Trooper, 3 others save man in I-195 crash

Michael Canty, 23, of Mattapoisett is facing charges in this accident on Interstate 195 in Swansea, State Police said.

Michael Canty, 23, of Mattapoisett is facing charges in this accident on Interstate 195 in Swansea, State Police said. (Massachusetts State Police)

July 22, 2010

SWANSEA – Three good Samaritans who helped a state trooper rescue a man from a burning vehicle on Interstate 195 in Swansea yesterday morning said the victim was pulled from the Jeep moments before it was engulfed in flames.

“It went up like a barn fire,’’ said Robert Flanagan, 61, of Denver.

His brother, George, 63, and Maureen Estes, 56, both of Swansea, had picked up Robert at T.F. Green Airport in Warwick, R.I., and were traveling east on Interstate 195 at about 1 a.m. when they saw a Jeep cross three lanes of traffic in front of them and crash into a tree.

George Flanagan pulled his 2002 Acura over, and the three got out, they said yesterday afternoon at a press conference at the State Police barracks in Dartmouth.

George grabbed a fire extinguisher from his trunk while Robert called 911, they said.

“George is always prepared,’’ said Estes.

Robert said he and George tried to put out the fire, which started in the front of the smoke-filled, overturned Jeep, along with State Trooper Allyson Powell, who arrived within minutes of the call with another fire extinguisher.

She broke the rear window of the Jeep, Robert said.

Robert said the fire was contained for a moment, and he entered the Jeep through the rear window while George and Powell went in through the front passenger side.

The trio worked together to free the driver, he said.

George said after the press conference that the trio moved the driver, identified by State Police as Michael Canty, 23, of Mattapoisett, about 40 feet from the vehicle before it was engulfed in flames.

“If he had been in there another minute, two tops, he wouldn’t have gotten out,’’ George said.

Estes added during the press conference that Canty was in pain after he was freed.

Canty was taken to Rhode Island Hospital, where he was in serious condition last night, the hospital said.

State Police would not detail his injuries.

He is facing charges of operating under the influence, operating to endanger, and speeding, State Police said. Information on his arraignment was not immediately available yesterday.

State Police said in a statement that Powell cut the seat belt Canty had been wearing before he was freed from the Jeep.

“The Department of State Police commends the heroic work of Trooper Powell, as well as the brave actions of Robert Flanagan, George Flanagan, and Maureen Estes, whose help was invaluable,’’ the statement said. “Their actions most likely saved the life of Michael Canty.’’

Powell was treated for minor injuries and released yesterday at Charlton Memorial Hospital in Fall River, police said.

Estes said during the press conference that she feared for everyone’s safety during the rescue.

“But there was a person in the car, so you can’t walk away,’’ she said.

When asked by a reporter whether they considered themselves heroes, the civilian rescuers said no.

Nursing Home Negligence

Falls in Nursing Homes

Litigators who work with cases involving long term care know how significant the issue of falls can be. Falls are the leading cause of injury and death by injury in adults over 65. Approximately half of the 1.6 million nursing home residents in the U.S. fall each year, and a report by the Office of the Inspector General found that about 10% of Medicare skilled nursing residents experience a fall resulting in significant injury; and, more than 1/3 of hospital falls result in injury. In the rehab setting, rates are often higher – for example, fall rates among stroke patients have been shown to be very high. Immobility and falls can lead to poor outcomes.

Fear of falling is defined as a geriatric syndrome. It not only occurs in older adults who have fallen, but in those with impaired mobility and is associated with decreased physical ability and depression. Care of older adults requires that clinicians be aware of the myriad of issues related to falls including knowledge of this syndrome, increased risk and interventions needed to prevent injury related to falls.

Just about every resident in a long term care setting, including assisted living and sub-acute rehab, is at risk for falling. Between medications, functional and medical issues and advancing age, older adults in most settings are prone to falling.

There are well established standards of care related to fall prevention; but, as I continue to review records related to issues like falls, I am amazed at how often these basic standards are not being practiced. The basics of a fall prevention program include assessment and ongoing reassessment of risk, ensuring a safe environment, medication review, providing therapy as needed, individualized interventions, and staff education.

Basic nursing practice includes assessment, planning (Care plan), putting interventions in place and then evaluating outcomes to determine if those interventions are appropriate and effective. Assessment includes completing fall risk assessments on admission and then as needed. Very often, the fall risk assessments completed by nurses in LTC are inaccurate. The tools utilized in long term care typically include these risk factors: history of falling, use of ambulatory aids, gait/balance issues, medications, secondary diagnoses (i.e. diabetes) and mental status. Care planning is the next step in nursing care - it is the standard of care that as the resident’s status changes, assessments and care plans must be updated, and often, are not. For example, with each fall, there should be updates, or if there is a new diagnosis, i.e. stroke, or worsening dementia, updated interventions should be put into place, with ongoing evaluation of effectiveness.

Care planning and interventions very often are generic and not individualized. For example, a toileting schedule that includes only after meals and before bedtime may not be appropriate. If a resident has issues with constipation or incontinence, this may lead to the need for more frequent toileting to prevent falls. The “make certain call bell is within reach” for residents with dementia is an example of a generic intervention. Older adults with dementia may not recognize a call bell or remember to use it. The debate about use of bed and chair alarms go on – they are a part of an individualized care plan, not a solution to preventing falls. Often, I see delays in putting interventions in place, i.e. with the resident who is incontinent NOT being put on a toileting plan immediately. The other common issue I see when reviewing records is the lack of updating care plans as the resident’s status changes – with every fall, with worsening dementia, physical decline, or new medical diagnosis (i.e. Parkinsonism).

Nurses reviewing records need to pay attention to the MDS, risk assessments, care plans and Interdisciplinary notes with attention to where the standard of care is not being met.
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