Elderly Patient Dies During Transport From Nursing Home to Hospital

This case involves a ninety-two-year-old male resident of a nursing home facility who presented to the emergency room with altered mental status and confusion. The patient had recently been hospitalized for Legionella pneumonia, chronic kidney disease, and congestive heart failure. The paramedic report stated that, upon arrival at the nursing home, the staff said that the patient became less responsive and increasingly confused. The staff, however, waited several hours before calling 911. EMS personnel confirmed decreased responsiveness and documented a heart rate in the thirties to forties en route to the hospital. The patient went into asystole and CPR was performed for twenty minutes until the patient was declared dead on arrival by the ER physician. The cause of death was determined to be cardiac arrest secondary to congestive heart failure.

Question(s) For Expert Witness

1. Should this patient have been transferred to the hospital sooner?

Expert Witness Response E-004768

Absolutely, this elderly patient was showing the classic signs of altered mental status that was most likely to due the renal impairment and toxins that were building up in his blood. The decision to delay his transport to a qualified hospital environment to treat an impending disaster is definitely negligent on the part of the nursing home. The outcome would have been dramatically different if this were addressed sooner.