By Spencer Hunt and Debra Jasper
The Cincinnati Enquirer

LuAnn Gale fell down four steps just after midnight in her Columbus nursing home, cutting her lip and the back of her head.

The state says the home should have taken greater care with her injuries. Ms. Gale, 43, died three days after the fall.

According to a state Health Department inspection report, paramedics were called to the Association for Developmental Disabilities' Whittier Street home after Ms. Gale fell.

She told them she didn't want to go to the hospital for stitches, and a company nurse told a night shift worker by phone to keep close watch and make sure Ms. Gale stayed awake. The nurse didn't tell the worker the signs or symptoms to watch for in a person with a head injury or concussion, the report says.

Ms. Gale talked for about an hour, then vomited. The worker asked her to go to sleep in a downstairs bed. She declined, but lost consciousness sometime during the night.

An ambulance wasn't called until the next morning, either at 8:40 a.m. or 9:40 a.m., according to conflicting reports from the home. Ms. Gale was hospitalized and had emergency surgery. She died of internal head injuries on Nov. 2, 1999.

The state Health Department threatened to decertify the home that January for problems related to the death. The home was cited for poor nursing services and failures to provide staff with medical training, to keep accurate records and to immediately notify Ms. Gale's family of her fall.

The state withdrew its threat after the home trained workers to recognize signs of illnesses and said a nurse would regularly document medical notes.

Robert Archer, head of the Columbus-based association that runs 24 nursing homes for the mentally retarded in Ohio, won't comment on specific details but calls Ms. Gale's death "a very sad situation."

"Regretfully, we always learn from every experience," he says. "This was a difficult one."

Those difficulties may not be over. Ken Blumenthal, a Columbus lawyer, is suing the company on behalf of Ms. Gale's two sisters. They're seeking at least $50,000.

"We don't feel LuAnn was properly monitored after her fall," Mr. Blumenthal says. "She developed all the red flags for a head bleed. By the time she was transported to the hospital, it was too late to save her."