Wrongful deaths: 82-year-old 'dead' woman found to be alive at funeral home

In at least two recent incidents, nursing homes have pronounced their patients dead—before they’ve passed away.

This month, in Long Island, N.Y., nursing home staff issued a wrongful death pronouncement for an 82-year-old woman. About three hours later, she was found alive and breathing at a nearby funeral home, according to news sources.

Another wrongful death assertion was made at an Alzheimer’s care facility in December, after which a 66-year-old woman was also found breathing at a funeral home, according to news sources.

Mistake or malpractice?

Pronouncing someone dead when they are still alive is no “oops” moment. And whether the assertion results from a mistake or malpractice, it can have long lasting or even life altering ramifications for all parties involved.

For the patient, the assertion removes them from vital medical care and can lessen their chances of surviving a medical emergency. For loved ones and family members, it can bring about a kaleidoscope of emotions like grief, trauma, and distress, and distrust of the healthcare system. For physicians, it can cost you your medical license, a lawsuit, or thousands of dollars. 

In the aftermath of the Iowa incident, it was reported that the Alzheimer's care facility now faces a $10,000 fine but not criminal charges.

Following the New York state incident, the New York attorney general’s office called the situation “awful, and said it “caused unnecessary trauma for the impacted resident and her loved ones," according to news sources.

However, nursing homes are under stress, as are other healthcare related fields, due to employee shortages.

According to one study, there are consistent medical-related staffing shortages at nursing homes around the country. For example, of the about 12,000 nursing homes monitored for the study only 54 percent met the expected staffing level less than 20 percent of the time.^[]

Verifying the presence of absence of a pulse

Faint pulses can be difficult to detect, especially if only using one or two methods, says former emergency care doctor, Kristen Fuller. It is important to check for a pulse by using multiple techniques or medical machinery, just in case. It is unclear what methods the nursing homes used to check for signs of life. 

“There are common instances where it is difficult to locate a pulse especially if it is weak or irregular,” says Fuller. “In that situation, a patient should always be hooked up to a heart monitor or a carotid pulse should be palpated or auscultated with a Doppler machine.” 

In the Iowa incident, a pre-death report noted that the patient had no breath sounds, no pulse detected on a stethoscope, and no movement of the abdomen as felt by the nurse’s hand. 

The importance of check-lists and documentation

Physicians should always follow some sort of checklist before making a pronouncement, says Fuller.

“It is really important to have a structured rubric and examination that you follow each time when pronouncing a death,” says Fuller. “That way you do not miss anything and it becomes a structured routine each time.”

She adds that she makes sure to meet with any family members to discuss the situation and offer condolences.

An example of steps to follow may include:

• Identifying the patient by the patient ID wristband.

• Listening for the absence of respirations.

• Noting the absence of the rise and fall of the chest.

• Listening for the absence of heart tones.

• Feeling for an absence of carotid pulse.

• Check for the absence of the pupillary light response.

• Confirming that the patient does not arouse from verbal or tactile stimuli.

• Carefully noting all findings in their medical chart, including the date, time of death and time of exam. 

If they are new to the scene, residents may be followed by an upper-level resident or attending physician to make sure they are taking the accurate steps before pronouncing a patient dead, Fuller says. However, In her years of experience, she has never issued nor witnessed a wrongful death pronunciation being issued, she adds.