North Carolina nursing home cited after maggots found in patient’s foot

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CHARLOTTE (FOX 46 CHARLOTTE) — A nursing home in the University City area of Charlotte was cited by the state after maggots were found inside the wound on the heel of a patient there.

A spokesperson for the North Carolina Department of Health and Human Services tells FOX 46 that University Place Nursing Home & Rehab Center admitted to being noncompliant about the maggots and “had implemented corrective action” after an unannounced investigation into the complaint on September 7 uncovered the issue.

According to state records, the facility “failed to remove maggots as soon as they were identified from the right heel wound for 1 of 3 sampled residents.”

The female resident in question was reportedly admitted to the facility on January 19 with non-Alzheimer’s dementia. An assessment on July 1 revealed that she was “severely cognitively impaired and required total assistance with all activities of daily living.” She also reportedly had pressure ulcers on her sacrum, left heel, and right heal which required scheduled treatments.

A nurse was interviewed by investigators on September 9 who explained that it was around 12 p.m. on August 29 when a nurses aide notified them of maggots in her right heel wound. The aide and a second nurse observed the wound and “confirmed there were approximately 50-100 maggots in the wound.”

The second nurse notified the director of nursing around noon. A couple of hours later, the assistant director of nursing and a treatment nurse arrived to the facility to remove the maggots.

The second nurse told investigators she observed the right heel wound with a wound dressing partially on and maggots inside the wound. She said she immediately notified the director who said that they would notify the physician.

The assistant director of nursing told investigators that he and the treatment nurse cleaned the wound with equal parts vinegar and water and the treatment nurse removed the maggots with tweezers and applied clean dry dressing. The treatment nurse said that the wound had been treated three times a week on Monday, Wednesday, and Friday and that the previous treatment reportedly occurred two days before.

Over the course of 48 hours, the facility reportedly checked all of the residents in the facility with wounds and none were found to have maggots. The treatment nurse contacted the woman’s power of attorney who requested she be transported to the emergency room to be checked out. The woman, at the request of her power of attorney, was not returned to the facility.

A physician for the facility told investigators that he was notified by the director of nursing about the patient, and he gave the order to clean the wound and remove the maggots. He stated that he would assess the wound and that “he did not think [redacted] needed to be sent to the emergency room as the maggots could be removed and the wound managed by the facility staff.” He did state, however, that it wasn’t appropriate for maggots to be in the wound.

The state report shows that the facility had been thoroughly checked by pest control on July 2 and August 11 and that recommendations by pest control were adhered to when the facility was checked again on September 7.

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A maintenance director identified an exterior door used for smokers was the likely source of entry for flies into the facility. Pest control technicians tell the state, however, that they sprayed for flies each visit and did not see a fly infestation at the facility each time.

The administrator of the facility stated that an investigation began and a performance improvement plan were put into place as soon as it was discovered the resident had maggots in her wound. She said that air curtains were ordered and scheduled to be installed over exterior doors and that flies coming in from those doors “were the root cause of the maggots.”

She said it was a “freak occurrence” and that “she hated that it happened.”

The room that the resident was in was reportedly deep cleaned, air curtains were ordered and installed, LED ultraviolet fly/bug lamps were ordered for rooms where residents had wounds. All rooms where residents had rooms were reportedly deep cleaned, window screens added, and outside doors with gaps were sealed.

Records show the facility has had a number of complaints dating back to 2011, with the most recent citing occurring in June when a state investigation uncovered expired and undated food.

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