A recent, unprecedented settlement against a U.S. nursing home is raising questions nationwide about how many nursing home residents are overmedicated with antipsychotic drugs without proper consent. The Las Vegas Review-Journal reports that Nevada is one of only two states in the nation where all 32 nursing homes were cited by state health inspectors for infractions relating to elder care in 2013. While alarming, these numbers also play a role in why patients, family members and a Reno personal injury attorney are increasingly concerned about how medication is administered in these facilities.
According to AARP, Inc., a lawsuit was filed against a California facility alleging a patient was severely overmedicated without proper authorization from the patient or her family members. The daughter of a patient at the Ventura Convalescent Hospital in Ventura, California, joined the class-action suit against the facility after her mother was administered strong antipsychotic medications without proper consent or good reason.
The plaintiff alleged that when her mother arrived at the facility, she had early-stage Alzheimer’s disease and prescriptions to help with blood pressure and cholesterol. She also used an inhaler for pulmonary disease. After 18 days at the facility, however, the plaintiff’s mother became completely withdrawn and began exhibiting unusual behavior like slumping in her chair and chewing on her hand. She was also no longer able to effectively communicate as she could prior to entering the home, and within a few weeks, she passed away. Her family believes the radical changes in her demeanor, and ultimately, her death, were the result of large amounts of illegally administered antipsychotic medications. If one medication caused drowsiness or anxiety, the plaintiff alleged, her mother was simply given a different prescription in an attempt to counter the effects of the first one.
The plaintiff believes that the drugs were illegally administered to make her mother more submissive and easier to care for by facility staff. A Ventura County Superior Court judge found merit in the allegations, and a first-of-its-kind settlement was eventually reached against the facility for administering dangerous drugs without proper consent of the patient or her family. While the Ventura County settlement was the first like it in the nation, many are hoping that its effects are felt nationwide.
A history of infractions
Nevada’s nursing homes have been under scrutiny for some time now. Families for Better Care, a nursing home resident advocacy group, gave the state a C grade for overall nursing home quality in 2014. While far from ideal, the C was actually a significant step up from the F ranking the state’s nursing homes received in 2013.
In addition to all 32 Nevada nursing homes receiving citations for mistreatment of residents and other offenses in 2013, one in three Nevada nursing homes was cited for a “severe deficiency.” Severe deficiency citations indicate that a resident either suffered significant harm or was placed in imminent danger as a result of the infractions. Furthermore, Nevada ranked lowest in the entire Pacific region in 2013 in five out of eight categories. Nevada’s low rankings, along with increased national scrutiny of the overmedication of nursing home residents, has a Reno personal injury attorney seeking additional solutions.
A national problem
Sadly, over-administration of strong antipsychotics is not limited to the western U.S. AARP, Inc. reports that as many as one in five residents of the country’s more than 15,500 nursing homes are administered unnecessary and potentially dangerous antipsychotic medications. Experts believe that this trend is a result of several factors. Inadequate training of staff members, understaffed facilities and an aggressive campaign by pharmaceutical companies to sell their products all play a role in the growing number of national overmedication infractions.
Late last year, Johnson & Johnson, the world’s sixth-largest consumer health company, was fined more than $2.2 billion in what the U.S. Department of Justice deemed “one of the largest health care fraud settlements in U.S. history.” The company was cited for its aggressive and illegal marketing of drugs, including strong antipsychotics, to nursing homes, as well as for offering kickbacks to physicians who prescribed Johnson & Johnson medications. A similar suit was settled in 2009 against drug-maker Eli Lilly, the manufacturer of the antipsychotic medication Zyprexa, for its aggressive marketing campaign targeting nursing homes and continuing care facilities.
Failure to adhere to black-box warnings and consent regulations
Antipsychotic drugs are designed to treat those suffering from severe mental illnesses like schizophrenia or bipolar disorder. These drugs carry FDA black-box warnings that plainly state the medications should not be administered to frail, elderly populations or those suffering from Alzheimer’s or dementia, as was the case with the Ventura patient. The black-box warnings raise concerns about the possibility of the drugs causing confusion, anxiety, agitation, disorientation and even death when administered to the elderly. Furthermore, drugs must be administered with the patient’s “informed consent,” and when that is unattainable, consent from a family member must be given. Elder-care advocates know this does not always happen, however, as was the case with the incident at Ventura Convalescent Hospital.
Calls for change
In the wake of incidents like the Ventura, California, case, some nursing homes are seeking alternative and humane treatment methods for elders that don’t involve the administration of antipsychotic medications. While some homes across the nation are campaigning for change, a Reno personal injury attorney knows the attention comes too late for the patient and her family in the Ventura case.
Anyone who suspects elder abuse or the unlawful administration of antipsychotic medications at a Nevada nursing home is advised to contact an attorney.