A former nursing home employee was found not guilty of abuse last week in an unusual case centering around the use of a gait belt to keep an elderly dementia patient from falling.
At trial, prosecutors in Ohio pitted staff members against one another and called the nursing home director to the stand to testify to a patient’s “right to fall.”
LPN Randi Noel McKinley, who maintained her license and now works in assisted living, was charged with abduction two years after the death of patient Robert Whittington. The patient happened to die the day after McKinley and other staffers reportedly restrained him in a reclining medical chair using the belt, but a coroner ruled that Whittington’s death was due to natural causes and unrelated to the incident.
A nurse aide and registered nurse were also charged in connection with the gait belt case and took plea deals, with at least one of them agreeing to testify against McKinley. But last week a jury found McKinley not guilty of abduction, tampering with evidence and forgery.
Warren Koster, a former county prosecutor and now an attorney with Hall Booth Smith in New York, called the case a politically motivated outlier, and said claims about a right to fall were “ludicrous.”
“That certainly would not have been [the] position at a deposition in a civil case had Mr. Whittington fallen and suffered serious injuries,” Koster told McKnight’s Long-Term Care Wednesday. “It is obvious the nurse and aide were placed in a difficult position. If they did not take any action and the patient fell from the chair, it is certainly possible he would have died because of his frail condition. In such a situation, they might have faced prosecution in Marion County for criminally negligent homicide.”
McKinley’s attorney, Rocky Ratliff, told the Marion Star newspaper that the not guilty verdict validated the challenging decisions healthcare workers must sometimes make in mere seconds.
“All of our medical people are there to protect us, not to let us fall and then pick up the pieces,” he said. “This is not a toddler that you’re teaching to walk; this is an elderly person that is facing safety issues. [The] verdict was a message from the public that our healthcare people should have some latitude on doing what they think is right to protect our elderly patients and those with dementia that don’t know their surroundings.”
Targeting the ‘weakest link’
Attorney Matt Keris of Marshall Dennehey told McKnight’s that McKinley and the aide with her appeared to be in a “no-win scenario” when helping the resident, though he acknowledged the gait belt may have been used without a physician’s order.
The case harkened back to the trial earlier this year of Tennessee nurse RaDonda Vaught, who was convicted of criminally negligent homicide in the accidental drug death of a hospital patient. The case was built largely on an admission of error she made during her employer’s internal review process, a factor observers noted could have a chilling effect on nursing professionals.
“It does smell of Vaught because the local DA was very aggressive on a case that appears to be based on negligence,” Keris said of McKinley’s case. “It is an example of law enforcement targeting the ‘weakest link’ in going after an individual nurse, as opposed to the institution.”
Keris also pointed out that other charged workers agreed to testify against McKinley, likely under “tremendous pressure” by law enforcement.
Koster said an unintended consequence of these cases could be a decrease in reporting incidents, based upon fear of criminal repercussions.
“Such reporting is critical to improving nursing care as it provides an opportunity to correct, conduct and, where warranted, institute a new protocol for staff to follow,” he said. “We learn not only doing a task correctly but by making mistakes that are correctable. These episodes provide teaching moments. We cannot afford to have healthcare professionals fear transparency. If that occurs, the quality of healthcare will decline.”
