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"State fines Laguna Hills nursing home in death of patient"

The Orange County Register

The 86–year–old woman choked while eating dinner alone at Palm Terrace Healthcare and Rehabilitation Center. Home was fined previously for 2003 death.

April 18, 2008
The Orange County Register

State officials have fined a Laguna Hills nursing home $75,000 in the death last year of a patient who was drowsy from morphine and choked while eating alone in her room.

The citation against Palm Terrace Healthcare and Rehabilitation Center was issued after an investigation by the California Department of Public Health. State officials last fined the nursing home in 2003 after a man fell out of bed and later died.

Dave Jorgensen, administrator of Palm Terrace, would not answer specific questions but said Palm Terrace is appealing the citation.

"It's a sad thing," Jorgensen said. "We feel bad. We're saddened by the loss of the resident. We do not agree with the findings of the state. This facility gives fantastic care and we stand by our caregivers."

Madeline Iannucci, 86, choked on a piece of meat while eating dinner, according to state and Orange County coroner records. She was taken to the hospital where she died three days later.

Toxicology reports showed that Iannucci had been given morphine. State investigators said in their report that according to documentation from Palm Terrace, she "was not prescribed opiate medications." The coroner's report ruled the death accidental but said the morphine appeared to play a significant role in the choking.

The Orange County Sheriff's Department launched a criminal investigation to determine who gave her the medications. Sheriff's department spokesman John McDonald said detectives eventually found that a doctor had prescribed the drug but it was "deep in the medical records."

The state's report says the nursing home failed to continually assess the patient. She was observed as tired and lethargic by staff but her dinner tray was left at her bedside, allowing her to eat unsupervised. Additionally, the report says the facility failed to ensure the patient only received medicine prescribed by a doctor.

As for the finding by the sheriff’s department, state spokeswoman Lea Brooks said the public health department stands by its citation and report.

The 99-bed facility has received more than the state average of complaints, according to the nonprofit California Advocates for Nursing Home Reform. The group’s Web site, Nursing Home Guide, says that last year there were 17 complaints about Palm Terrace.

In 2003, Palm Terrace, then called Manor Care Health Services and owned by a different company, was fined $60,000 after a 54-year-old stroke patient fell while getting out of bed. He was not medically evaluated and later died at a hospital.

There are roughly 1,400 nursing homes in California.