Elsie Blanche Meacham, 81

Elsie Blanche Meacham, a 81-year-old white female, died Monday, Dec. 17, in Altadena, according to Los Angeles County coroner's records.

According to coroner's records, Meacham was taken from Country Villa Park Marino Health Center, a nursing home, to a hospital where doctors found extensive bed sores. The doctor who treated her determined that she died as a result of infection from those sores.

Additional information added Jan. 27, 2010: An investigation by the California Department of Public Health concluded that three days before Meacham died, the pressure ulcer on her left thigh had doubled in size from 5 centimeters wide to 10 centimeters, and the skin tissue had begun to die, and had begun to look like a crater.

The surrounding skin had begun to turn black and red. Notes by a physical therapist caring for her showed Meacham was in obvious pain; Meacham was quoted as saying repeatedly, “Oh, God.” Meacham’s worsening condition was observed by a licensed vocational nurse, instead of by “a qualified registered nurse,” according to the state report.

The next day, Meacham was transferred to an emergency room after complaining of pain, feeling cold and difficulty breathing.

“I am so [tired]. It hurts so much,” she was quoted as saying in the state report.

Meacham’s daughter later told an investigator that by then, the pressure ulcers covered 60% of her mother’s upper leg areas on both legs. Hospital records show that Meacham’s skin wound had become infected, and the bacterial infection had entered her bloodstream, causing sepsis and her death.

The state cited the nursing home for failing to ensure that the patient’s pressure sores “received necessary treatment and services to promote healing, prevent infection and prevent new sores from developing.”

It later said, “There was no evidence that the facility attempted to identify the risk factor (prolong sitting in the wheelchair) and provide a pressure reducing device while sitting in the wheelchair.”

Pressure ulcers can develop when a person stays in a single position for too long without shifting weight, and can occur with those who stay in wheelchairs or are bedridden, according to the National Institutes of Health. A pressure sore can start as a blister; at its most severe state, skin tissue has died and looks like a crater, and muscle and bone underneath the dying skin has been damaged.

Four months before Meacham died, a care plan created for Meacham identified her as being “at high risk of skin breakdown related to decreased mobility, presence of pressure ulcer with contributing factor of diabetes.” But, the report said the plan did not specifically detail what kind of interventions would be made.

-- Rong-Gong Lin II