Police: Speed could be factor in fatal Westport crash

WESTPORT, Mass. (WPRI) — A Massachusetts teenager was killed in a single-car crash in Westport late Thursday night.

According to Westport Police Detective Jeff Majewski, the car left Reed Road at about 11 p.m. and struck a large tree.

Police said an 18-year-old man was driving a grey Mercedes when he skidded off the road, destroyed a mailbox and drove over a front lawn. He then crashed into a tree and his car caught on fire.

Majewski said the vehicle sustained heavy front and driver’s side damage, and the driver was killed as a result of the impact. Excessive speed appeared to have been a factor, the detective said.

“All you can think of is some parent was waiting for him to come home last night,” said Carl Alexander of Westport. “And what they got instead, probably, was a knock on the door.”

Alexander said he heard the collision from inside his home and he ran outside to help the driver.

“I knew right away, I could tell,” he said. “He was gone. Opened the door, checked the breathing, no breathing. Checked the pulse, no pulse. It was awful.”

Skid marks could be seen on the road Friday. The marks on the road drifted right onto Brandon Norcross’ front lawn. He said the crash woke him up.

“I got dressed as quickly as I can. Before I got dressed, my neighbors were already banging on my door,” he said.

Norcross is a professional EMT and he said he ran out to the crash with a fire extinguisher in hand.

“The car was pretty banged up, it was all smashed in – the driver’s side interior was completely on his lap,” he said. “The first thing I thought was to put the fire out and take him out.”

Alexander said he feels so sorry for the family.

“You know, you think of your own children. You think about what the parents gotta be going through. It’s awful,” he said. “He had a graduation tassel hanging – 2015.”

The speed limit on the winding road without streetlights is 25 miles per hour. Neighbors said there have been multiple crashes on that road over the years – and speed limit signs aren’t doing enough to stop them.

“They travel too fast down this road,” Alexander said.

The driver’s identity is not yet being released pending family notification. Majewski said the driver was a Westport native currently residing in Dartmouth.

The crash remains under investigation by the Massachusetts State Police Crash Analysis and Reconstruction Unit and Bristol County District Attorney’s Office.

Anyone with information about the crash is asked to contact the Westport Police Department’s Detective Division at (508) 636-1124.

Source: WPRI

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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