Workman killed by falling 50-lb. sandbag

SALEM — A Lynn man died Saturday afternoon after being struck in the head by a 50-pound sandbag that fell from a three-story brick building on Washington Street.

Juan Alvarado, 39, was pronounced dead at Salem Hospital at 1:08 p.m. Saturday, according to police Sgt. Kathleen Makros.

Alvarado was a part of a roofing crew with Sosa Construction of Beverly and had been walking near the building at 60 Washington St. when he was struck, Makros said.

Chad O’Connell of Salem was walking down Washington Street near the Dunkin Donuts when he heard cries for help in Spanish.

“I heard the guy scream from behind the truck,” said O’Connell, who works at Count Orlok’s Nightmare Gallery. “I ended up calling the police and ambulance. I don’t think he was even alive when they got there.”

O’Connell could not initially see what had happened because a truck and Dumpster was blocking the view from the street.

When he arrived at the accident, about four other people were surrounding Alvarado, O’Connell said. He first thought the man had fallen from the roof, but later learned the bag had struck him.

O’Connell said he phoned for help; the call came in to police at 12:24 p.m.

Sgt. Marc Berube was the first officer to arrive and started CPR right away, Makros said.

Fire and ambulance would soon follow and continue attempts to resuscitate Alvarado, she said.

“He was gray,” O’Connell said of Alvarado. “He wasn’t with us when they got there.”

Officials from OSHA, the state police and Salem police Detective Sgt. James Page were called to investigate the accident, Makros said. Attempts to reach an official at OSHA yesterday were unsuccessful.

At this time, the death is believed to be an accident, Makros said. It appeared that Alvarado had been in the wrong place at the wrong time, she said.

There was no answer at the Sosa Construction’s number yesterday afternoon.

Victor Sosa Construction is listed at 7 Bailey Ave. in Beverly, with Victor Sosa as its president, treasurer and secretary, according to the Secretary of the Commonwealth’s corporations division.


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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