Failure to report an adult patient’s neglect will end in a lawsuit filed by the house health agency

In several of my previous blogs, I even have discussed nurses’ responsibility to report cases of kid abuse and neglect to designated authorities. However, failing to report an adult patient’s neglect, even whether it is “self-neglect,” is equally necessary.

State statutes vary, but most include that the nurse has a “good faith belief” or “reasonable suspicion” that the injuries sustained are the results of abuse or neglect; a nurse has immunity from civil, criminal and skilled licensing actions if reported in this manner. “Good faith” is supposed unless family or others say otherwise; and the report is treated as confidential, so the nurse’s identity shouldn’t be made public. In the next A case from 2019 v. Healing Hands Home Health Care, the Kansas Mandatory Reporting Act was interpreted after the death of an adult patient with diabetes and “chronic, severe” paranoid schizophrenia who was receiving twice-daily home nursing visits. The patient’s schizophrenia resulted in “forgetfulness”, poor hygiene, “daily hallucinations and delusions” and the potential for self-harm – despite being “alert and oriented”. He was prescribed clozapine for schizophrenia, the unwanted effects of which included increased heart rate and decreased heat tolerance. The patient’s psychiatrist ordered twice-daily nursing visits, and the patient’s care plan was reviewed every two months. The care plan included:

• Daily assessment of the patient’s cardiorespiratory condition
• Setting up medications for the patient and reminding them to take them
• Assessment of the patient’s blood sugar level on Monday, Wednesday and Friday
• Assess the patient’s eating, hydration and toileting habits as needed

Did failure to report negligence contribute to death?

From May to the tip of June 2013, the nurses’ notes showed that the temperature within the patient’s apartment was very high. Nurses tried to intervene by asking the patient to activate the air con, but to no avail. In addition, his hygiene habits worsened. The patient’s blood pressure in June also increased from a previous 60-day period of 70-80 beats per minute to as high as 118 beats per minute, several times within the evening. On June 26-27, 2013, the county where the patient lived was under a heat advisory, with temperatures of 101 degrees and 117 degrees, respectively. The patient died on the night of June 27-28, 2013. His family found him. The reason behind death was listed as “probable hyperthermia.”

The patient’s mother filed a wrongful death and survival lawsuit against Healing Hands, alleging that negligence caused her son’s death. Healing Hands filed a motion for partial summary judgment, maintaining that there was no obligation under the law to tell the patient’s mother of her son’s condition and that the Kansas Mandatory Reporting Act didn’t require her or her employees to report his condition to law enforcement or state authorities.

The trial court granted partial summary judgment for a house care agency, finding that the Mandatory Reporting Act didn’t require the agency to report a patient’s condition. The jury also found that the agency had “no fault at all [the patient’s] death.” This ruling was based on numerous legal and other arguments presented by the home care agency, including the fact that the deceased patient’s air conditioning was not working during this period. The patient’s mother appealed against this decision.

Decision of the court of appeal on reporting negligence

The court of appeal overturned the judgment of the court of first instance and remitted the case for reconsideration (remitted for reconsideration). In assessing Kansas’ mandatory reporting law, the court carefully analyzed the lower court’s conduct. The court emphasized the arguments of both parties. In the case of the home health care agency, its position was that the deceased patient was an independently living adult, was able to protect his or her own interests before death, was competent, and – based on the statutory language regarding mandatory reporting – had no need for death protection services. until his death. However, the mother of the deceased patient argued that it was the agency’s duty to inform her about her son’s condition so that she could intervene. She further argued that the Act did not require an adult to first be found incompetent or appointed as a guardian to be subject to the Act.

The court opined that the purpose of the Act was “clearly apparent at a glance”; that is, it was enacted to “protect adults aged 18 years or older who are ‘incapable of protecting their own interests and who [are] suffered harm as a result of the act or omission of another person or by his own act or omission.”

The deceased patient, he added, was clearly under statutory protection. Despite his ability to take care of himself for a few years before his death, while the agency was caring for him, he was unable to achieve this and the agency due to this fact breached its obligations under the statute. The court also found that the house health agency fueled the fireplace by arguing that if the house health nurses weren’t negligent, the agency couldn’t be found negligent. This argument is inconsistent with the law of negligence – particularly with the idea of corporate liability.

Implications in your practice

Reporting negligence can often save a patient from further suffering or save a life. Therefore, nurses must clearly define their expectations. If you practice in Kansas, it might be price taking the time to learn in regards to the value of this case and even get an opinion from a nurse or attorney about your obligations under the Kansas Mandatory Reporting Act. For those of you who practice nursing in other states, listed below are some suggestions for reporting neglect or harassment:

• Find out what your state’s Mandatory Reporting Act and/or Nurse Practice Act requires when providing care to adults in any health care facility or home.
• Assess the patient’s overall condition frequently.
• Document your observations and discussions with the patient and others.
• Notify your nursing supervisor, the patient’s physician, and others of any issues you notice regarding the patient’s well-being.
• If your employer doesn’t support your concerns about reporting neglect or harassment under state statute, seek the advice of your nurse or lawyer.
• Remember that your responsibility to report adult abuse and neglect is a private responsibility and, if not done, may end in skilled licensing proceedings by the Board of Nursing and criminal prosecution (normally a misdemeanor).

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