Man killed, 2 hurt in Quincy crash

Drunken driving charges leveled

A Plymouth man is facing drunken driving charges after one man was killed and two others suffered serious injuries early yesterday in a two-vehicle crash in Quincy, authorities said.

State Police spokesman David Procopio said in an e-mail that troopers responded just before 12:30 a.m. to Quincy Shore Drive at Rice Road, where a head-on collision had occurred between a 1995 Ford Explorer and a 2007 Chevy Silverado.

Procopio said the investigation indicates that the driver of the Silverado, Anthony Deicicchi, 28, had been traveling southbound on Quincy Shore Drive when the vehicle moved into the northbound lane and struck the Explorer.

The driver of the Explorer, a 50-year-old man from Jamaica Plain, was taken to Boston Medical Center, where he was later pronounced dead, Procopio said. He said the man’s identity was being withheld yesterday pending family notification.

The victim’s passenger, a 22-year-old Dorchester man, was also taken to Boston Medical Center, along with Deicicchi’s sole passenger, a 27-year-old man from Hull, according to Procopio.

He said both passengers suffered serious injuries. Their conditions could not immediately be determined yesterday.

Procopio said Deicicchi and the passengers were wearing seat belts, but it was unclear whether the deceased was wearing his.

He said troopers determined that Deicicchi was intoxicated but did not specify the degree; they said the evidence was based in part on their observations at the scene.

Deicicchi was charged with motor vehicle homicide while operating under the influence, two counts of operating under the influence of alcohol causing serious bodily injury, operating under the influence of alcohol, negligent operation of a motor vehicle, and marked lanes violation, according to Procopio.

He said Deicicchi is scheduled to be arraigned today in Quincy District Court.

Procopio also had strong words for drunk drivers.

“The State Police will continue to hammer drunk drivers,’’ he said. “It will always be a priority to get them off the roads, but motorists have to realize too that getting behind the wheel buzzed or drunk is like playing Russian roulette, and sooner or later the chamber with the bullet is coming around, and the person who gets hit sometimes is not the one holding the gun.’’

It was not clear yesterday if Deicicchi had hired a lawyer. A woman who answered the phone at a number listed for his relatives in Hull declined to discuss the case.

“We’re just not going to speak to anyone right now,’’ she said. “There are still facts that are not in. . . . I’m sorry, thank you for calling.’’


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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6 days ago  ·  

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