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December 11th, 2015 –  1 killed in single-car crash into North Reading home
December 11th, 2015 –  Norwood Resident Killed by Alleged Drunken Driver
December 9th, 2015 –  Wareham soldier killed in motorcycle crash
December 7th, 2015 – Motorcyclist killed in crash with SUV in Boston
December 5th, 2015 – Massachusetts Man Killed After Hit By Tractor Trailer In Plainfield
December 4th, 2015 – Nantucket man killed in driveway accident
December 3rd, 2015 – Woman killed, 3 hurt in Lakeville crash
December 3rd, 2015 – Tractor-trailer, vehicle collide on Route 128 in Beverly
November 28th, 2015 – Three trucks collide on Mass Pike in Auburn
November 27th, 2015 – 1 Dead, 1 Hurt in Head-on Crash in Massachusetts
November 27th, 2015 – Police: Springfield, MA, driver crashes into another motorist on I-91 in Vermont
November 24th, 2015 – (Video) Male Killed After Vehicle Hits 3 Pedestrians in Natick, Massachusetts
November 24th, 2015 – Traffic: 7-car accident causing delays on Massachusetts Turnpike in Oxford
November 20th, 2015 – (Video) Police: Train, Vehicle Crash in Mass.
November 18th, 2015 – Massachusetts man arrested after Pelham, N.H. crash
November 18th, 2015 – Body Found After Hit-and-Run Crash in Leominster, Massachusetts
November 17th, 2015 – Massachusetts man killed in crash on Rt. 146, North Smithfield
November 15th, 2015 – Pedestrian Killed in Crash on I-95 in Dedham, Massachusetts
November 12nd, 2015 – Tractor-trailer driver facing third OUI charge after Route 128 crash
November 12nd, 2015 – Man dies in single-car crash on I-495
November 9th, 2015 – Driver in Fatal Mansfield Car Crash Charged with Drunken Driving, Vehicular Homicide
November 9th, 2015 – Passenger ejected from car, killed in 7-car Stoughton crash
November 8th, 2015 – 3 seriously injured in Interstate 93 rollover crash
November 7th, 2015 – Wrong-way crash kills 2 on I-395 in Thompson
November 7th, 2015 – Fatal crash sends vehicle into Boston’s Charles River
November 3rd, 2015 – Police: Motorcyclist, 39, killed in crash
November 1st, 2015 – Medway High School senior killed in crash
October 31st, 2015 – (Video) 17-Year-Old Girl Killed in Fiery Crash in Franklin, Massachusetts
October 29th, 2015 – (Video) Man killed in rollover crash on I-91
October 27th, 2015 – Woman dead, 2 children injured in head-on crash with cement truck
October 26th, 2015 – Teen driver dies in crash
October 25th, 2015 – Person killed in 2-car crash in Fitchburg
October 24th, 2015 – Conn. man dies in plane crash at Worcester Airport
October 24th, 2015 – 2 Injured in Westport Crash
October 23rd, 2015 – Bicyclist killed in Route 6 crash
October 21st, 2015 – 6 Injured When Pickup, Wheelchair Van Crash in Kingston, Massachusetts
October 20th, 2015 – (Video) Massachusetts school bus crashes in Rensselaer Co., no injuries
October 17th, 2015 – Mass. Man Arrested for DWI, Drugs After Crash
October 16th, 2015 – Woman killed in crash on Route 6 in Westport; man arrested
October 14th, 2015 – (Video) Mass. man arrested in connection with triple fatal crash
October 11th, 2015 – Driver charged after deadly Weymouth crash
October 8th, 2015 – 1 Hurt in Multi-Car Crash on I-93 Near Woburn
October 8th, 2015 – Driver in Milford crash charged with OUI
October 7th, 2015 – Video: Parker Street re-opens after two car crash in Springfield
October 7th, 2015 – Massachusetts woman in critical condition following Derry crash
October 5th, 2015 – Rehoboth teen killed in late-night accident in Somerset
October 3rd, 2015 – Buckland man arrested in connection with fatal three-car crash on Route 2 in Shelburne
September 30th, 2015 – Driver killed in tractor-trailer crash in Lexington
September 27th, 2015 – 2 dead in fiery car crash Sunday morning
September 27th, 2015 – Massachusetts man dies in motorcycle crash in Vermont
September 25th, 2015 – North Attleboro woman dies in Raynham crash
September 23rd, 2015 – Police: Woman Charged with Drunken Driving After Crash with Kids in Car
September 22nd, 2015 – 3 Hurt in Crash in Lowell, Massachusetts
September 20th, 2015 – 4 Car, Fatal Crash on Route 95 in Massachusetts
September 18th, 2015 –Plymouth man killed in rollover crash in Plympton
September 18th, 2015 –Author’s Widow Uninjured in Crash into Hamilton Bank
September 16th, 2015 – Massachusetts man charged after fiery drag-racing crash on Route 195, East Providence
September 16th, 2015 – 4 Car Crash Sends Two, Including Officer, to Hospital
September 13rd, 2015 – Hampden couple injured in I-495 motorcycle crash
September 13rd, 2015 – Car crash on Route 11 kills one, injures two
September 11th, 2015 – Nashua Woman Killed in Crash on I-93 Friday Morning
September 8th, 2015 – Massachusetts man dies of injuries from motorcycle crash
September 8th, 2015 – Massachusetts State Police respond to fatal crash on I-495 in Hopkinton
September 7th, 2015 – Teen injured in Sutton crash, faces drunken driving charge
September 6th, 2015 – Eight injured in crash on Interstate 495 in Mansfield
September 5th, 2015 – (Video) Patients Airlifted After Highway Crash in Mansfield, Mass.
September 5th, 2015 – 3 adults, 5 children seriously hurt in I-495 crash in Mansfield
September 2nd, 2015 – Stoughton Woman in Car Crash Dies from Injuries
September 1st, 2015 – Woman dies from injuries sustained in Worcester ATV crash
August 31st, 2015 – Massachusetts man dies in New Vineyard crash
August 29th, 2015 –Small plane crashes on runway at Minute Man Air Field
August 27th, 2015 – Framingham Teen Killed in Motorcycle Crash
August 25th, 2015 – New Bedford man killed in motorcycle accident
August 25th, 2015 – (Video) Billerica Police officer hurt in crash; driver arrested
August 23rd, 2015 – Woman critically injured in Hudson bike crash Sunday
August 22nd, 2015 – Worcester woman dies in I-190 wrong-way crash
August 21st, 2015 – 2 Injured in Serious Crash in Jamaica Plain
August 18th, 2015 – Motorist injured in West Boylston crash
August 17th, 2015 – 1 Dead, 1 Medflighted After Crash
August 16th, 2015 – Vehicle Crash on Rte. 129 Sunday Night
August 12nd, 2015 – (Video) WMass man sentenced for crash that killed close friend
August 11th, 2015 – Charlton woman who died in car crash loved children
August 10th, 2015 – Elderly woman killed in Hudson crash
August 10th, 2015 – Police-Involved Crash in Marshfield, Mass.
August 9th, 2015 – One dead, two injured in Topsfield crash
August 7th, 2015 – Mother, Two Young Sons Among Those Injured in Thursday Crash
August 6th, 2015 – Family and friends mourn East Bridgewater man killed in motorcycle accident
August 4th, 2015 – (Video) 2 tractor trailers crashed on Mass Pike in Ludlow
August 4th, 2015 – 16 vehicles involved in weather-related pileup on Mass. Pike
August 2nd, 2015 – Massachusetts man dead after motorcycle-truck crash
August 1st, 2015 – 3-Car Crash Snarls Cape Cod Traffic
July 31st, 2015 – Man Dies After Being Thrown From Motorcycle
July 31st, 2015 – Toll collector struck, killed on Mass Pike in Auburn
July 30th, 2015 – (Video) Boston Executive, Daughter on College Trip Killed in Plane Crash
July 28th, 2015 – Two seriously injured in Brockton rollover crash
July 27th, 2015 – One Person Seriously Injured in Main Street Crash
July 26th, 2015 – (Video) Taxi crashes into pizza shop in Springfield’s Upper Hill neighborhood
July 25th, 2015 – Jogger finds body of motorcyclist killed in overnight crash
July 22nd, 2015 – (Video) Truck Flips Over Multiple Times, Damages 6 Cars, 2 Boats
July 22nd, 2015 – Fatal Cape Coral pool hall crash leaves many in mourning
July 20th, 2015 – Passersby save driver from burning car in Plymouth rollover crash
July 20th, 2015 – Millbury motorcyclist killed in crash; second rider charged with drunken driving
July 17th, 2015 – (Video) 1 killed, 1 injured in SUV rollover on I-91 ramp
July 16th, 2015 – Motorcycle passenger in Brookline crash dies
July 16th, 2015 – Massachusetts State Police investigating deadly crash on I-495 in Norton
July 15th, 2015 – Wellesley Mourns Lacrosse Star Killed in Crash
July 14th, 2015 – Tractor-Trailer Crashes Into House
July 13rd, 2015 – (Video) 30 year-old killed in one-car crash in East Longmeadow
July 10th, 2015 – RI cyclist killed in Cape Cod crash, 3 others injured
July 9th, 2015 – 1 Killed, 3 Hurt in Head-on 2-Car Crash
July 8th, 2015 – Route 3A crash kills Scituate man, 74
July 6th, 2015 – Sterling man dies in Mass Pike crash
July 5th, 2015 – 2 Dead After Motorcycle, Car Crash on Route 9
July 4th, 2015 – (Video) One dead after crash involving Chicopee Police cruiser
July 3rd, 2015 – Man killed in southeastern Massachusetts motorcycle crash
July 2nd, 2015 – One Killed In Crash On I-495 In Methuen
June 29th, 2015 – State Police Investigating Serious Crash On I-93 In Wilmington
June 28th, 2015 – (Video) Officials: 3 Killed After Plane Crashes Into House in Plainville, Mass.
June 26th, 2015 – Haverhill Man Killed In Lowell Motorcycle Crash
June 25th, 2015 – Garbage truck crashes into lake in North Andover
June 24th, 2015 – Route 20 crash in Sturbridge claims life of 6-year-old girl
June 22nd, 2015 – (Video) 2 hurt following shooting, crash in Taunton
June 22nd, 2015 – 1 dead after rollover crash in northeastern Massachusetts
June 20th, 2015 – Woman dies in Georgetown I-95 crash
June 19th, 2015 – Woman and 1-Year-Old Injured in Serious Accident on Route 93
June 17th, 2015 – Salem man dies after crash on Route 28
June 16th, 2015 – Barre man killed in Route 49 crash in East Brookfield
June 14th, 2015 – (Video) 2 Injured After Fiery Plane Crash in New Hampshire
June 13rd, 2015 – Wareham Man Seriously Hurt In Bourne Ice Cream Truck Crash
June 13rd, 2015 – Five injured in Route 20 crash in Sturbridge
June 12nd, 2015 – 2 men killed in rollover North End crash
June 12nd, 2015 – Former Patriots LB Brandon Spikes cited in crash
June 7th, 2015 – One Dead in Serious Car Crash on Quincy Avenue
June 4th, 2015 – 2 Hurt In Truck Crash On Mass Pike
June 4th, 2015 – 8-Month-Old Child Dies After Crash
June 2nd, 2015 – Former Conway selectman Bean killed in car crash
June 1st, 2015 – Mass. Maritime student killed in Cape Cod crash
June 1st, 2015 – 8 injured when car crashes into school van in Lowell
May 30th, 2015 Rollover crash on I-93 sends two to hospital
May 29th, 2015 4 hurt in 2 accidents on Mass Pike in Ludlow
May 28th, 2015 Part of Route 146 In Sutton Shut Down After Fiery Crash
May 27th, 2015 State Police Seeking Second SUV in Fatal Crash Investigation
May 26th, 2015 2 People Killed in Mattapoisett, Mass. Car Crash
May 23rd, 2015 One Killed in Crash in Burlington, Mass.
May 22nd, 2015 Passenger Ejected, Driver Also Seriously Hurt in Crash
May 20th, 2015 Brian Tangney Jr., killed in Worcester motorcycle crash, was set to graduate from Quinsigamond Community College Thursday
May 17th, 2015 Cyclist Struck, Killed In Sudbury During Race
May 17th, 2015 State police investigating fatal crash on I-93
November 9th, 2012 – Lynn man struck by falling utility pole files lawsuit
June 19th, 2012 – Tyngsboro school bus driver arrested for OUI after crash
May 11th, 2011 – Widow of man killed in tunnel crash files suit
May 11th, 2011 – (Video) Family blames Big Dig railings for man’s death
April 25th, 2011 – (Video) Slain Social Worker’s Family Suing Facility
April 25th, 2011 – Slain woman’s family sues employer
Nov 5th, 2010 – Flood waters rise as storm winds down
Nov 5th, 2010 – (Video) Pedestrian struck, killed by police cruiser in Chelsea
May 12th, 2010 – (Video) Law suit filed against Methuen teen in hit and run case


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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