Before deadly fire, concerns arose about smoking at care facility 

Years before a deadly fire in a San Mateo County long-term care facility, concerns were raised about smoking at the building, according to state records.

As The San Francisco Examiner first reported, 67-year-old Bruce Smith allegedly dropped a cigarette and lit his gown on fire at the roughly 200-resident Burlingame Long-Term Care facility Dec. 23, according to the San Francisco medical examiner. Smith died three days later of complications from burns to 18 percent of his body — including his head, torso and arms — and the death was ruled an accident, officials said.

But before that, on an afternoon in September 2004, a “cognitively impaired” resident at the center flicked her cigarette off a second-floor smoking patio, starting a fire in the vacant lot below, according to state Department of Health and Human Services records.

A few months later, a state surveyor who observed the facility for several days reported that residents were allowed to smoke unsupervised, including the woman who started the September fire and several others considered “cognitively impaired.”

“The facility’s failure to properly supervise and monitor the residents who smoke put all the residents of the facility at risk from fire and smoke inhalation,” according to the annual state survey of the center completed Jan. 7, 2005.

After the 2005 survey, the county pledged to make a list of residents who need supervision while smoking, reassess residents to determine if they could safely smoke independently and make hourly checks of the smoking patio.

Also, the county responded to complaints by installing a call button and fixing a railing that one resident said was loose, records show.

“The plan of correction we put in place is still in place today,” said Dr. Susan Ehrlich, CEO of the San Mateo Medical Center.

The county has declined to describe the Dec. 23 incident, including whether Smith was supervised, citing patient confidentiality laws. Ehrlich said residents are currently only allowed to smoke independently after a clinical team evaluates the person’s mental and physical competency. He said very few of the roughly 30 patients who smoke there now need supervision.

The 2005 survey described a 2004 incident in which a resident threw a cigarette off a balcony, catching a pallet of cardboard and wood on fire. The Fire Department said residents should stop throwing out cigarettes, but hundreds of butts littered the area below the balcony during a recent visit by The Examiner.

The surveyor also reported two to five residents smoking unsupervised at any given time during a four-day period in January 2005, and the facility’s administrator acknowledged no one person was assigned to monitor the area. At least one cognitively impaired resident reportedly wore a flame-retardant apron while smoking.


Long-term care

The facility in Burlingame is run by San Mateo County. It offers residents many services, including:

- Medical care
- Skilled-nursing care
- Rehabilitation
- Social services
- Recreation therapy
- Meals
- Laundry service
- Housekeeping


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Shaun Bishop

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