What do you do when a patient wants to die? That’s the question at the center of a state health inspection at a nursing home in Indiana, where a healthcare worker reportedly removed a COVID-19 patient’s oxygen mask after they supposedly asked to die. The man later died from the disease. The nurse may now face criminal charges for actions as state investigators look for answers.
Taking Matters into Her Own Hands
The alleged incident took place in May of last year and is being reviewed as part of a state health investigation, as originally reported by the IndyStar. The nurse was working at Wedgewood Healthcare Center in Southern Indiana at the time. Local police and the operator of the facility, Ohio-based Communicare, say the investigation is ongoing.
According to the initial findings, the nurse, who isn’t named in the report, was caring for “Resident B”, who had been on oxygen for several days up until the day of his death.
The nurse says she saw the patient try to take off his mask several times. She also says he was struggling to breathe.
She later recounted the incident on social media, writing:
“I just want y’all to know the hardest thing I’ve ever done in 28 years [is] start a patient on O2 for 4 days 12 LPM, with a non-rebreather mask. I asked him on day 4 if he’s tired, he said yes I said do you want me to take all this off for you and let you go and fly with the angels and he said yes.”
She later added, “I took it all off of him, I went in the hallway and I cried and I let him go and he passed away…after I left.”
The report shows that Resident B didn’t receive any other care for the next eight hours until his death.
Inspectors are citing the facility for abuse, neglect, failure to notify changes in the patient’s condition, and other violations. The report shows neither the doctor nor the resident’s family were made aware of the oxygen mask until the patient had already passed away.
Administrators weren’t aware of the nurse’s action for several days. It wasn’t until one of her colleagues saw the post, took a screenshot, and sent it to the facility’s director.
“It’s just heartbreaking in a whole new way,” said Richard Mollot, executive director of the Long Term Care Community Coalition, a national group that advocates for nursing home residents.
The authorities have confirmed that the case has been referred to the state’s attorney general.
Reports show that the state of Indiana was facing one of the worst outbreaks of the coronavirus at the time of the incident, including peak infection rates in long-term care facilities and among the public.
Inside Wedgewood, 70 residents have contracted COVID-19 and 20 have passed away. Poor staffing may have contributed to the resident’s death.
Records show Wedgewood had one of the lowest nurse-patient staffing ratios in the country, ranking in the bottom 15% of the country and way below the national average.
During the investigation, the nurse told investigators that she was having a “terrible week” at the time and had been caring for as many as 40 COVID-19 patients at once, which is why she forgot to tell the doctor that she had removed the resident’s oxygen mask.
In a citation, state investigators said the nurse took matters into her own hands but that the facility should have done a better job of monitoring providers who were working more than 40 hours a week.
However, Richard Mollet says the facility is ultimately responsible for the care of the residents.
“The nursing home is responsible for the actions of its staff and for maintaining an environment where the staff is well-trained about residents’ rights and appropriate care and treatment. This is a system with a lot of checks and balances, and a lot of checks and balances were missing for this to occur,” he said.
In response to the investigation, the facility says it has updated its guidelines, increased oversight of its residents and any changes to their health, and they make sure providers working overtime get enough rest.
Parent company Communicare says it’s cooperating with the investigation. Beth DeFalco, a company spokeswoman, said, “Communicare staff have worked tirelessly to care for our residents during this global pandemic and we have followed all state and federal safety guidelines.”
Yet, reports show several facilities owned by the company in Indiana have been cited for safety violations in the past year. DeFalco tried to defend the facility by saying, “nursing homes are being held to a higher scrutiny than hospitals and ERs.”
As for the nurse, it’s possible she could face criminal charges for her actions. Unlike California, Colorado, District of Columbia, Hawaii, Montana, Maine, New Jersey, Oregon, Vermont, and Washington, Indiana doesn’t have a physician-assisted death or assisted suicide law, which means it’s a crime to end someone’s life, even if they ask to die.