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Choking / Aspiration of Food

Choking or the aspiration of food is a major concern and risk for elderly nursing home residents with cognitive difficulty such as dementia or Alzheimer’s disease. Stroke victims or individuals with swallowing disorders also face hazards from food. Many elderly residents require special diets and supervision while eating which needs are not met by nursing home facilities. It is the responsibility of the nursing home staff to identify those who may be at risk for choking.

If a nursing home resident has difficulty swallowing, the nursing home staff should provide soft foods, cut up food into small pieces and make sure the resident is in an upright position while eating. Most importantly, the nursing home staff should carefully monitor the residents during meal times to prevent choking. Choking incidents may result in injury, medical complications and death.

Meal times are when the nursing home residents are most reliant upon their caregivers. It is important that residents are attended by the staff that are familiar with their needs and ability. Too often, high staff turnover and understaffing lead to lapses in care. Most often, choking occurs when the resident is left unattended while eating their meals. The staff should monitor what the resident is eating, the amount of food consumed and whether the resident is swallowing properly to prevent choking or aspiration.

When choking incidents do occur, they are typically covered up and attributed to other causes. For example, the State of California in September 2008 fined an Anaheim Nursing Home $75,000 in the case of an elderly man whose death was reported for months as a heart attack- although he really choked on a tuna sandwich. The State Health and Human Service documents showed that the Anaheim Crest Nursing Center initially claimed that the victim died of a heart attack and did not disclose the sandwich incident until three months later and only after the coroner concluded that the resident choked to death. The victim was supposed to receive only pureed foods. According to state documents, the resident suffered from dementia and had two choking incidents that evening prior to his death. In the first incident, the patient was given the wrong diet even though there was a history of swallowing problems. Later that evening, the victim was left near the food cart where he grabbed a tuna sandwich and began to eat. He died within an hour. The staff at the nursing center did not try to clear his throat and provide appropriate emergency care.

The State of New York in 2008 fined the Crossings, a New York nursing home $13,000 for failing to provide emergency medical treatment to a resident who was choking. In that case, an 81 year old woman was left unattended by a nurse as she was eating her dinner. When the nurse returned to the woman’s room she found the resident with her mouth open, not breathing and her lips were blue. The nurse failed to call an appropriate “code blue” and the woman died.

Unfortunately, the State of Florida has not been vigorous in its regulation of nursing homes and assisted living facilities. Most adverse incidents are not aggressively investigated by the State. Even when negligence is found on the part of a facility, fines are either rare or low. In one of our recent cases, the State of Florida fined a Broward County Nursing Home $750 for violations which resulted in a death of a resident.Further, adverse incident reports and State investigative reports are privileged so that the family of residents are unable to obtain information which accurately describes the injury or death of their loved ones. As a result of such secrecy, these reports will not be admitted in evidence in any court proceedings arising out of the negligence of a nursing home.

At Fenster & Cohen, P.A. we have handled many choking cases where residents have died or became brain damaged as a result of food. In every case, the nursing home has not only failed to admit fault, but has claimed that the resident has either died from a heart attack or a stroke. It is only through aggressive representation and diligent inquiries from appropriate sources that these claims can be overcome. If you have a loved one in a nursing home or assisted living facility who has been injured as a result of choking or aspirating food, please call as and let us assist you.