Nursing home medication

Blood thinners can be dangerous, but nursing homes aren’t monitoring patients

Blood thinners are very common prescriptions for nursing home residents.

Drugs like warfarin—the generic name for Coumadin—keep the blood flowing smoothly throughout the body.

It’s an effective drug, but the dosage has to be carefully monitored.

  • Too much warfarin causes internal bleeding.
  • Too little warfarin results in blood clots, and strokes.
  • Warfarin interacts badly with some medications, including antibiotics.

Patients on blood thinners are supposed to have regular blood tests to see how long it takes the blood plasma to clot.

It sounds like a simple test, necessary to regulate a useful drug.

Since 15% of nursing home residents take blood thinner, it is alarming that nursing facilities are failing to regulate the dosage, according to the recent investigation by Propublica and The Washington Post.

“Coumadin is the most dangerous drug in America.”

Rod Baird, president of Geriatric Practice Management, said “Coumadin is the most dangerous drug in America,” because it is so easy to get the dosage wrong.

After a nursing home failed to give a patient her Coumadin for 50 days in a row — and didn’t perform a blood test — the woman had multiple blood clots in her legs. She suffered permanent injuries, and had to undergo multiple surgeries.

A nursing home resident in Texas was given Coumadin for 34 days —without a doctor’s order, and without monitoring. By the time he was sent to the hospital, blood was pooling in his mouth.

Coumadin prescription blood thinner for nursing home patients

1 in 6 nursing home residents take a prescription blood thinner. Since it is so common, many nursing homes are not regulating warfarin – or even do blood tests.

The Propublica investigation points to 165 nursing home residents were hospitalized or died after errors in dosing or monitoring warfarin in patients.

That is far too many warfarin errors, but it doesn’t even come close to the estimate from the 2007 study in the American Journal of Medicine.

Based on the yearlong study, researchers estimate nursing homes have an annual 34,000 fatal, life-threatening, or serious medical events from blood thinners.

That is a very large gap between the number of warfarin-related errors that are believed to occur—and the number actually reported in government inspections.

While the investigative reporting doesn’t explain the gap, the federal government has since asked health inspectors to watch for errors by nursing home staff in regulating blood thinners.

Center for Medicare and Medicaid Services is designing tools to help state health departments monitor nursing homes’ prevention and response to medication errors.

Find a nursing home in Washington and see recent inspections.




Image by Alisa Machalek, NIGMS/NIH [Public domain], via Wikimedia Commons

About Kevin

Kevin Coluccio was recently named one of the Top 10 Super Lawyers in Washington State. He has long history of successful elder abuse/neglect cases and has a stellar reputation for getting results for his injury clients in serious car crashes, pedestrian accidents, trucking accidents, maritime claims, and asbestos injury cases.