The acting Health and Disability Commissioner wants an Auckland rest home to apologise to the family of a man who died after falling twice in the Remuera facility.
The elderly man, known only as Mr A, had lived at Edmund Hillary Retirement Village since October 2007.
A few days after starting treatment for prostate problems he fell in the dining room of the home and the next morning he fell again in his bathroom.
He was seen by his GP who found no significant injury, but the following day Mr A was admitted to hospital with a fractured left eye socket and a spinal fracture. He was also dehydrated.
He died the following day.
The GP has already apologised to Mr A's family, and the acting commissioner recommends the home do so as well.