Articles Posted in Psychotropic Drugs

More patients in San Diego County nursing homes and across the country are being diagnosed with schizophrenia for reasons that are questionable and raise concerns about nursing home negligence, as a recent article in The New York Times suggested. But are some patients more affected than others, and is race playing a role? A follow-up report in The New York Times argues that Black residents are being disproportionately affected by these harmful diagnoses and subsequent administration of antipsychotic medications, suggesting that nursing home abuse has a clear racial dimension in these situations. Are schizophrenia diagnoses, and other issues in nursing homes, affecting Black residents more than other elderly patients at skilled nursing facilities? 

Black Nursing Home Residents are Diagnosed with Schizophrenia More Often

More nursing home residents are being diagnosed with schizophrenia so that the facilities can administer antipsychotic drugs to “difficult” patients, The New York Times has suggested. Indeed, since nursing home residents with schizophrenia can still readily be prescribed antipsychotic medications (whereas regulations have attempted to reduce the use of antipsychotics in other nursing home cases), there has been a surge in the number of patients diagnosed with schizophrenia. Since 2012, the number of elderly patients diagnosed with schizophrenia has “grown by 70%.” The article points to a new study in the Journal of the American Geriatrics Society, which found that the “impact of this has been more severe on Black residents.”

The recent sentencing of a former nursing home administrator from a Lake Isabella facility is sure to send shockwaves throughout the nursing home community. Channel 17 KGET news recently reported that Pamela Ott, a former nursing home administrator, was sentenced to three years probation and 300 hours of community service for the actions committed by lower ranking staff while under her watch and her subsequent lack of action to prevent further crimes. The news station reported that this is the first time in the country that an administrator was held criminally responsible for the administration of pyschotropic medications.


The facts of the case paint Ott not as someone committing criminal acts, but instead as someone who failed to respond to criminal actions. Because of Ott’s failure to act, eight residents of the home were seriously injured and three of those died. From August 2006 to August 2007, these eight residents were inappropriately medicated by lower ranking staff in order to keep them quiet and subdued. Ott failed to monitor the medicating practices of the staff and then later failed to investigate these incidents after they were reported to her. She received complaints about nursing director Gwen Hughes’ abusive actions at the home, but ignored those complaints and instructed the employees to follow the director’s instructions. Ott was told by staff members that residents were being “forcefully restrained and injected with medications” according to The Bakersfield Californian, but she failed to do anything about it. Ott plead no contest to a felony count of conspiracy to commit an act injurious to public health according to the report. Ott’s plea deal resulted in three years probation and 300 hours of community service. If she had fought the charges and had been convicted on all counts, she could have faced 20 years or more in prison.

Our San Diego Elder Law Attorneys point to this regretful situation as additional evidence that both residents of nursing homes and their family and friends need to keep a careful watch over the conditions within nursing homes and the actions of the staff. In this instance, employees of the nursing home were using abusive tactics involving restraints and medication in order to subdue and control the residents. The evidence presented showed that this behavior was reported, but the nursing home administrator failed to handle the complaints appropriately, leading to additional instances of abuse and the resulting mistreatment of the side effects of the abuse. Three residents died. Our Southern California nursing home abuse lawyers agree with the prosecution in making a resounding statement that this type of behavior should not go unpunished.

A Californian doctor, Dr. Hoshang Pormir, was sentenced to probation for improperly medicating nursing home patients, resulting in three deaths. Pormir will serve three years probation for his faulty actions in the Lake Isabella facility.

Dr. Hoshang Pormir was a staff physician at the nursing home. State authorities contend that from August 2006 to August 2007 this doctor incorrectly drugged these elderly patients with anti-psychotropic medication; psychotropic drugs are psychiatric pharmaceuticals that alter chemical levels in the brain which impact mood and behavior. His reason for implementation: “To keep them quiet,” according to KBAK Fox News. Some of the nursing home residents were even forcibly injected. Finally after two years worth of investigation, local police arrested Pormir in February of 2009.

pills%20%282%29.jpgMoreover, three other individuals are facing charges for their own role in the elder abuse case. Each of these defendants—former director of nursing Gwen Hughes, former pharmacist Debbi Hayes, and hospital administrator Pamela Ott—worked for the nursing home facility in Lake Isabella. Officials say that Hughes, starting in 2006, allegedly ordered for patients to receive high doses of these psychotropic medications, particularly to Alzheimer’s or dementia suffering patients. The former nursing chief Hughes mandated that the medications be given to patients who argued with her, made noise or were otherwise disruptive; Pormir merely signed off on the orders after the drugs were administrated. Scheduled for October, she will face eight counts of harming or causing the death of an elderly adult and two counts of assault with a deadly weapon. As for Ott, she pleaded no contest last month to a conspiracy charge with here sentencing coming next month.


It is being reported by California Watch that the U.S. Department of Justice is investigation what is being described as lax care at several California nursing homes, and even threatening criminal and civil actions against those homes. Specifically, the investigators will be examining the use of psychotropic drugs in these facilities and those injured by the misuse of such drugs. Also being investigated are the nursing homes that prematurely discharge patients whose condition requires them to stay.

The investigation was triggered in part by the federal health reform law that includes the Elder Justice Act. That act allows for the coordination between the U.S. attorney general’s office and local and state law enforcement to crack down on elder abuse and neglect. The Northern California office of the Justice Department retained the services of a consultant, who interviewed local ombudsmen’s offices about nursing home complaints. Out of those interviews, several facilities were identified.

U.S. Attorney Melinda Haag told California Watch that her office hired the consultant approximately two months ago, shortly after a California Watch article about the decline in the prosecution of elder abuse cases. “My office is in the process of evaluating the complaints our consultant gathered and will prosecute, to the fullest extent of the law, those individuals who are in violation of federal statutes,” Haag said in a written statement.

stop-sign1.pngThe California Advocates for Nursing Home Reform (CANHR) has launched a comprehensive website that addresses the growing problem of drug misuse in California nursing homes. Every day, approximately 25,000 California nursing home patients are given an antipsychotic drug. Half of all dementia patients are administered these drugs despite FDA warnings these drugs can kill a dementia patient.

Because of this CANHR has launched a campaign to help end the drugging of California nursing home residents. CANHR states its goal this way:

The goal of the campaign is to stop nursing homes and doctors from misusing dangerous antipsychotic drugs and other types of psychoactive drugs to chemically restrain residents and to replace drugging with individualized care. Through education, advocacy and political action, we seek to bring Californians together to end this harmful practice.

San Diego’s 10News I-Team has conducted an investigation into what it is calling the chemical restraint of elderly residents of nursing homes. That is, using anti-psychotic drugs not necessarily for their prescribed use, but to control behavior in residents who otherwise wouldn’t be candidates for the drugs.

The investigation profiles the family of Dr. Keith Blair, a retired dentist, who died at age 86 after a stay at Arbor Hills Nursing Center in La Mesa. The family contends Dr. Blair’s death was expedited by the use of the anti-psychotic drugs Risperdal and Haldol that were given without consent. Both drugs contain warnings that state the drugs are “associated with an increased risk of mortality in elderly patients.”

Upon one visit to the nursing home to see her father, Marian Hollingsworth told the I-Team that her father was “completely out of it. I shook him on the bed, I hollered his name. I asked the nurse what was going on. I couldn’t wake him up. She said, ‘Oh, he was sleepy last night.'”

A nursing home caregiver is being charged with second degree murder after the death of an Alzheimer’s patient in a North Carolina nursing home. Authorities believe that caregiver Angela Almore deliberately administered large quantities of morphine to 84-year-old patient Rachel Holliday in order to make her “more manageable.” It is believed that other residents were also given the drug for this purpose, and cite six other Alzheimer’s patients who required hospitalization while under the care of Almore.

The arrest and indictment of Almore stems from an investigation by Medicaid Investigations, who launched an investigation after nine of 25 patients in the nursing home’s Alzheimer’s wing at the nursing home tested positive for opiates. Sadly the use of opiates and other psychotropic drugs to control patient behavior is an ongoing problem at nursing homes across the country. Here at Walton Law Firm we have had several cases involving the improper use of medications, which exposes nursing home residents to untold number of dangers, including overdose, falls, or simply a loss of dignity.

Almore’s next court date is set for July 13.

Last year, the U.S. Drug Enforcement Administration began investigating allegations that some nursing homes were dispensing powerful narcotics to nursing home residents without a physician order. Because of the new scrutiny, however, nursing home and hospice trade organizations are arguing that many patients are now being left without pain medication as the nursing facilities try to find ways to comply with DEA regulations. Congress has also taken notice, and the subject will be addressed at a Senate hearing today.

The DEA intensified its efforts to battle abuse of prescription drugs in nursing home, after numerous reports of overmedication of patients in nursing facilities, many without prescription, and frequently used as a “chemical restraint,” not to treat a specific illness. In a letter to Congress last December, attorneys for the DEA said that allowing nurses to dispense medications without a doctor’s order, “trivializes the doctor-patient relationship and weakens the quality of care for the frail and infirm.”

Nursing home trade organizations, however, say that long-term care facilities don’t make available enough doctors to issue prescriptions every time. The DEA’s requirement on “hard copy prescriptions,” it says, places burdens on prescribers, pharmacists and nurses, and can lead to extended delays in the administration of pain medication.”

This story is flat-out disturbing, and started with a concern we have heard many times from the families of our nursing home abuse clients. It began with Phyllis Peters could not wake up her 97-year-old mother, who was residing in Kern Valley Nursing Home. When she complained to Gwen Hughes, the nursing home’s director, Hughes would “chemically restrain” the patient by giving her powerful anti-psychotic drugs to shut her up. Hughes did this to other residents in the nursing home, and three of them died.

In a report from the California Attorney General, Hughes ordered one patient drugged because she “glared” at her. Another was given high doses of an anti-psychotic drug for throwing a carton of milk. Several residents became severely malnourished, and were left in bed drooling and emaciated.

“In a couple cases, elderly people were actually held down, restrained against their will, and given excessive amounts of medicine to keep them quiet,” said AG Jerry Brown.

The Chicago Tribune recently published a brief article called 5 Things to Know about Psychotropics, which I thought I would pass along to you. Here are the five things:

Your rights: A nursing facility cannot administer a psychotropic drug without a physician’s order, which by law requires informed consent and a legitimate diagnosis. The standard of care requires that nursing staff must first try to calm patients, and other possible causes of agitation must be ruled out, such as infection.

The consent: Before psyschtropics can be used consent must be obtained by the “responsible party” of the resident, usually the person with power of attorney. The consent must be in writing.

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