Arizona Jury awards $6.5M in bedsore suit

This Arizona jury awarded $6.5 M ($3M compensatory, $3.5M vulnerable adult violation) for a SINGLE Stage III decubitus ulcer against Banner-University Medical Center in Tucson, AZ.  The 67 year old patient had fallen off of a roof and was a quadriplegic at the time of the development of the wound and subsequent infection.  Plaintiffs alleged that the wound and infection began a cascade of events that led to his death 5 years later.  What is interesting is that while this was an STACH, the plaintiffs focused on many of the same issues we see in nursing home cases, such as blood stream infection, UTI’s, nutrition-weight loss.  The complete article is below, but again exhibits the variability of outcome if left up to a jury.  The Arizona Daily Star

25-Mar-2015

Jury awards $6.5M in bedsore suit vs. Banner-UMC

The family of a Tucson man hopes a $6.5 million jury verdict against Southern Arizona’s only academic medical center sends a message to hospitals about protecting patients from pressure ulcers.

A Pima County jury announced the verdict Thursday after a three- week trial. The $6.5 million in damages will go to the family of Byron Van Tassell, putting an end to five years of litigation over claims of medical negligence and wrongful death.

The lawsuit is connected to a period between Dec. 4 and Dec. 26, 2007, when Van Tassell, then 63, was hospitalized at what was then called University Medical Center (and since March 1 has been called Banner-University Medical Center Tucson).

During that time, he developed a pressure ulcer that advanced to a serious stage three, suffered from malnutrition and lost 45 pounds, according to his lawyer, JoJene Mills. A stage three pressure sore is considered a "never event" in hospitals — something that is preventable and should never happen, she said.

Throughout the case, the hospital denied any negligence in its care of Van Tassell, and said it was not the reason he needed years of subsequent medical treatments. Banner-University Medicine, a division of the hospital’s new owner Banner Health, gave a written statement by email.

"While we understand that it has been a long and difficult struggle for the family, we are disappointed with the outcome of the trial," the statement says.

The case began as medical negligence when it was filed in 2009 but was amended to wrongful death in 2012 after Van Tassell, a retired utility company worker from upstate New York, died at 67.

A Pima County Medical Examiner’s report concluded Van Tassell died of "complications of paraplegia." The Van Tassell family argued that the sacral pressure sore, which he developed at University Medical Center, put him in an irreversible state of deterioration, and that his body tissue was no longer viable.

"I don’t even know how I feel about it yet. It has been really bittersweet. This all started when my dad was alive and he suffered through so much," said Van Tassell’s daughter, Marieke McCallister.

"It has been very hard. I haven’t stopped crying since yesterday. To put a figure on what my dad meant to me and my family. … There’s no amount of money we wouldn’t give to have him back."

The Van Tassell family members awarded damages were McCallister, who is 39, her sister Brenna Van Tassell-Hickman, 38, and their mother, Reyna Van Tassell. The family has since moved from Tucson to Colorado.

The damages were awarded in two separate sums — one for $3 million ($1 million to each family member) for the wrongful-death claim, plus an additional $3.5 million under the Arizona Adult Protective Services Act, which protects vulnerable adults from abuse and neglect. Mills said part of the award will go to Medicare and to Van Tassell’s insurance company, to reimburse them for medical costs.

"The family wanted some recognition that this should never happen," Mills said. "It’s not about the money. They want to do what they can to make sure it doesn’t happen again."

Van Tassell’s health problems began with a fall backward off a roof on Nov. 9, 2007, court documents show. He broke his back, was paralyzed from the waist down and was admitted to University Medical Center. That Nov. 20 he was sent to HealthSouth Southern Arizona Rehabilitation Hospital for rehab.

But he ended up back in University Medical Center on Dec. 4 with a pulmonary embolism. During his stay he developed pleural effusion, endured multiple code arrests, had chest tubes placed and was transferred to the intensive-care unit, court documents show.

He was hospitalized until Dec. 26, when he recovered from those life-threatening events and was sent back to HealthSouth. But when he arrived there, court documents show he had skin breakdown on his sacrum (at the base of his spine) and a pre-existing pressure ulcer on his left heel.

The sacral wound became infected and Van Tassell underwent surgery at Northwest Medical Center and was also treated with antibiotics.

But Van Tassell did not get better. Over the next four years he was admitted to hospitals and nursing homes more than 20 times. Among his problems were recurrent urinary tract infections, recurrent skin breakdown, gangrene, depression, bowel obstructions and diabetes, court documents say.

The jury did not find any fault with HealthSouth Rehabilitation.

Mills stressed that Van Tassell had been a good candidate for rehabilitation until the bedsore set him back.

Medicare recently penalized three Tucson hospitals, including Banner-University of Arizona Medical Center Tucson (then operated by the University of Arizona Health Network) for their rates of hospital-acquired patient injuries and infections.

Hospitals whose hospital-acquired condition scores were in the poorest performing quartile of hospitals nationwide were docked 1 percent of Medicare reimbursements for the current federal fiscal year.

The penalty was calculated by a score that tabulated three sets of data — central line-associated bloodstream infections (CLABSI); catheter-associated urinary tract infections (CAUTI); and a composite score based on eight patient safety indicators from the Agency for Healthcare Research and Quality, including pressure ulcers.

In January Banner-University Medical Center Tucson (then called the University of Arizona Medical Center) told the Star that the data was more than a year old and that officials have since made significant improvements in reducing hospital-acquired injuries and infections.

 

Author: Jerry
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