Resident at Facility Did Not Receive Required Coumadin
Resident neglect at Epiphany Senior Living was cited by the MDH. The Minnesota Department of Health investigated an allegation of maltreatment, in accordance with the Minnesota Reporting of Maltreatment of Vulnerable Adults Act, Minn. Stat. 626.557, and to evaluate compliance with applicable licensing standards for the provider type.
According to the report, the facility neglected the resident when the resident did not receive his coumadin (a medication that thins the blood), for multiple weeks resulting in a hospitalization and death.
The Cause of Death was SubTherapeutic INR Results
The Minnesota Department of Health determined neglect was substantiated.
The Minnesota Department of Health determined neglect was substantiated. The facility was responsible for the maltreatment. Facility staff entered the resident’s coumadin on the resident’s electronic medication administration record (EMAR), then discontinued the coumadin order. The coumadin was sent to the facility by the pharmacy but was discontinued by facility staff and not administered to the resident. The resident missed three weeks of coumadin then had a change in condition, was hospitalized and died. The investigator conducted interviews with facility staff members, including administrative staff and nursing staff.
The investigator contacted the resident’s hospital physician. The investigation included review of the resident record(s), death record, hospital records, pharmacy records, facility internal investigation, facility incident reports, personnel files, staff schedules, related facility policy and procedures. Also, the investigator observed the facility physical plant, medication administration, treatment administration and care being provided with staff interactions.
According to the report, during an interview, the physician stated the resident was supposed to be on lifelong coumadin. The resident’s INR was subtherapeutic (when a person’s blood is clotting faster than the desired rate for their condition) upon admission which led to the resident’s stroke, subsequent seizures, the need for a ventilator for which the resident acquired pneumonia. The cause of the cascade effect was from the stroke that was initiated by the subtherapeutic INR results. During an interview, the resident’s pharmacy obtained, dispensed and delivered the resident’s Coumadin to the facility. During an interview, a family member stated the facility staff were administering the medication ordered by the provider to the resident. A facility nurse reported the resident did not receive coumadin for several weeks.
In conclusion, the Minnesota Department of Health determined neglect was substantiated.
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