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Group: CVTC deaths avoidable

News & Advance - 5/23/2017

RICHMOND - At least six residents of the Central Virginia Training Center outside Lynchburg have suffered "prolonged and painful" deaths because of preventable urinary tract infections, according to the disAbility Law Center of Virginia.

The Richmond-based watchdog organization, which is responsible for monitoring serious incidents at state-run institutions, released a report Monday outlining six deaths between March 2015 and May 2016. The names of the patients who died were blacked out in the report.

Virginia's training centers house people with severe disabilities.

Colleen Miller, executive director of the disAbility Law Center, said she believes there were possibly four or five additional deaths caused by urinary tract infections at the Central Virginia Training Center during that period, but she can't be sure because the information the group receives from the facility in Amherst County'sMadison Heights area is not always timely or complete.

"It was alarming to see that a state-operated institution had this many UTI-related deaths," Miller said. "We've raised a number of issues with them about the timeliness of the reports and the absence of information we get in the reports. I don't think we've seen a lasting fix."

Urinary tract infections often are caused by bacteria entering through the urethra and building up in the bladder. When treated quickly, they rarely result in complications, but they can result in sepsis, a life-threatening complication of an infection, according to the Mayo Clinic.

The receptionist at the Central Virginia Training Center directed all questions to the Department of Behavioral Health and Developmental Services, which oversees training centers for people with disabilities.

"Before the disAbility Law Center of Virginia (dLCV) brought this issue to our attention, DBHDS was already taking steps to mitigate the effects of infections, specifically urinary tract infections (UTIs), at CVTC," Dr. Jack Barber, interim commissioner of the department, said in an emailed statement. "After working with dLCV on this matter, CVTC took a number of steps to reduce and prevent the number of UTIs."

Training center staffmembers have been trained on hydration and urinary tract infection symptoms, Barber said, and the "UTI Care Plan" provides instructions on care for each identified UTI diagnosis.

"DBHDS thanks dLCV for tracking this vital issue and highlighting DBHDS's efforts to address this challenge," Barber wrote.

According to the report from the disAbility Law Center, the Department of Behavioral Health and Developmental Services released an alert in 2015 regarding the dangers of urinary tract infections and the steps that need to be taken to prevent them.

The same year, the independent reviewer under the 2012 settlement agreement between the U.S. Department of Justice and Virginia "found the commonwealth's practices to be deficient and recommended that Virginia take more aggressive action to identify early indicators of potential harm, including UTIs, for individuals in the settlement agreement's target population," according to the report.

The disAbility Law Center wrote a letter to Central Virginia Training Center officials in September 2016 outlining the deaths and urging them to take "immediate steps to improve UTI prevention and treatment protocols, and infection control practices generally, to stem the tide of UTI-linked deaths at your facility."

By late 2016, the training center convened a committee to address the issue, according to the law center's report. The work group's plan was later outlined in the April 2017 issue of the employee newsletter.

The committee also developed documents for more effective use of medical equipment, and the training center has been promoting the health benefits of drinking more water.

"I would hope that nobody at Central Virginia Training Center needs to die from a UTI going forward," Miller said. "I'm not convinced that their practices will ensure that yet, but I do believe they're on the right track."

The training center is one of four designated for closure under the 2012 agreement with the Department of Justice.

The state was not required by the Justice Department to close the facilities, but officials opted to shut them in order to boost funding for the more than 11,000 people on a waiting list for services on the community level.

Two of the four centers are already closed. The Southwestern Virginia Training Center in Hillsville is set for closure in 2018, and the Central Virginia Training Center is scheduled to fully shut down in 2020.

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