T bus driver charged in drunken driving crash that injures Chinatown man

An MBTA bus driver was ordered held on $500,000 cash bail today after hitting a 68-year-old man in Dorchester last night while driving with a blood alcohol level more than three times the legal limit, prosecutors said.

Kathleen Abban, 39, of Dorchester, was charged with operating under the influence as a second offense, operating under the influence causing serious bodily injury, leaving the scene of an accident causing personal injury, leaving the scene of an accident causing property damage, and negligent operation of a motor vehicle, Suffolk District Attorney Daniel F. Conley’s office said in a statement.

Abban was arraigned in Dorchester District Court. If she posts bail, she will have to remain alcohol-free and submit to random testing. A not-guilty plea was entered on her behalf, prosecutors said.

She will return to court Jan. 27.

Abban was driving on Old Colony Avenue near the JFK/UMass Red Line station last night when she struck the Chinatown man, prosecutors said.

A witness at the scene told State Police a black SUV traveling at about 35 miles per hour struck the man, sending him “flying into the air.” The SUV continued driving, slammed into a guardrail, and drove toward the JFK/UMass Station, prosecutors said.

State Police stopped a vehicle matching that description and brought the driver, Abban, back to the scene. Abban reeked of alcohol and told officers she had had “way too many” drinks at a South Boston bar, prosecutors said.

Abban failed multiple sobriety tests. She could not recite the alphabet past the letter “F,” could not stand on one leg, and could not walk in a straight line. She blew a chemical breath test of 0.25. The legal limit is 0.08, prosecutors said.

The victim was transported to Boston Medical Center, where he remains in intensive care, prosecutors said.

Abban is an MBTA bus driver, but was behind the wheel of a private vehicle, not a T bus at the time, according to Kelly Smith, MBTA spokeswoman. Smith said Abban has been a T bus driver since 2003, and is now on unpaid leave pending an investigation by the MBTA.

Abban’s commercial driver’s license – which she needs in order to drive an MBTA bus — was revoked by the Registry of Motor Vehicles because she failed the chemical breath test given to her after the crash. Her standard driver’s license was also suspended for 30 days for the same reason, according to Mike Verseckes, spokesman for MassDOT.

Abban was investigated for drunken driving and her license was suspended in 2007 following a 2006 crash in Braintree. She was later held civilly responsible in the crash, according to RMV records. The drunken driving case was continued without a finding after she attended and completed a drunk driver’s education course, according to RMV records.

Abban was also involved in surchargeable crashes in 2001, 2005 and 2010 in addition to the Braintree crash, according to the RMV records.


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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