Nursing home fatality leads to discipline for 3
Published: May 20, 2009, 12:30 am
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Three employees have been disciplined after a state Health Department investigation into the February death of a 93-year-old resident of an assisted-living facility in Getzville.
The Health Department found that the employees, over an 11-hour period, each noticed that Trent Lockridge was not in his room but did not report it.
Lockridge either fell or jumped from his second-floor room in Dosberg Manor, part of the Weinberg Campus, on the night of Feb. 17, but his body was not found until the next morning.
“We are disturbed at what the report found,” Ken Scott, Lockridge’s nephew, told The Buffalo News. “We hope that procedures are going to be imposed so that this doesn’t happen to another family.”
The Health Department, in its report, required that Weinberg Campus discipline the employees involved, put in place new policies for ensuring the whereabouts of all residents and train its employees in the new system.
In its response, Weinberg Campus administrators agreed to comply.
“The plan of correction was approved by the Department of Health and has been implemented,” Nicole A. Passantino, Weinberg’s marketing director, said in a statement. “As always, Dosberg Manor is committed to ensur[ing] the safety and wellbeing of our residents.”
The Health Department and Amherst police both investigated Lockridge’s death, which was reported early on Feb. 18, when his body was found on the ground outside his room.
Lockridge suffered blunt-force injuries consistent with a fall, police said.
He had moved into the 83-bed Dosberg Manor, the adult home and assisted-living program at the Weinberg Campus, on Jan. 23.
Health Department investigators visited Dosberg Manor in the days after Lockridge’s death, interviewing staff members and reviewing facility records.
Their report found that the first employee had responded to a Feb. 17 call from Lockridge’s roommate requesting help in closing the window.
The employee noted that the window was wide open, Lockridge’s glasses were on the nightstand, and his walker was near the window. She neither investigated the fact that he was not in the room nor told anyone about it.
In fact, when first questioned by department investigators, she lied and told them that she had seen Lockridge in his room at 9:40 p. m. She later confessed to a co-worker that this was not the case, the report states.
The second employee, who went into the room at 11 p. m. as part of a daily census of residents, assumed that Lockridge had been hospitalized but did not follow up on this or attempt to confirm it.
The third employee, who was assigned to Lockridge’s floor, stopped by the room at midnight as part of her rounds and also noticed that Lockridge was not in his bed, according to the report.
Further, Lockridge’s medical records reflected that staff had helped him take a dose of medicine at 6:30 a. m. Feb. 18, when he was still missing. He was not reported missing until 6:45 a. m., when a nurse said she couldn’t find him.
His body had been outside for at least 11 hours in freezing temperatures, though police believe that he died either instantly or soon after falling from the window.
The report concludes that the employees should have notified a supervisor when they saw that Lockridge was missing and that the window was open. It does not name them.
Neither the Weinberg Campus nor the Health Department would say what disciplinary action was taken. Weinberg has agreed to put in place a new system for keeping track of Dosberg Manor residents and to train employees in the new procedures.
Amherst police investigated the incident and found that no crime was committed, Assistant Chief Timothy M. Green said.
Lockridge is survived by a brother-in-law, Lee Scott, and Scott’s son, Ken, who lives in the Albany area. Lockridge’s late wife, Doris, was Lee Scott’s sister.
Ken Scott said his family is very disappointed that Dosberg Manor employees did not pick up on the clues that something was amiss.
Scott said he believes that the window in the room was too low to the floor, making it easier for his uncle to get through it.
Lockridge, a World War II combat veteran and Bell Aerospace retiree, had been living in a North Tonawanda apartment. He was hospitalized in DeGraff Memorial Hospital in North Tonawanda and was told that he had to move into Dosberg Manor afterward, Scott said, a development that upset his uncle.
Also, the Iowa native’s longtime companion, Laura W. Helmich, died Jan. 2.
It’s “entirely possible” that Lockridge committed suicide, Ken Scott said, since he had been acting out of character at the time.
“He was trying not to be a burden on us,” Scott said, “and was discouraging my father from checking up on him.”
swatson@buffnews.com
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