New patients barred from home

An agency says a North Port nursing home failed to adequately care for a woman who died there.

By CURTIS KRUEGER

© St. Petersburg Times, published June 6, 2000

Because of its failure to aggressively seek medical care for an 87-year-old woman who was bitten more than 1,600 times by ants, a Sarasota County nursing home has been given an indefinite moratorium barring it from receiving new patients.

The state Agency for Health Care Administration said the Quality Health Care Center staff had failed to give Mary L. Morales Gay certain medicine and failed to let her doctor know about her steadily worsening condition after she was bitten.

In fact, the nursing home had not even properly eradicated the ant infestation until AHCA finished inspecting the facility seven days after Gay's death.

These "multiple violations and deficiencies" were so serious that they "placed residents in immediate danger with a substantial probability that death or physical harm would result," the state agency said in its moratorium order.

Gay died May 19 at the North Port nursing home, in southern Sarasota County, roughly 33 hours after receiving the ant bites. The autopsy is not complete.

"It frankly looks to me like no one reacted very well to it at the nursing home," said Don Greiwe, an attorney representing Gay's son and daughter.

Greiwe said it was "particularly traumatic to the family to realize that her condition really wasn't being communicated to the physician" and that she was not getting medicine the doctor prescribed.

Quality Care Health Center has had a good record for meeting health regulations in the past, according to state officials. The home now must submit a plan to the state proving that it has procedures in place to prevent a similar situation from occurring.

The nursing home referred all comments to an attorney who could not be reached for comment.

When the staff discovered Gay with the ant bites at 8 a.m. May 18, they brushed away the insects and gave her a shower. But even after observing more than 100 ant bites and an "extremely large red area covering 25-percent of (Gay's) body," state officials allege that registered nurses "failed to assess (Gay's) condition or administer medication to treat (Gay)," according to the moratorium order, which includes a synopsis of the incident.

After the shower, a licensed practical nurse noticed swelling in Gay's right knee and received a telephone order from Gay's doctor to give her Benadryl. When Gay spit out the pill, the nursing home staff "did not pursue the Benadryl order any further." She never received the medication, according to the written order.

At 11:30 a.m., about 31/2 hours after the ants were discovered, nurses noticed that Gay had "a thickened tongue, breathing difficulties and a worsening condition."

Her doctor ordered pain medication for her that afternoon, and it was two hours before the in-house pharmacy delivered it. At 9 p.m., Gay had "jerky movements, labored breathing and was pale."

By 5:30 a.m. May 19, she was "gurgling with a temperature of 101.3." At 9:40 a.m., she was "unresponsive."

That afternoon a nurse observed a huge amount of ant bites and saw that Gay had "jerking and twitching reactions, which are symptoms of an allergic reaction to ant bites." All these symptoms comprised "crucial information" about her condition, yet the nursing home "failed to ensure that (Gay's) physician received an accurate description" of her condition.

The state's moratorium order also said that on the day of the incident, an exterminator found three ant nests outside the nursing home but did not spray them with insecticide to kill the queen. They did not realize that was necessary until AHCA told them so on May 26, according to the document. After that, they exterminated the nests within 24 hours.

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