A nursing home resident in Grand Rapids, Minn., stumbled and broke a leg while being improperly lifted out of bed, then was left in the dining room for lunch without medical personnel being notified, according to a state investigation. The resident died about two weeks later.
The injury to the resident at Evergreen Terrace is being attributed to an aide who helped the resident by herself and did not heed requirements that two attendants and a mechanical lift be used when moving the resident from bed.
An aide "failed to follow the resident's care plan," according to details of the Health Department investigation released Wednesday.
The staff member explained that she "felt rushed" while assisting the resident to the dining room, the report said.
The resident was taken to a hospital emergency room, had surgery and returned to the home five days later, the report said. After another 10 days, the resident went back to the hospital and died.
According to the death certificate, the "primary cause of death was cardiogenic shock possibly related to the fall," the report continued.
Cardiogenic shock is most often caused by a severe heart attack and suddenly prevents the needed amount of blood to get to the heart. While rare, it is often fatal.
As is practice, the Health Department withheld the name of the resident and also did not say when the incident occurred. An investigator made her first visit to Evergreen Terrace in September.
A statement issued Friday by Evergreen Terrace's operator, Welcov Healthcare, said the aide was suspended immediately after the incident and later fired.
Although the nursing home was not held responsible for the resident being injured, it provided training for the aide and the rest of the staff on following residents' care plans and instruction on using mechanical lifts.
Evergreen Terrace is one of 55 facilities operated by Edina-based Welcov Healthcare across Minnesota and five other states.
Paul Walsh • 612-673-4482
