Middleboro plagued by third fatal accident in five weeks

David M. Farrell adored his family, loved making people laugh, and had a heart of gold, his sister-in-law said Sunday.

“He had the biggest heart. He was the guy who would give you the shirt off his back,” said Lynne Pina, 49, of Taunton, speaking on behalf of the family Sunday night.

Farrell, 53, a married father of two who worked as a truck driver, was killed late Saturday night in a motorcycle crash, less than a half-mile from his home, at the intersection of North and Oak streets.

Police said Farrell had been traveling south on North Street when he lost control of his Harley Davidson motorcycle and hit a cement water trough at the intersection of North and Oak streets about 11 p.m. Saturday. Farrell, a Taunton native, was on his way home when the accident occurred, his sister-in-law said.

“He was a loving husband, devoted father, caring son and beloved brother,” Pina said. “His sense of humor was hard to match. He loved for people to laugh with him and he would do anything for a laugh or a smile.”

It was the third fatal crash involving a resident of Middleboro, a town of about 23,000 residents, in just over five weeks. And two people died and two more were critically injured in a wrong-way crash on Route 105 in Middleboro on July 4, 2012.

Brian Donnelly happened to be at the scenes of two of those crashes – on Saturday and also on July 4.

Donnelly, who lives at the intersection of North and Oak streets, said he heard a loud scraping sound late Saturday night, then looked outside the window of his home.

He rushed outside while his wife, Melissa, called 911. He saw Farrell laying on his back on the ground. Donnelly said he felt a pulse. Farrell appeared to have a broken ankle but no other visible injuries, Donnelly said.

“I held his neck until the EMTs got here,” Donnelly said, adding that he and his wife watched anxiously as emergency crews administered CPR to Farrell in an ambulance.

Farrell was later pronounced dead at Morton Hospital in Taunton, police Sgt. Deborah A. Batista said. Officer Robert B. Rullo Jr. is investigating the crash.

On July 4, Donnelly rushed to help the victims of yet another horrific crash. That day, a Plympton man, Patrick Adams, 27, was driving in the wrong lane on Route 105 and caused an accident that killed him and Christopher Backman, 47, and left a mother, Linda Millett, 20, and her 5-year-old son, Evan, in critical condition.

Donnelly recalled helping Evan until emergency crews arrived.

“I wasn’t letting him go until the last possible minute,” he said of the young boy.

Saturday’s fatal crash capped an already horrific week after the Boston Marathon bombings, Donnelly said.

“It’s been a very emotional week,” Donnelly said. “We were at the Children’s Museum in Boston on Monday (when the bombings occurred). It’s a lot all at once.”

The town is still mourning the loss of two Middleboro residents in recent crashes involving alleged drunk drivers.

On March 30, college freshman Monica DeMello, 18, was killed in a head-on crash on Route 44 in Lakeville. Prosecutors said the driver of the other car, Kathleen Allen, 23, also of Middleboro, was drunk and on heroin.

On March 9, James Braga, a former Middleboro High School teacher and coach, was killed in a two-car crash at the intersection of Everett Street and Route 44 in Middleboro. Prosecutors said Zachary J. Lemmo, 20, also of Middleboro, was allegedly drunk when he ran a red light and killed Braga.


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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