Dementia Patient Dies of Hypothermia After Being Locked in Freezer at Assisted Living Facility

Facility Failures Leading to Tragedy

• 💡 A scathing report details how Waverly Assisted Living Facility failed to prevent the death of an 83-year-old dementia patient, Gan Ray, from hypothermia.
• ⚠️ The facility suffered from short staffing, with only one staff member scheduled for 48 patients on the assisted living side the night of the incident.
• 📌 Employees had previously complained about being understaffed, not taking breaks, and lacking adequate supervision at night.

Unsecured Premises and Wandering Patient

• 🔑 Basic safety measures were not in place, including the lack of locks on the kitchen door and a missing key for the walk-in freezer.
• 🚶 Video footage shows Gan Ray wandering the facility unnoticed for hours, entering and exiting the kitchen area and cooler multiple times.
• 🚨 A cook had previously expressed concern to the administrator about the inability to secure the kitchen, fearing someone might start a fire.

Discovery and Delayed Response

• 🥶 Gan Ray was last seen on video at 4:30 a.m. and discovered inside the freezer at 8:10 a.m., indicating he was trapped for approximately 3.5 hours.
• 🧊 Upon discovery, he was found shivering and responsive to commands, but a staff member did not move him, citing facility policy.
• ⏳ The staff member reportedly waited 20 to 30 minutes for rescue personnel to arrive, even though the patient's family was in a conference room within the same facility.

Fatal Consequences and Family's Grief

• 🌡️ Gan Ray was transported to Trinity Medical Center, but it was too late; his core body temperature was 66°.
• 💔 The preliminary cause of death was determined to be hypothermia by the Pasco County Medical Examiner.
• 🗣️ The family's attorney stated the excuse given for not moving the patient was that it was against facility training, a response the family found devastating.

Call for Accountability and Oversight

• ✅ The report from the Florida Agency for Health Care Administration (AHCA) provides a comprehensive picture based on interviews with staff, administration, and residents.
• 📞 The facility was contacted for comment but did not respond.
• 🔍 The report serves as a stark reminder of the importance of proper staffing and safety protocols in assisted living facilities.