Judge Grants Motion Limiting Experts Testimony - Unanimous Defense Verdict Awarded
On June 21, 2008, a defense verdict was rendered by the jury in this case involving a Mississippi nursing home.
Plaintiff filed suit alleging the following acts of negligence on behalf of the staff at YazooCity Health & Rehabilitation Center: (1) the development of a left heel wound which resulted in amputation; (2) the development of numerous Stage IV pressure ulcers; (3) failure to administer medication as ordered by the physician; (4) failing to provide proper hygiene and continent care which led to the development of numerous infections; (5) allowing the resident to become severely malnourished and dehydrated; (6) allowing the resident to fall and sustain injuries; (7) the development of significant weight loss; (8) failure to properly manage pain; and (9) death.
Prior to trial, a hearing was held on defendantsâ€™ Daubert motion challenging plaintiffâ€™s causation expertâ€™s, Dr. William Truly, opinions regarding the cause of the residentâ€™s left above the knee amputation (and subsequent revision removing the left leg at the waist). Dr. Trulyâ€™s chief criticism was that the staff at Yazoo City Health & Rehabilitation Center failed to timely administer a physician ordered medication, Pletal, when the resident first developed a wound on his left heel. In his expert report, Dr. Truly attributed this deviation from the standard of care to the development and worsening of the residentâ€™s left heel wound and subsequent amputation.
During the hearing, defendants called as their Daubert expert, Dr. Marc Mitchell, head of surgery at University of Mississippi Medical Center. Dr. Mitchell, who participated in the drug testing and trials of Pletal, testified and explained that the drug was not used to stimulate blood flow as opined by Dr. Truly, but only to treat the symptoms of pain associated with peripheral arterial disease. Dr. Mitchell further explained that during the period of time when the resident developed the wound on his heel, he was suffering from end stage peripheral arterial disease and had no measurable blood flow beginning at the origin of the left common iliac artery. As a result of this hearing, the attached order was issued excluding the following opinions of Dr. Truly: (1) anything related to peripheral arterial disease mismanagement; (2) the issue of Pletal; (3) the nursing home should have referred the resident to a wound care center; (4) the nursing home should have enrolled the resident in a smoking cessation program; and (5) the nursing home was negligent for failing to refer the resident to a vascular surgeon for revascularization.
At trial, the residentâ€™s family testified that during his second admission to Yazoo City Health & Rehabilitation Center (he was a resident of the facility on a prior occasion, however, this was not at issue in this lawsuit), they noticed that there was insufficient staff, a compete turnover in staff, and that the level of care at the facility had dropped significantly. They complained of frequently finding him soiled in urine and feces. They also claimed that at some point their loved one lost the ability to feed himself and that the staff, rather than feeding him, would leave his tray pushed against the far wall and out of his reach. They claimed this resulted in him losing weight and becoming malnourished. They attributed the poor care at the nursing home to the development of the heel ulcer which resulted in amputation and the poor care at the nursing home to the development of Stage IV decubitus ulcers on his coccyx, left hip, left posterior buttock and scrotum.
The defendantâ€™s rebutted the plaintiffâ€™s claims by focusing the case on the medicine (i.e. peripheral artery disease) and the medical records which showed no significant blood flow below the left hip. Although plaintiffâ€™s dietary expert was highly critical of what she deemed inadequate nutrition thereby resulting in the initial amputation, when faced with the doppler studies showing no measurable blood flow (plaintiffâ€™s counsel had not provided these records to her), she reluctantly conceded no amount of nutritional support would have prevented/healed the heel ulcer. During their case-in-chief, defendants called Dr. Ed Rigdon, a vascular surgeon, as an expert to testify regarding the disease of PAD. Dr. Rigdon drew diagrams and educated the jury as to the disease processes and how it affected the resident.
At the end of the six-day trial, the jury returned a unanimous verdict in favor of the defendant.