Police seek driver in near-fatal hit-and-run

METHUEN — Police are looking for a dark SUV they said struck and critically injured a young man last night.

Isaias Rivera, 20, of 86 Hazel Street, was fighting for his life last night, suffering from head trauma and internal injuries, after being hit on Woodland Street about 7 p.m.

Police Capt. Randy Haggar said Rivera was transported by ambulance from Lawrence General Hospital to Beth Israel Deaconess Medical Center in Boston because the weather prevented helicopter transportation.

Haggar urged the driver of the vehicle to come forward. He said the vehicle had a Massachusetts license plate.

“With the weather conditions, it’s an explainable accident and whoever’s involved should come forward,” Haggar said.

Eleni Varitimos has lived at 42 Woodland Street for more than 30 years, and has seen more than a dozen car crashes at her house. She figured it was another car accident when she and her husband, Kevin Higginbottom, heard a noise about 7 p.m.

“I said to him, ‘Go look,'” Varitimos said.

Outside was Rivera lying east to west across Woodland Street. Varitimos ran into the street to direct traffic while Higginbottom called 911.

“My concern was that he was going to be hit again because it was so dark,” Varitimos said. “I ran from side to side to stop traffic. It was kind of crazy.”

One driver pulled around Rivera, beeping the horn as he passed.

“I just found the whole scene shocking,” Varitimos said.

She added that many neighbors called out from their houses asking what they could do to help.

“It was kind of like the ying and the yang of good Samaritans,” Varitimos said.

Varitimos described Rivera as a “neighborhood kid.” She said Rivera was unconscious and breathing.

“That’s someone’s little boy and I can’t imagine what that would feel like to get that call,” said Varitimos, who has two boys with Higginbottom.

“It’s just a terrible disregard for another person’s safety,” Higginbottom said of the hit-and-run.

Varitimos and Higginbottom won’t let their two boys play in front of their house. The couple most recently had a car crash near their house last year on New Year’s Eve. The couple said it can sometimes take them between five and 10 minutes to cross the street.

“This is a horrible road,” Varitimos said. “It’s a straightaway. People come up from Lawrence and go bombing down here.”

Haggar said Woodland Street is one of the department’s most highly patrolled streets, and that the police write a lot of citations.


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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