On May 6,
2013, Matthew M. Merrill of the law firm of Brown & Ruprecht, PC, Kansas
City, Missouri won a jury verdict in favor of defendant skilled nursing
facility in a “pressure ulcer” case styled Christine Dupriest v. The Bishop
Spencer Place, Incorporated.

The venue—the
Circuit Court of Jackson County, Missouri—is considered extremely “plaintiff
friendly.” Some refer to it as being tied with the City of St. Louis, Missouri
for the most “plaintiff friendly” venue in the State of Missouri. By way of
example, in a 2012 nursing home negligence and wrongful death case related to a
fall and hip fracture, which up to Monday was the last “nursing home” case
tried in Jackson County, the plaintiff asked the jury for $1,000,000 and was
awarded $1,500,000: $500,000 more than requested. Since then, plaintiffs’
lawyers have cited to the verdict at mediation when trying to justify their

Mr. Merrill
took the Christine Dupriest case to trial on behalf of his skilled
nursing facility client beginning Monday, April 29, 2013. Closing arguments
were made Monday, May 6, 2013 and the jury deliberated for 4 ½ hours before
entering its verdict in defendant’s favor.

As to the
facts of the case, plaintiff—an African-American female age 66—was a resident
in defendant’s skilled nursing facility for approximately one month in 2011.
She was admitted to the facility on May 6. Prior to the admission, plaintiff
had been at home unable to get out of bed for 6 days from April 24 through
April 30, and then had been in the hospital unable to get out of bed for
another 6 days from April 30 through May 6. During her 6 days of immobility at
home she had become dehydrated, malnourished and had been lying or sitting
upright on her sacrum, sometimes in her own urine. She had refrained from
having bowel movements during that time as well, and had pre-existing medical
conditions including diabetes and renal disease.

Plaintiff was
admitted to defendant’s facility on May 6 without any indication of skin
breakdown on her sacrum. On May 9, a pressure ulcer opened on her sacrum
despite the fact that she had been using a low air loss mattress since
admission and despite an every two hour and as needed repositioning schedule,
and eventually she had two areas of skin breakdown that quickly developed from
Stage II to Stage IV. Plaintiff claimed that she developed two pressure ulcers
due to not being repositioned on a frequent basis, leading to the wounds
developing into Stave IV decubitus ulcers, infection of the tissue and bone,
and ultimately surgery to excise the wounds and the coccyx followed by a V-Y flap
closure and rehabilitation. Plaintiff claimed that she will suffer permanent
pain and discomfort for her lifetime due to the excision of a large amount of
tissue in her sacral area, and that she will be more susceptible to future

claimant that plaintiff did not develop the pressure ulcers at its facility.
Rather, plaintiff had developed a deep tissue injury during her 6 days of
almost complete immobility at home coupled with her pre-existing medical
conditions that made her more susceptible to tissue damage. Her deep tissue
injury was not ascertainable on admission because of the dark skin pigment of
her sacral area, because of the heavy layer of adipose tissue that prevented
the area from feeling different than surrounding tissue, and because it had not
yet become close enough to the surface to detect. The deep tissue injury became
worse during her 6 days of inability to get out of bed at the hospital. The
pressure ulcers that opened on May 9 were inevitable and unavoidable because it
is necessary for a deep tissue injury, which forms from the “inside-out,” to
open to heal. It never did heal and the plastic surgeon was consulted for a
“non-healing” wound. The wound was removed, and the area closed. Plaintiff had
a good recovery.

asked the jury for $4,511,000. That amount consisted of $211,000 in past
medical bills, $1,000,000 in past non-economic damages, $300,000 in future
noneconomic damages and $3,000,000 in punitive damages. Over defendant’s
objection, the judge allowed plaintiff to submit the issue of punitive damages
to the jury.

The jury
rendered a complete defense verdict. It found defendant skilled nursing
facility 0% at fault, and plaintiff 0% at fault. No damages were awarded.

“This is a
victory for skilled nursing facilities and other healthcare providers in
Missouri and particularly in Jackson County, Missouri, where some have said
that it is extremely difficult to win a ‘nursing home’ case, and even more
difficult to win a ‘pressure ulcer’ case,” Mr. Merrill said. Hopefully this
will reduce the value of this type of claim in this venue and will help support
the long-term care and aging services industries, which truly are trying their
best to care for Missouri’s aging citizens.

Mr. Merrill
is a partner with the law firm of Brown & Ruprecht in Kansas City Missouri
and practices medical malpractice and long-term care defense in Missouri and

Dupriest v. The Bishop Spencer Place, Incorporated, Circuit Court of Jackson
County, Missouri at Kansas City, 1216CV03491.



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