Staff at an Ottawa nursing home recently discovered that maggots had infested a resident’s leg wound, landing the woman in hospital, horrifying her family and triggering a police investigation.
The Ottawa force said Tuesday its elder-abuse unit has deemed the incident to be a non-criminal matter.
But the discovery – suggesting flies laid eggs and larvae hatched in the sore before anyone noticed – raises anew questions about the quality of care in Canadian long-term-care facilities.
Ontario’s health ministry inspected West End Villa last month and issued an order for voluntary changes to the home’s practices.
It takes days for fly larvae to reach a full-grown stage, something that should not happen in a properly treated patient, said Jeff Tomberlin, a Texas A&M University professor and chairman of the American board of forensic entomology.
The incident comes two years after the same woman, 89-year-old Luba Ignatieva, was “viciously” attacked by another resident at West End, sending her to hospital with a broken hip, her daughter, Lara Gerol, said.
In the most recent incident, Ignatieva failed to get one of the twice-weekly dressing changes required for a chronic “venous stasis ulcer” on her leg.
When staff finally removed Ignatieva’s bandage on Oct. 10 after six days, they found the sore crawling with maggots and sent her to hospital.
“I was in shock,” said the daughter, who believes either hospital employees or paramedics called the police. “It means the wound was not cleaned properly … It means they’re not even looking.”
I don’t have enough words in my vocabulary to describe the horror
In a letter to the home, she wrote: “I don’t have enough words in my vocabulary to describe the horror (we felt) when we learned my mother went to hospital with maggots in her leg.”
Extendicare Inc., West End Villa’s owner, said in a statement that it can’t comment on specific residents, but that Ignatieva is being looked after by a team that includes a doctor, while the facility is in an “open dialogue” with the family.
“We can assure you that the quality of care of our residents is of utmost importance to us,” the statement said.
In a letter to Gerol obtained by the National Post, West End administrator Kelly Keeler said the ulcer, caused by poor circulation, won’t heal partly because Ignatieva refuses to have her leg elevated. Keeler said the woman also declined twice on Oct. 7 to have the dressing changed.
But the daughter says Ignatieva told her no one even tried to replace the bandage, and that it would have been completely out of character for her to refuse.
Gerol alleged the letter also seemed to play down the incident and almost blame her mother. Keeler argued “maggots are not the result of a dirty environment or unprofessional care,” and said Ignatieva liked to spend time outside in the garden, where she said flies are plentiful.
The administrator also noted that in some countries, maggots are used for wound care.
But Tomberlin, the entomologist, said there is a world of difference between the “medical-grade” larvae that are reared in sterile conditions and used in some clinics, versus wild ones that can deliver nasty infections “or worse.”
Ontario Health Ministry spokesman David Jensen said a “critical incident” inspection was carried out at West End on Oct. 18.
An order for a “voluntary plan of correction” was issued to the home, and a report will be posted on the ministry website later this month, he said.
Maggots in live humans — a phenomenon scientists call myiasis — is not unheard of, though it occurs mostly in tropical and sub-tropical countries, according to the U.S. Centers for Disease Control.
A University of California study in 2000 found 45 cases throughout the U.S., the largest group being homeless people.
Gerol said some of the staff at the home — where her mother has lived for seven years — are “wonderful, dedicated, really good people,” but that turnover is high and many other employees are less skillful and caring.
Two years ago, she had asked that West End remove the other resident living in Ignatieva’s room, believing the person to be “very dangerous.” The request was denied and her mother was almost killed in a subsequent attack, Gerol said.
She sued the home, with the case eventually settled out of court.
Tom Blackwell | October 31, 2016 | Last Updated: Nov 1 11:31 AM ET