Maggots infest wound of nursing home patient
The Ottawa police elderabuse unit is investigating a nursing home after staff discovered maggots had infested a resident’s leg wound, landing the woman in hospital and horrifying her family.
The discovery suggests flies laid eggs and larvae hatched in the sore before anyone noticed, raising anew questions about the quality of care in Canadian long-termcare facilities.
It takes days for fly larvae to reach a full- grown stage, said Jeff Tomberlin, a Texas A& M University professor and chair of the American board of forensic entomology.
“Maggots in a wound are not good,” he said. “I can’t think of a case where you could actually say it’s not negligent.”
“If they found fully developed larvae in it, you have to wonder how frequently they’re cleaning the wound, and really paying attention to what they’re doing.”
The incident comes two years after the same woman, 89- year- old Luba Ignatieva, was attacked by another resident at West End Villa in Ottawa, sending her to hospital with a broken hip, her daughter, Lara Gerol, said.
In the recent incident, Ignatieva failed to get one of the twice- weekly dressing changes required for a chronic “venous stasis ulcer” on her leg. When staff removed Ignatieva’s bandage on Oct. 10 after six days, they found maggots and sent her to hospital. “I was in shock,” said the daughter, who believes either hospital employees or paramedics called the police. “It means the wound was not cleaned properly … It means they’re not even looking.”
In a letter to the home, she wrote: “I don’t have enough words in my vocabulary to describe the horror (we felt) when we learned my mother went to hospital with maggots in her leg.”
Extendicare Inc., West End Villa’s owner, said in a statement that it can’t comment on specific residents, but that Ignatieva is being looked after by a team that includes a doctor, while the facility is in an “open dialogue” with the family. “We can assure you that the quality of care of our residents is of utmost importance to us,” the statement said.
In a letter to Gerol obtained by the National Post, West End administrator Kelly Keeler said the ulcer, caused by poor circulation, won’t heal partly because Ignatieva refuses to have her leg elevated. Keeler said the woman also declined twice on Oct. 7 to have the dressing changed.
But the daughter said Ignatieva told her no one even tried to replace the bandage, and that it would have been completely out of character for her to refuse.
Gerol alleged the letter also seemed to play down the incident and almost blame Ignatieva. Keeler argued “maggots are not the result of a dirty environment or unprofessional care,” and said her mother liked to spend time out in the garden, where she said flies are plentiful. The administrator also noted that in some countries, maggots are used for wound care.
But Tomberlin, the entomologist, said there is a world of difference between the “medical- grade” larvae reared in sterile conditions and used in some clinics, versus wild ones that can deliver nasty infections “or worse.”
The Ottawa force is investigating but will not comment on specifics to avoid compromising the probe, said Const. Chuck Benoit.
Ontario Health Ministry spokesman David Jensen said a “critical incident” inspection was carried out at West End on Oct. 18. A “voluntary plan of correction” was issued, and a report will be posted on the ministry website in November, he said.
Gerol said some of the staff at the home — where her mother has lived for seven years — are “wonderful, dedicated, really good people,” but that turnover is high and many other employees are less skilful and caring.
Two years ago, she asked that West End remove the other resident in Ignatieva’s room, believing the person to be “very dangerous.” The request was denied and her mother was almost killed in a subsequent attack, Gerol said. She sued the home, with the case eventually settled out of court.