Officials sound alarm over drug-resistant bacteria

By MIKE STOBBE
The Associated Press

Family: Woman denied CPR wanted no intervention
By TRACIE CONE, Associated Press

SACRAMENTO, Calif. — The company whose employee refused to administer CPR to a dying woman said Tuesday that the employee wrongly interpreted its policy.

But the elderly woman's family said she would not have wanted life-prolonging aid.

The family's statement to the Associated Press absolving an elder care home of blame came less than 1 hours before the company issued a statement saying the employee's failure to heed a 911 dispatcher's was the result of a misunderstanding of the company's emergency medical practices.

The developments were the latest twist in a controversy following release of a 911 tape that recounts a dramatic 7-minute conversation on Feb. 26 between a dispatcher and a nurse who refused to cooperate with pleas for someone to start CPR as firefighters sped to the scene.

The dispatcher insisted that the woman who identified herself as a nurse perform CPR or find someone willing to do it.

Lorraine Bayless, an 87-year-old resident of Glenwood Gardens independent living home, later died.

Bayless' family said she was aware that Glenwood Gardens did not offer trained medical staff, yet opted to live there anyway.

"It was our beloved mother and grandmother's wish to die naturally and without any kind of life prolonging intervention," said the statement.

"We understand that the 911 tape of this event has caused concern, but our family knows that mom had full knowledge of the limitations of Glenwood Gardens and is at peace."

The home's parent company, Brookdale Senior Living, later said, "This incident resulted from a complete misunderstanding of our practice with regards to emergency medical care for our residents. Glenwood Gardens is conducting a full internal investigation."

The company said the employee was on voluntary leave during the process.

City fire officials say Bayless did not have a "do not resuscitate" order on file at the home. The family and the company have not commented

Glenwood Gardens is an independent living facility, and company officials say no medical staff is employed there.

The woman who identified herself as a nurse to the dispatcher was employed at the facility as a resident services director, the company said.

The nurse's decision has prompted multiple state and local investigations.

The California attorney general was "aware" of the incident, said a spokeswoman, Lynda Gledhill.

Bakersfield police were trying to determine whether a crime was committed when the nurse refused to assist the 911 dispatcher looking for someone to start CPR.

The nation's largest trade group for senior living facilities has called for its members to review policies that employees might interpret as edicts to not cooperate with emergency responders.

"It was a complete tragedy," said Maribeth Bersani, senior vice president of the Assisted Living Federation of America.

"Our members are now looking at their policies to make sure they are clear.

Whether they have one to initiate (CPR) or not, they should be responsive to what the 911 person tells them to do."

Bayless collapsed in the Glenwood Gardens dining hall on Feb. 26.

Someone called 911 on a cellphone asking for an ambulance to be sent and eventually a woman who identified herself as a nurse got on the line.

Brookdale Senior Living said in a statement that the woman on the 911 call was "serving in the capacity of a resident services director, not a nurse."

The Tennessee-based parent company also said that by law, the independent living facility is "not licensed to provide medical care to any of its residents."

But it added later that it was reviewing company policies "involving emergency medical care across all of our communities."

Bayless' family said she was aware that Glenwood Gardens did not offer trained medical staff, yet opted to live there anyway.

"We understand that the 911 tape of this event has caused concern, but our family knows that mom had full knowledge of the limitations of Glenwood Gardens and is at peace," the family's statement said.

The death shines a light on the varying medical care that different types of elderly housing provide — differences that consumers may not be aware of, advocates say.

Even if independent living homes lack trained medical staff, some say they should be ready to perform basic services such as CPR if needed.

The California Board of Registered Nursing is concerned that the woman who spoke to the 911 dispatcher did not respond to requests to provide aid or to find someone who might want to help.

"If she's not engaged in the practice of nursing, there's no obligation (to help)," agency spokesman Russ Heimerich said.

"What complicates this further is the idea that she wouldn't hand the phone over either. So that's why we want to look into it."

The family said it would not sue or try to profit from the death, and called it "a lesson we can all learn from."

"We regret that this private and most personal time has been escalated by the media," the statement said.
NEW YORK — Health officials are reporting an alarming increase in some dangerous superbugs at U.S. hospitals.

These superbugs from a common germ family have become extremely resistant to treatment with antibiotics. Only 10 years ago, such resistance was hardly ever seen in this group.

Infections from these superbugs are still uncommon. But in the first six months of last year, nearly 200 U.S. hospitals — about 4 percent — saw at least one case, the Centers for Disease Control and Prevent reported Tuesday.

"I would call them a major threat emerging in our hospitals," said Dr. Arjun Srinivasan, an infectious disease expert at the CDC.

Health officials call them "nightmare bacteria" that have now been seen in 42 states and threaten to spread their resistance to more and more of their bacterial brethren.

"We only have a limited window of opportunity to stop spread" of these superbugs, said CDC Director Dr. Tom Frieden. At a press conference Tuesday, he said he was "sounding an alarm."

The CDC urged hospital workers to watch for the infections and take steps to prevent passing the germs to other patients.

The report did not include better-known superbugs like the staph infection MRSA or the intestinal bug known as C-diff, which have plagued hospitals.

It focused on the superbugs that have emerged from one specific bacteria group. At least five of the 70 kinds in that family have developed resistance to a class of antibiotic called carbapenems — considered one of the last lines of defense against hard-to-treat bugs.

Some of those bacteria seem to have terrifying potential. Among them: Klebsiella pneumoniae, a bug that killed at least seven patients at a federal research hospital in Bethesda, Md.; and those made resistant by a gene called NDM-1, named for New Delhi.

The bacteria usually live harmlessly in the gut but can cause pneumonia, and urinary tract and bloodstream infections if they get into other parts of the bodies of patients with weakened immune systems. As many as half the patients who get the bloodstream infections die, Srinivasan said.

However, CDC did not provide figures on deaths attributed to these superbugs.

In 2001, U.S. hospitals reported that only 1 percent of samples from the bacterial family were resistant to the antibiotic carbapenems. By 2011, it had risen to 4 percent.

It was more of an issue in the nation's 400 specialized, long-term hospitals — 18 percent of them reported seeing such a superbug. The Northeast had the most, followed by the South.

U.S. health officials are keeping a close eye on the NDM-1 superbugs, which first showed up in India in 2010 and have been seen as more of a concern in other parts of the world. Of the 30 cases in the U.S., about half have been reported since July, including eight patients at a Denver hospital.

___

Online:

CDC report: http://www.cdc.gov/vitalsigns

Last modified: March 06. 2013 12:44AM
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