Choking and Asphyxiation Can Often Be Preventable Neglect
Choking Asphyxiation Lawyer. Nursing homes and other providers that take on the service of providing respiratory specialized services, tube feeding, and tracheostomy care must provide the services commensurate with the standards of care. Common issues which cause residents to suffocate, choke, or have obstructed breathing include a failure to suction tracheal tubes as required resulting in bolus or mucus which causes an obstruction. Another common cause of residence choking is an improper diet or food that is served which is not consistent with a residents ability to consume it such as steak, Brussel sprouts, hot dogs, and even bread. Residents need to be assessed for risks that may cause them respiratory distress and interventions taken to reduce the likelihood of an occurrence.
Residents can also suffer from aspiration due to aspirational pneumonia. This condition if unmonitored can also lead to serious outcomes. Facilites need to assess resident risks and take interventions to reduce the change of aspiration.
Facilities Must Ensure Specialized Care Are Provided According to Standards
Pursuant to 42 CFR 483.25 (i) Respiratory care, including tracheostomy care and tracheal suctioning. The facility must ensure that a resident who needs respiratory care, including tracheostomy care and tracheal suctioning, is provided such care, consistent with professional standards of practice, the comprehensive person-centered care plan, the residents’ goals and preferences, and § 483.65 of this subpart.
According to 42 CFR § 483.65 Specialized rehabilitative services.
(a) Provision of services. If specialized rehabilitative services such as but not limited to physical therapy, speech-language pathology, occupational therapy, respiratory therapy, and rehabilitative services for a mental disorder and intellectual disability or services of a lesser intensity as set forth at § 483.120(c), are required in the resident’s comprehensive plan of care, the facility must—
(1) Provide the required services; or
(2) In accordance with § 483.70(f), obtain the required services from an outside resource that is a provider of specialized rehabilitative services and is not excluded from participating in any Federal or State health care programs pursuant to section 1128 and 1156 of the Act.
(b) Qualifications. Specialized rehabilitative services must be provided under the written order of a physician by qualified personnel.
Pursuant to 42 CFR 483.25 (i) Respiratory care, including tracheostomy care and tracheal suctioning. The facility must ensure that a resident who needs respiratory care, including tracheostomy care and tracheal suctioning, is provided such care, consistent with professional standards of practice, the comprehensive person-centered care plan, the residents’ goals and preferences, and § 483.65 of this subpart.
According to 42 CFR § 483.65 Specialized rehabilitative services.
(a) Provision of services. If specialized rehabilitative services such as but not limited to physical therapy, speech-language pathology, occupational therapy, respiratory therapy, and rehabilitative services for a mental disorder and intellectual disability or services of a lesser intensity as set forth at § 483.120(c), are required in the resident’s comprehensive plan of care, the facility must—
(1) Provide the required services; or
(2) In accordance with § 483.70(f), obtain the required services from an outside resource that is a provider of specialized rehabilitative services and is not excluded from participating in any Federal or State health care programs pursuant to section 1128 and 1156 of the Act.
(b) Qualifications. Specialized rehabilitative services must be provided under the written order of a physician by qualified personnel.
According to 42 CFR § 483.25 (g) Assisted nutrition and hydration. (Includes naso-gastric and gastrostomy tubes, both percutaneous endoscopic gastrostomy and percutaneous endoscopic jejunostomy, and enteral fluids). Based on a resident’s comprehensive assessment, the facility must ensure that a resident—
(1) Maintains acceptable parameters of nutritional status, such as usual body weight or desirable body weight range and electrolyte balance, unless the resident’s clinical condition demonstrates that this is not possible or resident preferences indicate otherwise;
(2) Is offered sufficient fluid intake to maintain proper hydration and health; and
(3) Is offered a therapeutic diet when there is a nutritional problem and the health care provider orders a therapeutic diet.
(4) A resident who has been able to eat enough alone or with assistance is not fed by enteral methods unless the resident’s clinical condition demonstrates that enteral feeding was clinically indicated and consented to by the resident; and
(5) A resident who is fed by enteral means receives the appropriate treatment and services to restore, if possible, oral eating skills and to prevent complications of enteral feeding including but not limited to aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, and nasal-pharyngeal ulcers.
Contact an Experienced Attorney to Discuss Your Case
If you have concerns about a failure to provide care or notice changes including improper tracheal or respiratory rehabilitative services or other care issues in a nursing home or assisted living facility, contact attorney Kenneth LaBore for a free consultation at 612-743-9048.
