Voc-Tech student dies in Dartmouth accident

DARTMOUTH — A 16-year-old junior at Greater New Bedford Regional Vocational-Technical High School was killed in a two-car crash Thursday night in Dartmouth as he and his friend backed out of a driveway.

Police investigators are trying to determine what caused the accident which took the life of Alec J. Viera, Dartmouth Police Detective Lt. Robert Levinson said.

On Friday, at GNB Voc-Tech, students and staff were stunned by word of Viera’s death. He was enrolled in the school’s HVAC program.

“We had heard about it early this morning before school,” GNB Voc-Tech Superintendent-Director Michael Shea said. “We had our crisis team in house, meeting immediately, to set up a plan to help our students. We also addressed the students in Alec’s shop first thing this morning.”

Shea said he had spoken to Viera’s parents, who were grief-stricken and not ready to talk to media.

He described Viera as a good student who regularly attended class.

“His mom told me how much Alec loved the school,” Shea said. “He was just an ideal student. He was here every day. He had perfect attendance, no discipline problems. … We loved him being here in the school.

“It’s a very difficult time for many of these kids,” said Shea, who described the mood among some of the students as somber. “For many, it’s the first time they’ve lost a friend. It’s tough. The school will do as much as it can to help them.”

Shea added that grief counselors were made available Friday to students and may be provided Monday, as well.

The deadly crash occurred around 6 p.m. Thursday. The teens were backing out of the driveway at 341 High Hill Road when their 1999 Mercury Mountaineer was struck from behind by an oncoming 2000 Jeep Grand Cherokee driven by a 23-year-old woman from Acushnet, police said.

The impact caused the teens to be ejected from their vehicle, which was spun around. They were not wearing seat belts. The woman’s car traveled a short distance before coming to a stop, police said.

Both teens suffered head injuries and lacerations. They were transported by ambulance to St. Luke’s Hospital, police said.

The woman was also taken to the hospital to be treated for an ankle injury, police said.

Viera was pronounced dead on arrival at St. Luke’s, according to police.

Police have not released the names of the other two people injured in the accident.

According to his obituary, Viera was taking college preparatory classes at Voc-Tech and was an avid Patriots, Celtics and Red Sox fan. He enjoyed playing video games, baseball, basketball and golf. He had just started at BJ’s Wholesale Club in Dartmouth as a cashier.

Viera had four sisters and was the son of Stephanie Torres of New Bedford and Douglas Y. Viera of Assonet. The family has established a memorial scholarship fund in Alec’s name.

Viera’s death occurred days after the U.S. Centers for Disease Control and Prevention released a report showing that teenage traffic deaths declined nearly 17 percent last year for youths ages 15 to 19.

The report said Massachusetts had the lowest teen traffic mortality rate — 4.9 per 100,000 people — but pointed out that motor vehicle crashes remain the leading cause of death for teenagers.

Before Thursday’s accident, Levinson said Viera and his 16-year-old friend had just visited their friend’s house in Dartmouth. The driver — who had just received his license — told police he was planning to drop Viera off at his house in New Bedford before heading home.

State law prohibits 16-year-old motorists from driving with any passengers — other than relatives or licensed drivers over age 21 — for the first six months after getting their licenses.

“That is an issue that we may look at later on but, right now, there is a bigger investigation to worry about,” Levinson said.

The area of High Hill Road where the crash occurred is a fairly long straight stretch with few curves. Dartmouth and state police investigators are conducting an accident reconstruction to determine what caused the collision.

“Was it a matter of speed being a factor or inattention? It’s too early to say right now,” Levinson said.

“That part of High Hill Road is a straightaway. It really wasn’t dark out yet, so it’s kind of odd. We don’t know why someone wouldn’t be able to get out of the way, or if maybe the car backed out too quickly.”

Levinson said the crash investigation will likely take several weeks to complete.


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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