The first criminal prosecution of nursing home officials for use of psychiatric drugs as chemical straightjackets on elderly patients ended in a three-year prison term Wednesday for the former director of nursing.
Gwen D. Hughes, 59, the head of nursing for a Kern County skilled nursing facility was sentenced based on her plea of no contest to a single count of elder abuse that contributed to a death. Hughes was accused of illegally ordering psychiatric drugs for elderly dementia patients, to control them, even though the drugs are considered dangerous to give to dementia patients.
Her sentence marks the first criminal prosecution in California alleged elder abuse for the misuse of psychiatric medication.
Three elderly patients at Kern Valley Valley Healthcare District hospital died shortly after being given the drugs. Another 23 suffered some form of adverse physical reaction, according to a statement by Attorney General Kamala Harris.
The overuse and abuse of psychiatric drugs to control dementia patients may not be isolated. Nearly 83 percent of the Medicare claims for use of drugs for the elderly were off-label uses, raising the specter of abuse, according to Congressional testimony last year.
Hughes ordered the use of psychotropic medications on 23 elderly residents of the skilled nursing facility, not for therapeutic reasons, but to keep them quiet, prevent wandering and for the convenience of the staff, according to Harris.
Three elderly dementia patients died during 2007 at Kern Valley, after being given powerful antipsychotic drugs to control them, despite warnings that the drugs increase the risk of death in elders with dementia.
Mae Brinkley, 91, Joseph Shepter, 76, and Alexander Zaiko, 85, died in the 74-bed facility in rural Lake Isabella, about 30 miles northeast of Bakersfield. THe cases came to light after an ombudsman reported to the state that a patient had been held down and forcibly injected with the antipsychotic medication. Investigators later uncovered that 23 patients, some with Alzheimer’s — the most common form of dementia — had been given high doses of antipsychotic medications to control them for staff convenience.
The facility’s former chief executive officer, Pamela Ott, signed off on the orders and pled no contest to conspiracy. She was ordered to provide 300 hours of volunteer service and serve three years probation. Dr. Hoshan Pormir signed off on the prescriptions, after the fact, without examinations or monitoring reactions, according to Harris. In July, Pormir was sentenced to 300 hours of volunteer service and restitution, pending the conclusion of civil lawsuits.
The original charges included five counts of elder abuse and two counts of assault with deadly weapons — the psychotropic drugs Zyprexa and Risperdal, according to the criminal complaint.
Earlier this year, Tony Chicotel, an attorney with the California Advocates for Nursing Home Reform (CAHNR), warned, “There are dozens of Kern Valley Hospitals that drug with impunity.”
Of the nearly 305,000 elderly nursing home residents nationally, about 14 percent received antipsychotic drugs in just the first six months of 2007 at a cost of hundreds of millions of dollars, according to Toby S. Edelman, senior policy attorney for the Center for Medicare Advocacy. She told a congressional hearing in November that 83 percent of Medicare claims for use of the drugs on the elderly were for off-label conditions, meaning the drugs were used in ways they were not intended. A startling 88 percent were conditions specifically cited as dangerous by the Food and Drug Administration, according to a government study.