Young Lawyer, Office Manager Killed in Pizza Shop Crash in Newton, Massachusetts

Authorities have identified the victims killed Tuesday night when a vehicle slammed into a pizza shop in Newton, Massachusetts, as a Boston attorney and the office manager of a law firm.

Gregory Morin, a 32-year-old lawyer who lived in the neighborhood, and 57-year-old Eleanor Miele of Watertown, were killed in the crash. Both were at Sweet Tomatoes when a 55-year-old Newton man crashed into the restaurant.

Relatives of the victims are having a hard time making sense of what happened.

“I can’t explain. I’m devastated,” said Miele’s sister-in-law, Patricia Desmond. “I’m just heartbroken.”

Miele’s husband of nearly 38 years, George Miele, was too upset to talk on camera, but told necn he lost his best friend.

Co-workers at the law firm where Miele had been office manager for 12 years said she was just picking up a pizza when she was killed, on her way to do volunteer work at her church.

“A warm, kindhearted person who was always going out of her way to help others in need, we’re all very devastated by this loss,” Miele’s co-worker, attorney Robert Joyce, said.

In Morin’s neighborhood, shock and sadness has set in.

“When this happens in your neighborhood, by the grace of God, go on,” said Nancy McGrath, who lived near him. “I have two kids and they could have been picking up the pizza. It’s just being in the wrong place at the wrong time.”

Morin was a lawyer at Latham & Watkins LLP in Boston. The firm issued a statement Wednesday mourning his death.

“We are deeply saddened by this tragedy,” it read. “Greg was a wonderful colleague and friend to many in Boston and throughout our firm. He was a highly-skilled young lawyer and a compassionate person with incredible spirit and singular wit. Our thoughts and prayers are with Greg’s family and friends, as well as the other victims.”

The driver, 55-year-old Brad Casler, will not be charged, but his license has been revoked.

“I believe he had some type of neurological condition,” said Jack Porter, who says he has known Casler for 10 years and taught him in real estate school.

One of the seven victims injured in the crash is 24-year-old Casey Vaughan of Marshfield, a long-time manager at Sweet Tomatoes.

“She initially thought one of the pizza ovens exploded,” said Jeff Vaughan. “I do believe she was knocked out unconscious. The pizza oven actually is what fell on top of her. One of her co-workers, had at the last second, pulled her away, thankfully – otherwise, she probably would have been crushed.”

He tells necn his daughter suffered a broken leg, second and third degree burns, and had to have staples put in for a large cut to her head.
He added that she had surgery Wednesday and remains in intensive care at Beth Israel.

“She was trying to help the guy next to her while she was trying to get herself out from under the oven and he wouldn’t wake up,” said Jeff Vaughan.

Vaughan says his daughter is in critical but stable condition. She is expected to make a full recovery, but it may takes months or even a year.

Meanwhile, the family of Eleanor Miele is planning her funeral.

Source: NECN

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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6 days ago  ·  

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