Resident Fractures Femur on Facility Mini-Bus at Fairway Oaks Center
Fairway Oaks Center in Tampa has been cited after the facility failed to ensure residents received appropriate supervision and safety devices to prevent falls. The citation occurred after a resident fell from her wheelchair on the mini-bus and fractured her femur. In addition, one resident sustained at least 13 falls in less than 30 days. Another resident experienced 6 falls in 43 days, one of which resulted in staples to the head.
The first resident sustained a right femur fracture that later required surgery while being transported in the facility’s mini-bus. The resident stated the injury occurred while on her first trip to the store with other residents. The facility normally takes residents on outings every Tuesday; there are always two nursing aides on the bus and the bus driver.
The resident stated an aide bolted her wheelchair to the bus but did not belt her into the wheelchair, even though there were harnesses and straps available. When the mini-bus stopped, she fell out of her wheelchair and was scrunched up into the wheelchair in front of her. The aide and recreation person put her back into the wheelchair and buckled her in after the fall. She stated her leg did not hurt, so they proceeded to the store. However, the pain started later.
When she got back to the facility, a portable x-ray was conducted. They found out her femur was broken and sent her to the hospital. She was equipped with a leg immobilizer after surgery. The resident said there was a bus driver, an aide, and an activity person on the bus who could have belted her in but failed to do so.
The activity aide on the bus at the time of the incident stated they had never buckled residents prior to the incident; an aide latches the wheelchairs onto the bus while the driver mans the lift gate. She stated the bus driver had hit the brakes, and the resident slid out of her wheelchair onto her knees behind another resident’s wheelchair. The activity aide and a restorative aide came from the front of the bus to help her back into the wheelchair.
At that point, they put a harness/strap hanging from the ceiling of the bus around the resident’s waist. The resident did not complain of pain at the time. There were three other residents in wheelchairs on the bus, but they were not strapped in. Because the resident did not complain of pain, the shopping trip continued.
One of the staff members on the bus stated she’d never been trained on buckling the residents in their wheelchairs prior to the accident. The staff member stated that when the resident fell out of her wheelchair, they should have stopped, called 911 and Emergency Medical Technicians, and evaluated the resident. They also should have called the facility.
The bus driver – who had been driving for three years with no incidents – stated he was not trained to use the harnesses on the bus. He puts the residents on the lift, and an aide straps their wheel chair down. He was never taught to use the harness/seat belt. He stated there was only one harness/seat belt in the mini bus, and it was not being used. At the time of the incident, the bus driver put on his flashers while the aides helped her back in the chair. The resident did not complain of any pain, so he figured she was okay. The aides then put the harness onto her wheelchair, and they went on to the store. After the trip, he went to his desk to report the incident.
In an interview with the Director of Activities, he stated he was “kind of over the mini-bus trips.” When they got the bus five years ago, they were trained by the property manager. Everything had stayed the same, and the bus driver trained the aides. Prior to the incident, the director was not sure whether the harness/strap was being used or not to secure residents into their wheelchairs. He knew there were bags on the sides of the bus which contained harness/straps, but he didn’t know if they were utilized. The facility did not do their due diligence in making sure they followed proper procedures for ensuring the safety of residents. They put the safety and lives of residents at risk by not adapting to new procedures.
The Maintenance Director stated it was the responsibility of the driver to report anything wrong with the bus. When he checked the bus after the incident, everything was in working order. Maintenance does a safety check on the mini-bus monthly, and the harnesses were in working order. He said there were 3 sets of harness/straps in bags on the mini-bus that were available to be used to strap the residents into their wheelchairs.
When asked why the interviewed staff who were present on the bus during the incident had not mentioned and were not aware of these harness/straps in bags on the mini-bus, the Maintenance Director stated that he thought the Director of Activities knew how to use the chest belts. He thought the driver had been instructed when the mini-bus first came into use. When asked who was responsible to assess that the driver was using the safety devices properly, he stated, “I don’t know, not me.”
After the incident, the weekly outings were paused so the bus could be equipped with new seat belts and the staff could be properly trained. Had the staff members been trained before the incident, the resident wouldn’t have suffered and undergone surgery. Nursing homes are responsible for the care and safety of their residents, and they put their lives at risk when they choose not to establish or follow safety protocols.
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