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Cops: Ex-dispatcher hit teen in fatal OUI

FALMOUTH – The morning after her son Jack was pronounced dead at a Boston hospital, Kelly Pearsall watched in Falmouth District Court yesterday as the woman police said killed him — a former police dispatcher — was arraigned on charges of drunken driving and motor vehicle homicide.

“It’s ironic that at the same time she is here, exactly to the minute, my son was donating his heart,” Pearsall said through tears.

Monica Mitchell, 42, of Mashpee is accused of being drunk while driving her Ford Explorer and striking Jack Pearsall, 16, of East Falmouth about 10:30 p.m. Friday as he and a group of friends were leaving the community picnic and fireworks at Mashpee High School, according to court records.

Mitchell, who now works for the Housing Assistance Corporation on Cape Cod, was a Falmouth Police Department dispatcher for three years, said her attorney, Drew Segadelli.

Mitchell hid her face with her hair throughout her arraignment. District Court Judge Joan Lynch released her on personal recognizance.

Segadelli described Mitchell as distraught over the teen’s death. He said it wasn’t clear whether Mitchell realized she had hit something Friday night, “surely there’s no recognition of hitting a human.”

He said she was not at risk of leaving the state, telling Lynch that Mitchell is the mother of a 7-year-old daughter and has family “roots” in the area.

Mitchell is scheduled for an Aug. 10 pretrial hearing. Jack Pearsall, a soccer star who would have been a junior at Falmouth High School in the fall, was hit as he was walking with three friends, authorities said. The survivors told police the SUV swerved and hit Jack near the intersection of Old Barnstable Road and Leather Leaf Lane, court records state.

Two of Pearsall’s friends told police that they had to jump out of the way of the vehicle.

Mitchell allegedly continued driving after the accident until being stopped by Mashpee police as her car sat in a line of traffic leaving the fireworks.

Pearsall was flown by helicopter to Massachusetts General Hospital but was pronounced dead at 10:37 a.m. Monday, court records state.

Mitchell was charged with motor vehicle homicide while under the influence of alcohol and driving to endanger; leaving the scene of personal injury accident resulting in death; a marked-lanes violation; and a separate charge of driving to endanger.

“This is all I have of him,” Kelly Pearsall said outside the courtroom while clutching a tattered piece of her son’s baby blanket. “I have this piece and he has a piece of baby blanket in his hand.”

Source:  bostonherald.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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