Bus crash injures UMass students, driver

Vehicle veers off Vt. highway; operator called seriously hurt

PUTNEY, Vt. — A runaway bus carrying University of Massachusetts students on a ski trip to Canada crashed into a roadside embankment and rolled onto its side yesterday, leaving 16 students injured and the driver hospitalized in critical condition.

The tour bus was traveling north in the right lane of Interstate 91 in southern Vermont just before 4 p.m. when it abruptly veered across the four-lane highway, rumbling across a grassy median and two lanes of southbound traffic before crashing to a halt among some trees.

Of the 45 people on board, 17 were injured, authorities said. No other vehicles were involved, and all the students had been released from nearby hospitals by 9 p.m.

Vermont State Police at the scene in Putney, a small town just north of Brattleboro, said the driver did not appear to apply the brakes as the bus lost control.

“I can see clear tread patterns of dirt,’’ State Police Sergeant Michael Sorensen said from the scene. “If the brakes were locked, I would see black marks. I don’t see any black marks.’’

The bus was one of eight bound for a ski trip in Canada. Students on the trip said they had been told the driver had a heart attack.

Sophomore Eva Laznicka, 19, was on the bus that crashed and was transported to Springfield Hospital, where she received stitches on her right hand. She said a passenger sitting in the front remembers the driver going limp, and his head slouching over.

The bus swerved first to the right before veering left across the northbound lanes, into the middle ditch, and into the southbound lanes before flipping over, Laznicka said.

“I didn’t know if we were going to hit another car because we couldn’t see,’’ she said. “I didn’t know when we were going to stop moving. I think people were more in shock about what was happening. People freaked out once the bus flipped over and people were on top of each other.’’

Laznicka said the other buses traveling with her bus pulled over, and passengers in the other buses were trying to cross the highway to help.

Sorensen said the bus remained upright as it rolled over a slightly depressed median. The crash occurred about 5 miles north of Exit 4 on a relatively flat, straight stretch of highway. Road conditions were dry and clear.

“The bus somehow entered the median on its wheels, went into the southbound lanes on its wheels, and was on its wheels when it hit the embankment,’’ Sorensen said from the highway near the overturned bus, which was illuminated by spotlights.

Police closed I-91 southbound at Exit 5 immediately after the accident, according to Stephanie Dasaro, spokeswoman for State Police. I-91 northbound was limited to one lane of travel, where motorists gawked at the overturned bus, which was flanked by more than a dozen police cruisers, firetrucks, and other emergency vehicles with lights flashing. State Police opened both lanes before 7 p.m.

Liz Brown, a spokeswoman for Tour World, a charter bus company in Danville, Pa., said eight of its buses were traveling from Amherst, Mass., to Quebec City.

Shortly after 9 p.m., she said all the students had been released from hospitals and were being taken back to campus.

The other seven buses, all containing UMass Amherst students, continued on to Quebec, she said.

The driver has worked for the company for several years and is reliable, Brown said. “His wife is extremely distraught,’’ she said.

Rescue workers had to cut out the front windshield to extricate the driver, who was not identified, and at least one other passenger, Sorensen said. The driver was taken by helicopter to Dartmouth-Hitchcock Medical Center in Lebanon, N.H., where he was reported in critical but stable condition.

A spokeswoman for Brattleboro Memorial Hospital said eight injured passengers were treated there and released. Others injured were taken to Springfield (Vt.) Hospital, said Barbara Gentry, a spokeswoman for Brattleboro Memorial.

Martin Greenberg, a UMass student, was in the bus that flipped over.

He was among the eight brought to the Brattleboro hospital with what the group was calling “partial injuries.’’ Greenberg said he had a deep cut on his arm, cuts down his back, and a torn ligament in a finger.

He said he was riding in an ambulance with a male student on a stretcher who was having back problems but was conscious and texting. Greenberg also saw a girl who was placed in a stretcher and was “shivering like crazy.’’

After the crash, he said he heard screams. “Some people panicked, but we tried to keep people calm and get the injured people out.’’

“Me and another man helped people get out; we had to get people out of the window, which was about 10 feet off the ground.’’

Four of the students taken to the Brattleboro hospital outpatient center were given bus rides back to campus and the other four received rides home.

“I feel bad for the driver,’’ said Greenberg. “I hope he’s all right.’’

Another passenger, UMass Amherst student Martin Mullis, said he knew that a few people had injuries, but did not know how severe.

“Everybody is kind of shook up,’’ he said. “Nobody wants to talk about it right now.’’
A student in another bus, Chris Martin, said they had been told the driver had a heart attack, and that some injured students had concussions.

The students were on a private ski tour, a UMass Amherst spokesman said. The university was trying to find out how many students were on board and who they were, he said.

“Our working assumption is that there are many UMass students there,’’ said Ed Blaguszewski.

Jack M. Wilson, UMass president, said, “We are delighted that our students are safe and have been released from the hospital. This is the best possible news that the University of Massachusetts could have received at the end of this very trying day. I want to thank everyone who was involved in aiding and treating our students. Our students were the beneficiaries of an outstanding team effort. We are very grateful.’’

Robert Connolly, a UMass spokesman, said the university sent staff from the student affairs office to hospitals to comfort students and assist family members.

On campus, students were unnerved by the crash.

They said the trip was a yearly event for the UMass Ski and Board Club.

“When my dad told me, my stomach just literally hit the floor because my best guy friends all went on the trip, and I hadn’t heard from any of them for a little while,’’ said junior Emma Gray.

Gray later learned they were not seriously injured. “It’s just absolutely devastating this had to happen.’’

“An hour ago I was worried about the assignments I had due next week,’’ said student Peter Vomero. “But now I’m wondering who I know on the trip.’’


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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