Real Life Impacts: The Story of Clifford TousignantClifford Tousignant, a veteran of the Korean War, and the recipient of three Purple Hearts, became infected with Salmonella after eating contaminated peanut butter at the nursing home where he lived in Brainerd, Minnesota, in 2008. Although he received skilled medical care throughout his illness, he did not survive his infection. This is his story.
In the late 2000s, Clifford moved to Brainerd, Minnesota to live with his son, Marshall. He remained there until November 14, 2008, when he moved into a skilled nursing facility, also in Brainerd.
On Friday, November 14, Cliff arrived at his new home. Marshall lived just a short drive away, and continued to see his father on a near-daily basis.
Happily, the move to the skilled nursing facility ended up being a good fit. It allowed Cliff to explore his sociable nature while also being under the attentive care of skilled nurses. Cliff got to know his neighbors well, and was frequently found chatting them up. He also enjoyed the meals, one of his favorites being peanut butter sandwiches, a meal he ate almost daily.
All was well until a marked change occurred on Sunday, December 28. That day, Cliff began to have diarrhea. When staff members at the nursing home were made aware of the development, they obtained a stool sample and sent it to a medical center lab to be tested.
Throughout the rest of Sunday and into the next day, the frequency of diarrhea-episodes increased steadily. When checked on Monday morning, he was found to have passed a large stool and was in distress over the situation. He demanded to be taken to the hospital for treatment.
Cliff’s son, Marshall, arrived a short time later to visit and calmed him down a bit. But the diarrhea and abdominal cramping continued without relent. Cliff was given Imodium, but it did little to slow the frequency of his loose stools.
First Hospitalization for Salmonella—December 30, 2008 to January 4, 2009
On Tuesday, December 30, Cliff was again noted to have “loose brown stools” and so additional amounts of Imodium were provided. His doctor became concerned, as dehydration can be a serious health risk with profuse diarrhea. He gave orders for Cliff’s transfer to the emergency room for further evaluation.
Cliff was moved to a room a short time after his admittance to the ER. A decrease in his short-term memory was noted, but it was not deemed a problem. The results from an ordered stool culture were still pending, but the treating physician believed his diarrheal illness could be a Salmonella infection, or, in the alternative, from a viral source.
Overnight Cliff remained calm, despite intense pains and diarrhea. In the morning he was re-checked and found to be alert and oriented. His blood pressure was checked and had come down, a significant improvement from the day prior. Later that afternoon the results of his stool culture revealed the reason for his declining health—he was infected with Salmonella.
The next day, January 1, 2009, marked the beginning of a new year, and also a slight turnaround for Cliff. He was in better spirits than he had been for the past few days, although he was still having “loose mushy green stools,” albeit less frequently. The pain medication was also providing relief from the stabbing abdominal cramps.
The seemingly unending blood draws and cleanings began to wear on Cliff, a man who was normally very sweet and gentle, but who valued his independence and privacy. He particularly dreaded the cleanings made necessary by the never-ending diarrhea. The skin in that area was significantly compromised, causing constant pain and itching, and it eventually ulcerated. To Cliff, it was pure misery.
Cliff’s body also ached all over and grew increasingly weak. By Saturday, January 3, he required almost complete assistance just to get in and out of the bed. That night, after yet another nurse woke him up, and the accumulated frustration of being in the hospital got the better of him, Cliff had an angry outburst. It was just too much.
Thankfully the next day, Sunday, January 4, brought some good news. The diarrhea was now much less frequent and Cliff was feeling better. Other than keep him hydrated and provide assistance as needed, there was little else the hospital could do at that time to treat his Salmonella infection. He was thus discharged that afternoon to the care of the skilled nursing facility.
Cliff was relieved to be back at the familiar surroundings of the facility, but over the next week, he continued to struggle.
Second Hospitalization—Sunday, January 11, 2009
In the afternoon on Sunday, January 11, Marshall stopped by to check on his dad, and visit for a little while. He noticed a shift in his dad’s demeanor; he was lethargic and agitated, and then became completely unresponsive. Marshall had no idea what was going on, and in a panic went to the nursing station to request an immediate blood sugar check for his dad’s diabetes and an ambulance to the ER.
The ambulance arrived at 4:40 PM. Marshall and the nurses told the emergency medical technicians (EMTs) of the events leading up to their arrival. While Cliff was awake, he would not respond to anyone. The EMTs moved Cliff to the ambulance and sped off to the hospital. Marshall followed closely behind in his own car.
Once Marshall arrived, he explained that his father had been in the hospital just a week before being treated for a severe Salmonella infection, and that his diarrhea had not improved since the time of his discharge. The decision was made to admit him again for further tests and monitoring, including another stool culture.
In medical records, it was noted that, at the time of his admission, Cliff was weak, lethargic, and “in such a state that he cannot carry on any useful conversation.” It was also noted that “there has been an outbreak of Salmonella at the nursing home.”
That night, he passed a bloody liquid stool, and began vomiting. The vomiting episodes came frequently, and lasted all through the night. A blood sample collected at the time of admission was cultured and confirmed to be positive for Salmonella. This was extremely bad news, because it meant that bacteria had made its way from his gastrointestinal tract into his blood stream. The prognosis was dire.
By morning on January 12, Cliff was completely unresponsive. A plan was made for the insertion of a central line catheter and for the transfusion of platelets to combat his plummeting platelet count, but unfortunately those plans did not amount to anything. At 11:08 a.m., Cliff took his last breath and quietly passed away.
At the time of his death, Cliff left behind six children, fifteen grandchildren, and fourteen great-grandchildren.