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It was supposed to be a routine trip to the doctor for 83-year-old Bernice Martens. But in the parking lot of the medical center, a caretaker dropped Martens while trying to lift her from the car to her wheelchair. It happened a second time when the caretaker tried to lift her client back into the car.

Less than two weeks later, Martens was dead.

Her caretaker, it was discovered later, wasn't qualified to work directly with clients -- something her employer, Senior Helpers in Bloomington, didn't know because the company didn't do a background check until after firing her.

An investigation by the Minnesota Department of Health into the incident last October found negligence on the part of both the employee and Senior Helpers, and identified three violations of state statute. The employee, who wasn't named, denied to investigators that she dropped Martens and said she thought she used transfer belts, but wasn't sure. The employee was fired two days after the incident.

"We want to extend our sincerest apologies to the family," Senior Helpers owner Mike Johnson said in a statement. "This is an isolated incident and we have a well established reputation of excellence serving this community. We thoroughly trained our caregiver and unfortunately this person did not follow procedure."

It's the only substantiated complaint against Senior Helpers filed with the Minnesota Department of Health since 2008. The company, which operates nationwide, hires caregivers to work with seniors like Martens who lived on their own.

For Martens' family, the findings come too late. The mishandling of Martens by her caretaker contributed to her rapid decline in health and ultimately her death, the family's attorney Mark Niemeyer said.

"She was in very good health," he said. After falling, "she declined in a matter of days."

The family will try to settle with the company out of court, but is prepared to sue, he said.

Only weeks before her death, Martens, 83, had moved from Illinois to an Eden Prairie senior apartment to be closer to her son, Scott Martens, and his family. They hired Senior Helpers caretakers to get Martens to appointments.

On Oct. 25, 2011, Martens' daughter-in-law went with her to an appointment. According to the state report, the Senior Helpers employee arrived to pick her up, but had to get help lifting Martens from her wheelchair to the car. When they got to the appointment, the caretaker attempted to move Martens from the car to the wheelchair and dropped her on the ground. Medical center staff had to help get Martens into a wheelchair. The daughter-in-law reported the incident to Senior Helpers, but after the appointment, the employee dropped Martens a second time trying to lift her into the car.

The caretaker didn't use a transfer belt in any of the three cases, even though Martens' care plan called for it, the report said.

That night, Martens complained of pain to a different caretaker, who noted a "very large" bruise from her waist to arm pit, 6 inches wide. It wasn't reported to a nurse, according to the state.

Two days later, Martens told a staff member she was "in pain all the time" after the two falls. The following day, she was admitted to a hospital with a massive hematoma. She died there a week later, her death certificate citing "aspiration pneumonitis."

A background study is required of staff before direct contact in facilities licensed by the Department of Health or the Department of Human Services. But Senior Helpers didn't submit one for Martens' caretaker until the day after firing her.

"Had [Senior Helpers] conducted the background study prior to the [employee] providing services as required by statute," the state report said, "[Senior Helpers] would have been notified that the [employee] could not provide direct contact with clients."

The state faulted Senior Helpers for failing to follow Martens' care plan, conduct a background study or report the maltreatment to a nurse. It is now in compliance, said Stella French, director of the Office of Health Facility Complaints.

Neglecting to complete background studies on employees is rare, she said, but incidents involving transferring a patient from one place to another are "very common, unfortunately."

Kelly Smith • 612-673-4141 Twitter: @kellystrib