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Calif. woman dies after nurse refuses to do CPR

By Associated Press

LAST UPDATED: 06:28 p.m. HST, Mar 04, 2013

BAKERSFIELD, Calif. »  A nurse's refusal to give CPR to a dying 87-year-old woman at a California independent living home despite desperate pleas from a 911 dispatcher has prompted outrage and spawned a criminal investigation.

The harrowing 7-minute, 16-second call also raised concerns that policies at senior living facilities could prevent staff from intervening in medical emergencies. It prompted calls for legislation today to prevent a repeat of what happened Feb. 26 at the Glenwood Gardens in Bakersfield.

Lorraine Bayless collapsed in the dining room of the retirement home that offers many levels of care. She lived in the independent living building, which state officials said is like a senior apartment complex and doesn't operate under licensing oversight.

"This is a wakeup call," said Assemblywoman Mariko Yamada, chair of the California Assembly Aging and Long-term Care Committee. "I'm sorry it took a tragedy like this to bring it to our attention."

Yamada cautioned that while it's not yet known whether intervention would have saved the woman's life, "we want to investigate because it has caused a lot of concern and alarm."

Independent living facilities "should not have a policy that says you can stand there and watch somebody die," said Pat McGinnis, founder of California Advocates for Nursing Home Reform, a consumer advocacy group. "How a nurse can do that is beyond comprehension."

In all her years of advocating for the elderly, McGinnis said: "This was so horrifying. I've never seen this happen before."

State officials did not know today whether the woman who talked to the 911 dispatcher actually was a nurse, or just identified herself as one during the call. She said one of the home's policies prevented her from doing CPR, according to an audio recording of the call.

"The consensus is if they are a nurse and if they are at work as a nurse, then they should be offering the appropriate medical care," said Russ Heimerich, spokesman for the California Board of Registered Nursing, the agency that licenses health care providers.

The executive director of Glenwood Gardens, Jeffrey Toomer, defended the nurse in a written statement, saying she followed the facility's policy.

"In the event of a health emergency at this independent living community, our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives," Toomer said. "That is the protocol we followed."

Toomer offered condolences to the woman's family and said a thorough internal review would be conducted. He told KGET-TV that residents of the facility are informed of the policy and agree to it when they move in. He said the policy does not apply at the adjacent assisted living and skilled nursing facilities.

Multiple calls to the facility and its parent company seeking more information were not returned.

Unlike nursing homes, which provide medical care, independent living facilities generally do not.

"These are like apartments for seniors. You're basically living on your own. They may have some services provided by basic nursing staff, but it's not their responsibility to care for the individual," said Dr. Susan Leonard, a geriatrics expert at the University of California, Los Angeles.

Residents of independent living communities can still take care of themselves, but may need help getting to doctor's appointments. In skilled nursing facilities and nursing homes, many residents require around-the-clock care.

Staff members are "required to perform and provide CPR" unless there's a do-not-resuscitate order, said Greg Crist, a senior vice president at the American Health Care Association.

Bayless did not have such an order on file at the facility, said Battalion Chief Anthony Galagaza of the Bakersfield Fire Department, which was the first on the scene. That's when firefighters immediately began CPR, continuing until she reached the hospital.

Dr. Patricia Harris, who heads the University of Southern California's geriatrics division, said the survival odds are slim among elderly who receive CPR. Even if they survive, they are never the same. She said she would override the home's policy and risk getting fired "rather than watch somebody die in front of me."

During the call, an unidentified woman called from her cellphone, and asked for paramedics to be sent to help the woman. Later, a woman who identified herself as the nurse got on the phone and told dispatcher Tracey Halvorson she was not permitted to do CPR on the woman.

Halvorson urged the nurse to start CPR, warning the consequences could be dire if no one tried to revive the woman, who had been laid out on the floor on her instructions.

"I understand if your boss is telling you, you can't do it," the dispatcher said. "But ... as a human being ... you know, is there anybody that's willing to help this lady and not let her die?"

"Not at this time," the nurse answered.

Halvorson assured the nurse that Glenwood couldn't be sued if anything went wrong in attempts to resuscitate the resident, saying the local emergency medical system "takes the liability for this call."

Later in the call, Halvorson asked, "Is there a gardener? Any staff, anyone who doesn't work for you? Anywhere? Can we flag someone down in the street and get them to help this lady? Can we flag a stranger down? I bet a stranger would help her."

"I understand if your facility is not willing to do that. Give the phone to a passer-by. This woman is not breathing enough. She is going to die if we don't get this started, do you understand?"

The woman had no pulse and wasn't breathing when fire crews reached her, Galagaza said.

Sgt. Jason Matson of the Bakersfield Police Department said its investigation so far had not revealed criminal wrongdoing, but the probe is continuing.

First responders say often it's hard to find someone willing to provide CPR in an emergency.

"It's not uncommon to have someone refuse to provide CPR if they physically can't do it, or they're so upset they just can't function," Kern County Fire Department Deputy Chief Michael Miller said. "What made this one unique was the way the conversation on the phone went. It was just very frustrating to anyone listening to it, like, why wasn't anyone helping this poor woman, since CPR today is much simpler than it was in the past?"


Cone reported from Sacramento. Associated Press writers Garance Burke in San Francisco and Alicia Chang in Los Angeles contributed to this report.

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XML808 wrote:
How can this nurse live with herself?
on March 4,2013 | 04:17AM
Grimbold wrote:
This comment has been deleted.
on March 4,2013 | 07:49AM
Publicbraddah wrote:
Without knowing all the facts, it's hard to say whether the decision not to resuscitate was the correct on. If the patient had a DNR mandate, the decision was correct. What was the condition of the 87 year old? Gotta have all the facts.
on March 4,2013 | 08:24AM
Anonymous wrote:
Totally agree Braddah!
on March 4,2013 | 04:55PM
aomohoa wrote:
She did not do CPR because it was the protocol of the facility, not because the nurse is a good person!
on March 4,2013 | 06:05PM
Pocho wrote:
it's part of the job. I have an elderly parent that stayed at a skilled nursing home facility. They also stated that policiy this nurse heeded too. If there's acknowledgement or paperwork accepting the rules, why would one go against it's policy and open one's self to a sue job?
on March 4,2013 | 04:26AM
Grimbold wrote:
This comment has been deleted.
on March 4,2013 | 07:57AM
aomohoa wrote:
This had nothing to do with DNR, it was policy. It's not the same at all. If that was true the nurse would of said it. She said it was not there policy to do CPR.
on March 4,2013 | 06:07PM
false wrote:
It's called DNR. If you agree to live there, then that's what you agree to.
on March 4,2013 | 04:51AM
Bdpapa wrote:
Yes! A lot of elderly have this in place.
on March 4,2013 | 05:09AM
mzack9 wrote:
If it's a Do Not Resuscitate policy, then why call paramedics? Just leave 'em stay where they lay. Seriously though, this makes no sense. They can be resuscitated by someone, just not the employees. That is crazy.
on March 4,2013 | 05:11AM
GooglyMoogly wrote:
DNR applies to taking extensive measures to keep one alive. It would not apply in the case of, say, someone choking on food. We don't know all the details of the case, but based on how it's worded in the story, it sounds like it started simply enough but took a turn for the worse and ended with this poor woman losing her life. Sadly, we live in a time where facilities need to have policies like this as a defense against an overly litigious customer base. I do feel bad for that nurse, because she probably had to go against her instincts by refusing to perform the CPR. It's not a happy ending for her, either.
on March 4,2013 | 07:57AM
Grimbold wrote:
This comment has been deleted.
on March 4,2013 | 08:05AM
aomohoa wrote:
I understand the situation with your mother and I agree completely, but we don't know what condition this woman was in and what she wanted.
on March 4,2013 | 06:09PM
soundofreason wrote:
Open and shut case. And I hope they turn around and sue this lady for a frivolous lawsuit to prevent their costs from going up by others.
on March 4,2013 | 05:37AM
kukaikid wrote:
cpr is over rated and rarely works. i'm certified but i am not sure anymore if i would use it on someone to try to save their life. doctors would perform it, but none of them want it for themselves
on March 4,2013 | 05:05AM
eoe wrote:
X1000. People think this works like on TV - a few gentle chest compressions and "wake up aunt flo!" and her eyes flutter, she sits up and everything is OK. Reality: best case 20% survival rate, usually much less, but of those many have brain damage or other permanent complications (full recovery rate is in single digits), broken ribs, lacerated organs, damage to the abdomen, throat or heart etc. The statistics are even grimmer for the elderly. As you state, studies consistently show that 90% of doctors do not want CPR performed upon them -- that should be all anyone needs to know about CPR.
on March 4,2013 | 05:19AM
Usagi336 wrote:
My cousin worked on an unresponsive toddler found floating in the water. Literally brought him back to life with cpr. That one success is worth a thousand attempts. It gives hope at the least and saves lives at best. Better than just standing around doing nothing.
on March 4,2013 | 07:10AM
aomohoa wrote:
That is not true! It saves lots of lives.
on March 4,2013 | 06:10PM
JimLoomis wrote:
What's missing here is the REASON for that policy! Would sure help in deciding where the blame goes. And there's plenty of that to be awarded!
on March 4,2013 | 05:26AM
false wrote:
I'm a retired paramedic and ER nurse. I remember when I had to perform CPR for nearly an hour in heavy pouring rain in the middle of a highway and the patient not only survived but had no permanent damage. As for the policy at this facility, it is a direct conflict to the Hippocratic oath taken by both nurses and doctors which basically states that you will do everything in your power to preserve a human life. Most people have no idea what DNR means let alone reading and understanding a contract filled with "legalese". IMHO the nurse in question should lose her license despite the policy that was in place because she did nothing to help the woman. Her basic refusal to even attempt to help the woman is a disgrace to the profession. I praise the 911 operator for doing everything she could to try and save the woman.
on March 4,2013 | 06:08AM
loquaciousone wrote:
I agree. I hear comments of sue job and not my job but that's ridiculous. In addition most States have Good Samaritan laws that covers this type of situation. There is no way this nurse should remain a nurse let alone be part of the human race.
on March 4,2013 | 06:18AM
soundofreason wrote:
Aside from "legalese", people UNDERSTAND the INTENT of DNR. If I die...leave.....me...........alone. THAT'S what people understand. Not real complicated.
on March 4,2013 | 06:30AM
Maneki_Neko wrote:
I've had a DNR in place for years and nobody has bothered me.
on March 4,2013 | 11:27AM
aomohoa wrote:
Be careful and make sure everyone knows it. The paramedics came to my mother in laws house because a friend called and they didn't know. She was on machines for weeks.When I get old I think I will wear a wrist band that says so.
on March 4,2013 | 06:15PM
aomohoa wrote:
If she had a DNR order this would have never happened. Yes I also have one, but that is not the issue here.
on March 4,2013 | 06:14PM
nitpikker wrote:
i thought hippocratic oath was "first you do no harm" . and think about it, a lot of elderly don't want lifesaving measures to be performed because there's a chance that even if they survive they may be comatose or incapacitated and become a terrible financial burden.
on March 4,2013 | 06:34AM
Pacej001 wrote:
Thing that got me was the lack of concern in the nurses voice. Pretty chilling.
on March 4,2013 | 09:06AM
medigogo wrote:
Good point. This policy assertion is absurd. How if a resident chokes in the pool and is sinking. Would they help in such a medical condition? Or just watch and wait?
on March 4,2013 | 02:14PM
aomohoa wrote:
I agree with you completely False. I was a nurse and I was have gladly loss my job before I watched some die like this.
on March 4,2013 | 06:12PM
loquaciousone wrote:
This nurse needs to find a different vocation. How can someone who is trained to do precisely what this patient needed refuse to help? This is the most ridiculous example of humanity that I've ever heard.
on March 4,2013 | 06:15AM
DABLACK wrote:
The nurse's pay is good. She will not look for another job....! She'll wait for the pink slip and sue the nursing home for retaliation !
on March 4,2013 | 06:59AM
cojef wrote:
Can't see her getting a pink slip, she followed institution policy to not get involved in these situations. If anything, the institutions should change its policy relating what the RNs must do and cannot in such situations. The clients have rights also and their desires should be honored if a signed/sealed DNR if filed. Myself(87) have a DNR on file with Kaiser.
on March 4,2013 | 07:33AM
Publicbraddah wrote:
Actually, the care home's policy leaves room for interpretation. The policy is that they wait for emergency personnel to show up. It doesn't say the RN should be hands off with the patient.
on March 4,2013 | 08:27AM
SteveToo wrote:
Why have a nurse at the place if she don't do anything?
on March 4,2013 | 07:44AM
aomohoa wrote:
That was my first question.
on March 4,2013 | 06:16PM
nodaddynotthebelt wrote:
The laws orverride all rules and regulations in private facilities such as care homes, hospitals and the like. This is intended negligent homicide. The nurse should be held accountable. I doubt that the facility had a rule that barred saving a life. And if it did, in fact, say that in their writ, they also should be held accountable.
on March 4,2013 | 08:42AM
entrkn wrote:
Her certification should be permanently revoked, she should be charged with negligent homicide, and the nursing home owners and staff should be charged as accessories, and they should be permanently prohibited from being in any way involved with nursing homes.
on March 4,2013 | 09:41AM
If the nurse couldn't do the CPR, ALL she had to do was to call the fire department or police and they know how to do it. Usually the fire department can be there in 5 minutes. If you notice, every neighborhood has a fire department and is able to be at your location in 5 minutes, then the ambulance or police would arrive next. Shame on that nurse, so much for that home.
on March 4,2013 | 04:55PM
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