A monthslong investigation by the D.C. Department of Health found Washington, D.C.-based United Medical Center at fault for the improper care of a patient who repeatedly cried out that he couldn't breathe hours before his death, according to The Washington Post.
Here are five things to know.
1. D.C. health officials launched an investigation in October to determine if a breach in care protocols at UMC contributed to the death of a 47-year-old patient, Warren Webb. Mr. Webb died Aug. 25, 2017, around 6 a.m at UMC's nursing home. About an hour before his death, he yelled for help about 25 times, complained he couldn't breathe, fell out of his bed and was left on the floor for an extended period of time. An audio recording obtained by The Post reveals he was left on the floor by his charge nurse for about 20 minutes.
2. The investigation, which was made public this week, found multiple shortcomings in the care provided to Mr. Webb. In particular, officials at UMC were unable to prove they promptly and effectively assessed Mr. Webb prior to his death.
"[There is] no evidence that facility staff assessed [the patient] after he complained of not being able to breathe," the report reads, according to The Post.
3. While the D.C. hospital filed an incident report about Mr. Webb's death, the investigation revealed that hospital officials omitted key details of the incident. In particular, the report left out that Mr. Webb died, and also contained a false account of the patient being told at the end of the incident to "wait for staff before attempting to get out of bed by himself," according to The Post.
4. It is unclear what consequences the hospital, its leaders and its staff will face from the investigation's findings.
5. In a corrective action plan submitted after the health department's latest investigation, UMC officials said they "disciplined" two employees and would retrain nurses on "respiratory assessments, treatments and documentation."