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Murder charge filed in nursing home death

Posted June 7, 2010

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— A registered nurse was indicted Monday on a charge of second-degree murder in the February death of an Alzheimer's patient at a Chapel Hill nursing home, authorities said.

Angela Almore, 44, of 724 Berwick Valley Lane in Cary, also was charged with six counts of felony patient abuse. She was taken to Duke University Hospital in Durham following her arrest when she complained of chest pains.

Almore was booked into the Orange County jail Monday night. She was being held under a $500,000 bond. She is due in court on Tuesday morning.

Britthaven nursing home sign Woman charged with murder in nursing home death

Almore’s neighbor told WRAL News he saw investigators searching through her car on Monday.

Nine of the approximately 25 patients in the Alzheimer's unit at Britthaven of Chapel Hill tested positive in mid-February for opiates, a class of controlled substances often used for pain management, officials said. Six of them were hospitalized, and 84-year-old Rachel Holliday, died on Feb. 16.

An autopsy wasn't performed on Holliday, but a medical examiner who reviewed her records determined that she died because of pneumonia-related asphyxiation. The report lists "morphine toxicity" as a contributing factor to her death, noting that tests done at UNC Hospitals before her death determined she had a morphine level of more than 50,000 nanograms per milliliter of urine.

Drug testing done in the military and many workplaces considers a morphine level of 2,000 nanograms per milliliter as a positive test result.

Officials have said Holliday and some of the other Alzheimer's patients who tested positive weren't supposed to be receiving any pain medication at Britthaven.

The Medicaid Investigations Unit of the state Attorney General's Office pursued the criminal case against Almore as part of its investigation into possible wrongdoing at Britthaven, at 1716 Legion Road.

Britthaven officials declined to comment on the arrest.

Jim Jones, a spokesman for the state Department of Health and Human Services, said Monday that the state Nursing Home Licensure Section would  proceed with its own investigation of any procedural violations now that the criminal probe is finished.

The agency sent a team of inspectors to Britthaven two days after Holliday's death to gather information about drugs administered to Alzheimer's patients there.

Britthaven tested all staff members of the Alzheimer's unit for drugs and placed them on paid leave. The tests came back negative, but a spokesman for the Kinston-based chain of nursing homes said staffing for the Alzheimer's unit remains under review and none of those on duty at the time of hospitalizations have returned to work.

Britthaven of Chapel Hill now monitors the Alzheimer's unit around the clock, and officials have replaced some medication and eliminated some dietary supplements for patients.

16 Comments

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  • Vietnam Vet Jun 8, 2010

    Truthfully I haven't seen a nursing home that ISN'T understaffed and overworked and I've seen a few of them. Heavily medicated patients are a lot less trouble and work, but I have to wonder how she got the morphine??

  • samiam1244 Jun 8, 2010

    She can kiss her Nursing License goodbye..

  • davidgnews Jun 8, 2010

    They should seriously investigate all Britthavens. Many are understaffed and overworked. My dad was in one of them for rehab PT only, and they started loading him up on drugs he never needed. The Dr. only gave face time by request, otherwise he was in after hours, read the chart, and pushed the rest on the nurses.

  • Fiddlemom Jun 7, 2010

    I have also worked 20 plus years as a nurse and 10 of those in an dementia unit. It takes special people to work in one but can also become quite rewarding when you know you can bring some sunshine in their lives. Yes, there is a strict regimen of counting and securing narcotics and I am wondering where she got them. Morphine is usually given for end-stage pain management, but not always. The problem with the geriatric population is that many drugs do not clear their system as it does in younger persons. Many of these opiates accumulate and cause respirations to cease. I agree with North, if this case makes it to court she will probably be found not guilty.

  • mulecitybabe Jun 7, 2010

    Officials have said Holliday and some of the other Alzheimer's patients who tested positive weren't supposed to be receiving any pain medication at Britthaven.

    I hope by this statement it is meant that they are not supposed to be receiving narcotic pain relievers. An Alzheimers patient is able to feel pain even if they can't verbalize it. To withhold pain medication from someone who needs it is inhumane.

  • bombayrunner Jun 7, 2010

    herolynp ... you have it exactly RIGHT. Everyone wants the security of being an RN. But it is a job that trusts you have a caring heart and personal honor. This is why nursing instructors peer into your eyes when you are trying to get into school. Do you want a paycheck? or do you want to take care of patients? The answer MUST be the ladder. No one wanted to be an RN when it paid 20k a year. This is why Cops make what they do, they'll never run out of folks who want to carry a gun for next to nothing.

  • carolinaprincess62 Jun 7, 2010

    Speaking as a nurse, yes, there are checks and balances when it comes to medications. Especially, narcotics. There are controlled drug sheets and the meds have to be counted between shifts. That being said, diversion of drugs goes on in just about any setting there are medications to be had especially narcotics..hospitals, EMS, ambulance services, nursing homes and hospices. There are unscrupulous people in every profession. Now, after saying that, it takes a special person to be able to work on an Alzheimer's Unit. It is one of the hardest places to work. It is very stressful, emotionally and physically. If she administered the medications to these patients to soothe their agitation, she has committed a crime. I can understand why she did it but I do not condone it. She should have found another job. If she didn't do it, I certainly hope the cause is determined.

  • bombayrunner Jun 7, 2010

    isadaniels56 ... yes, for narc's there are all kinds of checks. If she was to blame for this, and with what it takes to charge someone, shes probably got some heavy explaining to do. She was probably overwhelmed with work. Its no excuse, ofcourse. But I'm just equating this to someone spiking a baby bottle with alcohol to get them to sleep. The nurse in this case probably has a couple problems 1-drugging the patients and 2-where did she get the drugs to do it?

  • isadaniels56 Jun 7, 2010

    From what I know there should be some type of checks and balance when it comes to medications and the person receiving them. I am willing to bet that she was not a lone wolf, if in fact there is good evidence found against her. Some one might want to check on what the person over her was doing. Was her supervisor sleeping on the job? If and when the day comes when a family member or myself need to be with a health care agency, I hope that we don't have that problem.

  • herolynp Jun 7, 2010

    I worked in a medical setting for 7 years and have done everything from changing diapers and bedpans to administering meds to performing cpr to preparing bodies for the morgue. The job itself is as frustrating as anyone could imagine, but the thought of someone who has taken an oath to provide care to sick and elderly, deliberately soing things to hurt them just tear my nerves into bits. That nurse that deliberely administered meds to alzheimers patients should be tried and convicted of premeditated first degree murder, and guess what, I need to be sitting on the jury, and the judge who get to hand down the sentence. She is a disgrace to the entire medical profession. Thank God, all nurses doesn't share her sentiments. She's nothing more than a murder.

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