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Two New Englanders killed in S.C. plane crash

NORTH MYRTLE BEACH, S.C. — It was a misty midwinter day, perhaps the only real quiet time in an area that attracts 14 million visitors a year, when the whining drone of an aircraft engine could be heard low over the trees.

Multiple explosions then shook the Briarcliffe RV Resort as the single-engine plane clipped a tree, smashed into a camping trailer, and destroyed a car nearby.

The midday accident Tuesday killed a Massachusetts pilot and a woman from New Hampshire on the ground in a trailer.

“It was so low, we knew something desperate was going to happen,’’ said Doreen Boorman, 74, of Fredericton, New Brunswick, Canada, one of thousands of so-called snowbirds who flock to the Carolina coast each year to escape Northern winters.

“It sounded like a NASCAR car, and then, in a split second . . .’’ said Carson Hackney, 72, of French Lick, Ind. The pilot was identified as Kenneth Thode, 62, of Plymouth, who authorities said was practicing takeoffs and landings at an airport about a mile away. The woman was identified as Eva Sullivan, 70, of Sunapee, N.H.

Both Thode and Sullivan were snowbirds. Friends said Sullivan was an expert quilter whose arrived earlier this month with her husband, Thomas, who suffered burns and was hospitalized.

Thode had a vacation home in the area and sometimes flew his plane, a 2004 single-engine Cessna, from Plymouth to South Carolina, said Bill Leppert, a local flight instructor who flew with Thode in the past.

“He was practicing approaches, and everything seemed to be fine,’’ Leppert said. “He had his pilot’s license for at least four or five years.’’

The Sullivans were inside their trailer at the time.

After the plane hit, all was confusion in the park where trailers and RVs sit on concrete slabs near live oak and cypress trees.

“There were two explosions,’’ said Boorman’s husband, Roy. “The truck behind it exploded, and the plane exploded.’’

“There were three explosions, and you couldn’t get close to it,’’ said Michael Norrell, 48, a retiree from Winston-Salem, N.C., who is also staying at Briarcliffe.

“There were four explosions,’’ Hackney said. “Two bottles of gas from the camper over there blew.’’

Jeff Brackett, 66, of Raleigh, N.C., was on a computer in his RV about 20 yards away when the plane crashed.

“I heard this loud rumbling, which I thought was a muffler,’’ he said. “The next thing I know, I heard a boom, then I ran out like everyone else. My instinct was to go see about the pilot, but I couldn’t get any closer because of the billowing black smoke and the heat.’’

Investigators from the National Transportation Safety Board are expected to be on the scene for several days.

On Wednesday, they sifted through twisted metal and shreds of yellow insulation while the plane engine was being hoisted by a crane. Nearby, other debris remained snagged in a live oak.

It was the second time in a year someone has died on the ground in a plane crash in South Carolina.

A man was struck and killed last March on Hilton Head Island as a plane tried to make an emergency landing on the beach.

Three people, a North Carolina couple and their granddaughter, died last summer in North Myrtle Beach when their plane crashed into a mobile home park, slightly injuring two people on the ground.

While RV park guests were stunned by the accident Tuesday, most plan to return to the park.

“The Good Lord was looking out for a lot of people here,’’ said Hackney, adding that the damage could have been much worse if the plane slid through a larger section of the park.

Source:  boston.com


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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