A 76-year-old woman who lived at a nursing home in Ohio walked out of the building after telling employees that she was leaving.
Phyllis Campbell was gone for 8 hours until an employee found her dead in the courtyard, according to The Associated Press, which added that she had frozen to death.
The cause of death was hypothermia, according to AP. The temperatures at that time when she walked out of the Hilty Memorial Home, in Pandora, Ohio, were around zero degrees Fahrenheit.
The Ohio Department of Health released a report on her death last week.
The state’s report said that Campbell had a history of dementia and wandering off, AP reported. She had apparently told a nurse’s aide that she was “going home.”
The report also said that she was wearing a monitor, which should have set off alarms if she went outside the doors. She was found dead 30 feet away from the doors.
Staff members said that the monitoring device didn’t always work. Officials also tested the device, but it didn’t always go off when it passed sensors, Limaohio.com reported.
Two nurses aides told investigators said they didn’t complete the scheduled 2 a.m. and 4 a.m. welfare checks, but they were marked as completed. The last check reportedly came at midnight.
Laura Voth, chief executive of Mennonite Home Communities of Ohio, said that in the wake of the incident, the nursing homes made changes.
“Let me restate that we are deeply saddened by this loss. We are grieving for the family and extend our heart-felt sympathy to them,” she said, according to AP.