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Alleged Drunken Accident Near School Leads to Eight Charges

Winchester man faces eight charges, including second offense OUI.

A Winchester man was arrested Thursday after he allegedly fled from the scene of two accidents in Medford while under the influence of prescription drugs and whiskey.

Michael Barrile, 39, of Winchester, allegedly hit a car and a tree with his gray Toyota Corolla in separate accidents on Route 16 and drove off, witnesses told police. The accidents occurred about 3 p.m. Thursday.

The accident with another car took place at the light for the pedestrian cross walk behind St. Joseph School, witnesses said.

Witnesses told police Barrile’s car was driving in the left lane, coming close to on-coming traffic, and he was continually slamming his brakes. It’s the second time Barrile has been charged with driving under the influence, according to police.

Barrile was arrested after Officer Eleanor Whalen, driving eastbound on Route 16, spotted his heavily damaged Toyota parked on the left-hand curb about 3:15 p.m., according to a police report.

When Whelan reached the traffic light near the I-93 off-ramp, another driver pulled along side her cruiser and told her a car in traffic behind her was hitting things and the driver appeared to be “drunk or something,” the report, written by Whalen, said.

Whalen recognized the car as the same one she spotted parked on the curb and got out of her crusier and walked up to it, the report said.

“The front passenger window was smashed and the entire inside of the vehicle was covered in glass piece, including the driver,” Whalen wrote.

Barrile, who had blood on his hand, denied that he had been drinking, the report said.

“I’m just a bad driver,” he said, according to the report.

When Barrile stepped out of the car, he appeared disheveled and wreaked of alcohol, according to the report. There was an opened bottle of Bushmills Irish Whiskey in plain view in the passenger seat, Whelan wrote.

He was given three road-side sobriety tests and allegedly failed them all. A search of his car turned up Adderall, Vicodin, Alprazolam and Xanax, the report said.

An off-duty Somerville Police Officer arrived at the scene, who told Whelan he was at the Nissan Car Dealership and heard an accident on Route 16. Dealership employees told police they also heard the crash and saw Barrile’s car driving away from a tree.

Police recovered pieces of his car on the road behind the dealership, according to the report.

Another witness also came forward to police, who said she saw Barrile’s car hit another car at the pedestrian crosswalk behind St. Joseph School on Route 16 and drive off.

Barrile told police he was on his way home from work in Woburn, the report said. He lives in Arlington, but picks up his mail in Winchester, he told police.

“I get my mail in Winchester,” he said, according to the report. “I love my parents.”

Barrile was arrested on eight charges, including two counts of operating under the influence of liquor, operating under the influence of drugs, three counts of possession of a class E drug, possession of a class C drug, and two counts of leaving the scene of property damage.

He was arraigned in Somerville District Court Friday morning, where he was released on $300 surety. He is expected to appear in court next on Nov. 1 for a pre-trial hearing.

Source:  patch.com


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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