A lawsuit filed in April 2023 claims that a Delaware nursing home failed to change a resident’s catheter for more than a year, leading to the man’s death by sepsis and organ failure. The lawsuit was filed on behalf of the man’s family and claims that the nursing home was negligent in its care of the resident, leading to his untimely death.
According to the lawsuit, the man, who used a catheter, was admitted as a resident at the nursing home in November 2019. In March 2021, it was noted in his medical records that his catheter bag was empty and that he had not been scheduled for a urology evaluation for several months. Nurses also noted bloody discharge, that his abdomen was swollen, and that there was no urine input in the catheter. The resident was then admitted to the hospital.
The complaint states that facility staff had not changed the resident’s catheter for over a year. Indwelling catheters are supposed to be changed regularly to prevent infection. The resident was diagnosed with a severe infection from which he never recovered. He died in May 2021.
The lawsuit claims the resident’s death was caused by the facility’s failure to change or care for the catheter and schedule regular urology appointments. It seeks monetary damages and names the facility as well as facility officials as defendants.
Compliance Perspective
Issue
According to F690 in the State Operations Manual, Appendix PP, a resident with or without an indwelling catheter must receive the appropriate care and services to prevent urinary tract infections to the extent possible. The facility is responsible for ongoing assessment of the resident who currently has a catheter, including the removal of the catheter as soon as possible when the resident’s clinical condition demonstrates the catheter is no longer necessary. While the use of a catheter may promote skin integrity and assessment of output, it is also associated with the increased risk of catheter associated urinary tract infections (CAUTI), including the development of sepsis. A catheter that is used for appropriate indications and in a dignified manner may enhance an individual’s independence and dignity. Conversely, an improperly or indiscreetly used catheter may negatively impact independence and dignity. If a facility provides care for a resident with an indwelling catheter, in collaboration with the medical director and director of nurses, and based upon current professional standards of practice, resident care policies and procedures must be developed and implemented that address catheter care and services.
Discussion Points
- Review your policies and procedures on catheter care and services. Ensure that they cover documentation; timely and appropriate assessments; insertion, care, and catheter removal protocols that adhere to professional standards of practice and infection prevention and control procedures, and ongoing monitoring by a physician. Update them as necessary.
- Train clinical staff on catheter care and services, the importance of timely and appropriate assessments, and infection control procedures. Conduct catheter skills competencies for all levels of nursing staff upon hire and at least annually thereafter to ensure they follow your policies, procedures, and standards of practice according to each person’s specific areas of responsibility and the residents’ needs. Document that the training occurred, and file in each employee’s education file.
- Periodically audit staff understanding to ensure that they are following insertion, care, and catheter removal protocols that adhere to professional standards of practice, and are regularly changing catheters. Audit care delivery through observation and interviews of residents receiving that care. Ensure that any complaints received are fully investigated, addressed appropriately, and reported per requirements.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
