In This Issue:

- Three Dallas Area Daycare Facilities Under Investigation

- Worst Nursing Home in the Country

- Two Fentanyl Pain Patch Recalls

Three Dallas Area Daycare Facilities Under Investigation

Recently, three separate Dallas area daycare facilities have come under investigation for possible abuse and / or neglect of the children under their care.

Police are investigating Braswell Child Development School in Dallas after they had left a child in a daycare van for about an hour before realizing he was missing, left in the daycare van. The Dallas child was picked up from his home in the daycare van and apparently fell asleep on the ride to the daycare. When the van arrived at the daycare, no one noticed he was left behind in the van.

In another report, a 3-month-old baby was found dead at a Dallas area home-based daycare Wednesday afternoon. The baby was discovered around 4 p.m. at a home-based daycare in Farmers Branch, Texas. The daycare worker who found the infant called 911 and paramedics rushed the infant from the daycare to RHD Medical Center, where the baby was pronounced dead. The cause of death has not been determined yet, but police say there was no visible indication of trauma. The autopsy and investigation could take 1-2 weeks depending on the depth of the investigation.

The most troubling is allegations of sexual abuse of a 4-month-old baby while in the care of a Killeen Daycare. Police in Killeen, Texas are looking into the possible daycare sexual abuse case involving a 4-month-old baby. The investigation was escalated when the Texas Department of Family and Protective Services got involved days after the original report.

When the 4-month-old was picked up from the Little Blessings Daycare, her mother was told that her daughter had a diaper rash. After an examination, her doctor suspected sexual abuse based on bruising that typically indicates such.

The child's family has contacted a daycare abuse attorney to help with the situation.

Worst Nursing Home in the Country

Nursing home abuse and neglect is a growing problem in the US and is very difficult to discover. Fortunately there is a new service helping families avoid the worst nursing homes. The names of 131 of the nation’s worst nursing homes have been published to help potential residents avoid these sub-par facilities. The list was released by the Centers for Medicare and Medicaid Services (CMS) listing nursing home facilities that have been designated as being a "special focus facility". The special focus facility designation identifies nursing home facilities that need increased oversight. The nursing homes on this list are required to have state inspections every six months rather than once a year.

The list shows 52 nursing homes as not showing improvement after they were cited as being a higher-risk nursing home, while another 52 indicated some improvement. In the last six months, 27 nursing homes were added to the list. Of the original 54 nursing homes disclosed as poor performers, 21 have shown some improvement, according to the CMS. With this new publicity, hopefully more and more nursing homes will ensure they do not end up on the list by taking the steps they should have all along to protect their residents.

Few nursing homes are perfect and most average six to seven deficiencies per survey. The special focus facilities, on average, had about twice as many deficiencies and were not corrected or took too long to correct. The special focus designation is determined by each state and inspection policies and standards vary for each state.

Common nursing home problems that are seen in facilities in the special focus list include misuse (too much or too little) of medication and a lack of safety measures to protect their residents from accidents. Many elderly nursing home residents need constant care, particularly those with Alzheimer's disease or residents who have limited mobility.

The Centers for Medicare and Medicaid Services published the complete list of cited nursing homes at: http://www.cms.hhs.gov/CertificationandComplianc/Downloads/SFFList.pdf

Two Fentanyl Pain Patch Recalls

Fentanyl pain patches have been recalled due to concerns that they put users and caregivers at risk of accidental overdose. The recall includes 14 lots of Fentanyl transdermal system CII patches and 25 to 100-microgram-per-hour Duragesic Pain Patches sold in the United States.

Some of the patches may have a cut or tear in the lining where the drug is held. If the Fentanyl leaks out of its packaging, it could directly contact patients or caregivers and cause accidental overdose which could lead to difficulty breathing and possibly death.

Fentanyl is a powerful opioid drug intended to treat severe chronic pain over extended periods of time. Cancer patients are commonly prescribed Fentanyl, but it has been prescribed for a wide variety of pain. The FDA found that some doctors prescribed it for recurring headaches or post-surgical pain.

The affected patches should not be handled directly do the possibility of overdose. Anyone with Actavis Fentanyl transdermal system patches with the below listed lot numbers should discontinue use immediately and contact their doctor or care provider. If you are unsure wether your Fentanyl patches are affected by these recalls, you should contact your doctor or health-care providers.

The Fentanyl pain patches covered by the Actavis recall include:
27261 (exp 05/09), 27317 (exp 05/09), 27318 (exp 06/09), 27319 (exp 06/09), 27391 (exp 06/09), 27409 (exp 06/09), 27475 (exp 07/09), 27476 (exp 06/09), 27488 (exp 06/09), 27514 (exp 07/09), 27536 (exp 07/09), 27537 (exp 08/09), 27538 (exp 08/09), 27545 (exp 07/09), covering the following strengths: 25 mcg/hr, 50 mcg/hr, 75 mcg/hr and 100 mcg/hr.

Fentanyl / Duragesic pouches containing recalled Fentanyl pain patches are individually labeled with an Abrika Pharmaceuticals label, but the outer carton bears the Actavis logo with the following product names:

Actavis Fentanyl Transdermal System, 25 mcg/hr. NDC 67767-120-18.
Actavis Fentanyl Transdermal System, 50 mcg/hr. NDC 67767-121-08.
Actavis Fentanyl Transdermal System, 75 mcg/hr. NDC 67767-122-08.
Actavis Fentanyl Transdermal System, 100 mcg/hr. NDC 67767-123-08.