State Cites Brooklyn Park Assisted-Living Facility for Neglect in Patient Death
State investigators have determined a Brooklyn Park assisted-living facility was neglectful in its care for a stroke patient who later died.
A report by the Minnesota Department of Health’s Office of Health Facility Complaints found that Second Horizon Living, located on Modern Road, did not give a stroke patient the recommended amount of water nor administer the proper medications over a period of weeks.
The report stated that the patient received nutrition through a feeding tube, but was deprived of a “significant amount of water.”
According to the report:
The patient required a gastrostomy tube for feeding and hydration and provider orders required staff to flush the tube with 180 milliliters of water every four hours. Instead the resident received only 30 milliliters of water every four hours.
“The direction to staff limited the resident of a significant amount of water during the resident’s 10 weeks at the facility,” the report read.
A nurse interviewed by investigators stated there was “miscommunication among staff.”
“The nurse stated the previous nurse did not put in the order for water and the two current nurses did not catch this error,” the report continued.
In addition, the patient did not receive necessary medications.
“The nurse stated the resident’s medications were available however, the staff did not recognize the generic name of the medications and therefore, did not administer the medications,” the report stated.
The stroke patient, who was not named in the report, eventually died at a hospital from pneumonia, urinary tract infection and sepsis. A family member of the patient requested a hospital evaluation after noticing a change in her condition.
