Student Cyclist Struck by Car

Hospitalized with head injury after Comm Ave accident

BOSTON – An 18-year-old BU student was rushed to Brigham and Women’s Hospital with a head injury early Wednesday evening after being struck by a car while riding her bike on Comm Ave at Buick Street.

Witnesses said the victim was in the bike lane when she was hit; she was thrown onto the hood of the car, and her head smashed the windshield.

Police declined to identify the victim.

The driver of the car, a 21-year-old BU student who has lived in the Boston area for four years, was issued a criminal citation for failing to report his address change to the Registry of Motor Vehicles and failing to obtain a Massachusetts driver’s license. The state Department of Transportation requires that drivers whose primary residence is in Massachusetts obtain a license within 30 days of becoming a resident.

According to a report filed by Boston police, the victim was heading west on Comm Ave at about 6 p.m. when she was hit by a 2011 BMW crossing the road from Buick Street.

Eddy Chrispin, a spokesperson for the Boston Police Department, says the impact shattered the car’s windshield. He says the cyclist, who was not wearing a helmet, was taken by ambulance to Brigham and Women’s Hospital, where she is undergoing treatment for a head injury that police say is not life-threatening.

Officers from the Boston Police Department, the BU Police Department, and the Boston Fire Department responded to the call for help. “The woman was conscious and somewhat alert,” says Sgt. Patrick Nuzzi of the BUPD. Nuzzi was flagged down by a BU bus driver who saw the accident. Nuzzi found the victim seated at the curb, talking to a person who identified himself as a doctor. The damaged car was up on the curb, Nuzzi says, and the driver was so emotionally distraught that Boston police had someone drive him home.

Nuzzi says he’s alarmed by the number of cyclists who don’t wear helmets. “I can’t tell you how many people I ask every day, why aren’t you wearing a helmet?” he says. He stresses that cyclists and motorists must learn to share the road. “Drivers aren’t checking their mirrors, and bikes run red lights,” he says. “There’s a lot of ignorance on both sides.”

The intersection at Buick Street and Comm Ave, between Student Health Services and FitRec, is one of several on the Charles River Campus where the road bears a painted “Look Left for Bikes” sign, part of an effort to make drivers and pedestrians aware of the increasing number of cyclists. According to a 2010 study conducted by the University, the number of cyclists on the Charles River Campus increased 64 percent in the previous three years. The Boston Police Department reported 340 bicycle accidents citywide in 2010, including 6 fatalities. The same year, cyclists reported 118 accidents at Comm Ave and the BU Bridge, according to Boston Bikes, a program administered by the mayor’s office. Comm Ave was listed as the most dangerous road in Boston for cyclists in the Boston Bikes annual accident survey for 2009.


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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7 days ago  ·  

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