Driver in MBTA Bus Crash Allegedly Lied to Police

The driver of the MBTA bus involved in this weekend’s crash, Shanna Shaw, allegedly lied to investigators about having a cell phone with her when the accident occurred and initially blamed a sneezing attack for the crash, according to an MBTA Transit Police affidavit.

Shaw later admitted to having a cell phone after police heard it ringing in her purse while she was being treated at the hospital, the affidavit said. It said she also admitted to holding it in her hand at the time of the crash, but only after investigators informed her the surveillance video from inside the bus showed the device in her hand. The affidavit said there was an item in her other hand as well, though it is unclear what that item was.

Police included witness accounts from passengers in the affidavit, including one that claimed Shaw was driving too fast as she turned onto the highway overpass. The same passenger said he did not hear the driver sneeze or cough, but that he also didn’t “observe her being distracted.”

Shaw has been cited for speeding, operating to endanger, and impeded operation by MBTA Transit Police. She was also charged with obstruction of justice after allegedly misleading authorities looking into the incident.

Shaw’s public Facebook profile lists the Massachusetts Attorney General’s office as a previous employer. The AG’s office confirmed that a woman of the same name worked there from February 1993 to December 1994.

The affidavit said “there were no calls or texts” around the time of the crash that could be found on the phone itself, but a search warrant obtained by investigators will allow them to search her phone records.

A ban on cell phone use for MBTA bus, subway, and trolley operators has been in place since 2009, according to the transit service’swebsite. The announcement for the ban describes the policy as “zero tolerance” and calls for “immediate suspension and recommendation for dismissal” for any driver found to be violating the rule.

A report from The Boston Globeadded that Shaw, who has worked with the MBTA since 1996, has a questionable driving record in her personal vehicle. In the last 10 years, she has been in at least three at-fault accidents and has been cited for speeding, seat-belt violations, improper passing, and failure to stop, according to RMV records.

The Associated Press reported Shaw will be arraigned on May 27.

Eight people, including Shaw, were taking to the hospital after the crash on Sunday, though none of their injuries were life-threatening.

You can reach me at Follow me @dougsaffir


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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