Complaint Investigation Report

455002783-10-5-2023-59-AS-LCRR-CXJPRK-20231113103247

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SACRAMENTO NORTH ASC , 9835 GOETHE ROAD, SUITE 100

This is an official report of an unannounced visit/investigation of a complaint received in our office on

05/01/2023 and conducted by Evaluator Jaynae Boyles

COMPLAINT CONTROL NUMBER: 59-AS-20230501105533

Resident (R1) was pronounced deceased on scene and at the facility on 04/29/2023 at 1748 hours, following an episode of vomiting and seizure. The cause of death listed on R1 death certificate is Probable Sudden Unexpected Death Due to Epilepsy. There were no medical records available. Per the Deputy Coroner, R1 was not transported to the hospital and an autopsy was not performed because R1 “had an extensive medical history. The caregiver kept watch and provided medication.” R1 primary care physician, was interviewed and stated as part of the procedure before signing a death certificate, doctors nurse called the facility and spoke to the Administrator. Per the doctor’s nurse’s notations, Administrator stated that R1 had been having diarrhea, followed by a seizure and vomiting, leading to R1 becoming unresponsive. CPR was conducted on scene for about 30 minutes and R1 was pronounced deceased at the facility. The doctor advised, when a patient dies at home, “we go off what they tell us, “When determining cause of death. Sudden unexpected death due to epilepsy “can happen” and was the most probable determination based on “what they told us.”

Due to the information above, CCL finds the allegations to be UNSUBSTANTIATED meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.