Nurse ‘did not check patient after fall’

A nurse who allegedly failed to provide adequate care to an 85-year-old nursing home resident is the subject of a disciplinary inquiry.

An expert witness argued that nurse Allan Lasam Sanchez had failed to carry out a basic assessment on the elderly woman, referred to as Ms C.

However, the witness said there were mitigating circumstances, including the fact that Mr Sanchez had a large number of residents to look after at the time.

Ms C, who suffered from dementia, was a resident at the Carysfort Nursing Home in Dublin when she fell on the night of July 7, 2013. The nursing home can accommodate up to 52 residents.

Mr Sanchez faces allegations relating to the care he provided to Ms C after she fell. Among other allegations, it is claimed that he failed to examine her or provide appropriate care after her unwitnessed fall. He faces allegations of professional misconduct and poor professional performance.

Mr Sanchez, who worked at the nursing home from 2011 until the incident in July 2013, was not present yesterday at the inquiry.

Night care assistant Xiaohui Liu told the inquiry that, on the night of July 7, she saw Ms C lying on the floor. She told Mr Sanchez about it, and then, a couple of minutes later, returned to assist him. Ms Liu said she did not witness Mr Sanchez examine Ms C.

According to Ms Liu, Ms C did not mention being in pain. She did appear to be sad and said a number of times she wanted to go home, but that was not unusual.

Nisha Vijayan, a former staff nurse at the nursing home, said she was working the day shift on July 7, and went home around 8.30pm. Mr Sanchez rang her to ask whether Ms C had a bruise, and Ms Vijayan told him no. She said Mr Sanchez did not mention at the time that Ms C had fallen.

The inquiry later heard Ms C had fallen the previous week, and suffered bruises and minor cuts.

On the morning of July 8, during the handover at around 8.30am, Mr Sanchez told Ms Vijayan that Ms C had been found on the floor during the night but she had slept well. He had noticed swelling in her hip at 6am, and gave her paracetamol.

Ms Vijayan then visited Ms C along with her director of nursing, Liny Raju Meparathil.

Ms Meparathil said Ms C had been able to move about without much assistance prior to the unwitnessed fall.

On the morning of July 8, when she went into Ms C’s room, she could immediately tell something was wrong. Ms C’s left leg was not under the duvet, was rotated outwards and appeared to be shorter than her other leg.

Ms C woke up and started to cry. She said she was in pain. She was transferred to St Vincent’s hospital, where an X-ray confirmed she had sustained a fracture in her pelvis.

Expert witness Catherine Dunleavy said that, after Ms C’s fall, Mr Sanchez should have done a head-to-toe examination, which is essential after someone with dementia has such an incident.

Ms Dunleavy, a registered nurse and expert in the nursing home sector, said Mr Sanchez “failed to carry out a basic assessment”.

“We are taught from day one how to carry out basic assessments,” she said. “He should know how to carry out a basic assessment — and he failed to do that.”

However, she believed Mr Sanchez did not pick up on what was happening because he had so many patients to look after.

The inquiry continues at a later date.


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