Health Facility Complaints concerning nursing homes, assisted living and other elder care providers view resolved complaints at the MDH website.
If you have concerns about neglect of health care or any other form of elder abuse or neglect contact Minnesota Elder Abuse Attorney Kenneth LaBore at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.