Dr. Keith P. Blair became a victim of medical negligence when he was admitted to the hospital at the age of 86 to diagnose the source of his back pain. At the time, he had some short-term memory problems, but he was able to follow the news, sports, and his favorite tv shows, as well as take care of all of his physical needs.
Without his family’s knowledge or consent as power of attorney, Keith’s primary doctor gave him a cocktail of Risperdal, Haldol, Ativan, Morphine, and Tylenol with Codeine. He entered a sudden mental decline; his family was told the decline was due to “hospital delirium” a condition where older adults get confused in the hospital environment. He was sent to a nursing home for rehab, where he was given more antipsychotic drugs, along with double doses of Ambien. Again, there was no informed consent from his family. In fact, the nursing home doctor never returned the family's phone calls or discussed his condition with them. In less than three weeks, he suffered severe dehydration, heart and kidney problems, 7 falls in 12 days, contracted MRSA infection, developed a bedsore, and suddenly became diabetic. The heart troubles and sudden diabetes were side effects of Risperdal, but no one — neither doctor nor nurse — ever mentioned this. Dr. Blaire ended up in a hospital after his 7th fall, where his family was told his heart and kidneys were failing. This time, his family was told his mental decline was not due to any drugs or hospital delirium, but rather “sudden onset Alzheimer’s.” His condition continued to deteriorate and he died within a month. He was only in the nursing home for 18 days.
After Dr. Blair’s death, his family obtained the nursing home and hospital records and realized what had been done to him and how many doctors had lied to them. They also discovered a number of falsified consent forms including a “Do Not Resuscitate” order. His family had to file three com
plaints to the California Department of Public Health (CDPH) and appeal the case in Sacramento before the nursing home finally received 5 deficiencies related to the drugs, and one citation for willful material falsification of a consent form. Because of Dr. Keith Blair’s case, the CDPH passed a new policy mandating that nursing home verify consent or obtain a new informed consent before administering anti-psychotic drugs.
His family filed suit against the nursing home but lost in forced arbitration. Because of the loss, the family’s attorney told them he would not pursue a case against the nursing home doctor. The Medical Board of California repeatedly told them that their complaint against the doctor resulted in a letter or reprimand with conditions, a discipline that is reserved for cases where the patient suffered no harm. Three years after the WMF citation was levied, the nursing home challenged it in arbitration and the judge overturned it.
The most tragic detail of the story is what came to light in the autopsy. His back pain, the reason for his initial arrival at the hospital, was spinal stenosis, a condition that could have been treated at home with physical therapy and over-the-counter medications.