Jury Returns Verdict in Favor of Nursing Home

     Carl Hagwood and Michael Phillips won a defense verdict on May 16, 2008 in case tried in U.S. District Court for the Southern Division in Natchez.

     Plaintiff claimed the resident suffered from: (1) 24 falls; (2) numerous pressure ulcers which were allowed to become infected resulting in gangrene thereby causing both of his legs to be amputated; (3) frequent urinary tract infections leading to urosepsis; (4) dehydration; (5) malnutrition; (6) weight loss; (7) PEG tube placement which became dirty, necrotic and infected; (8) pneumonia; (9) gastrointestinal bleeding; and (10) development of avoidable contractures. Prior to trial, plaintiff withdrew her claim for wrongful death.

     The resident’s admitting diagnoses included cerebral vascular accident/stroke, hypertension, diabetes mellitus, hyperlipidemia and neuropathy. By June of 2002, he was diagnosed as suffering from insufficient blood flow to his lower extremities or peripheral arterial disease (PAD). By June of 2003, the resident’s cumulative diagnoses included chronic renal failure, persistent vegetative state, seizure disorder and end stage vascular dementia.

     Prior to trial, a hearing was held on defendants’ Daubert motion seeking to strike the testimony of plaintiff’s causation expert, Dr. David Seignious. When deposed, Dr. Seignious’ sole criticism was that the resident’s bilateral above the knee amputations resulted from inadequate pressure relief and the nursing home’s staff’s failure to provide proper wound management. Dr. Seignious testified that the resident’s diagnosis of PAD played no part in the development and worsening of his heel wounds/bilateral amputations. During the Daubert hearing, defendants put on proof from its vascular surgeon expert and wound care expert to explain the role of PAD in the resident’s wound development/amputations. Although the District Court denied defendants’ motion to strike, the court took judicial notice of the fact that plaintiff’s causation expert limited his criticisms to wound development and worsening and precluded plaintiff’s RN expert from offering any opinions outside these parameters. As such, plaintiff was prevented from putting forth any proof regarding the 24 falls, urinary tract infections, dehydration, malnutrition, weight loss, PEG tube issues, gastrointestinal bleeding and contractures.

     At trial, the resident’s family testified that every time they visited him, he was nearly always soiled with feces and urine. They criticized the staff for not keeping him clean and failing to regularly change his bed linens which were also nearly always soiled. They further criticized the staff for not turning the resident regularly as he was always found facing in the same direction when they visited. They attributed this neglect to the development of bedsores on both his feet as well as his hip. The family further criticized the nursing staff for allowing the resident’s lips to become parched and failing to provide him enough water so as to prevent becoming dehydrated. The family further stated that any time the resident communicated about the treatment he was receiving at the nursing home, he would cry and become visibly upset. The family was cross examined on the fact they never attended any care plan meeting and never shared these concerns with anyone. Documentation from hospital records was also utilized to show hospital personnel were under the impression the resident had no family as no one ever visited.

     To counter Dr. Seignious’ opinions regarding the wounds and resulting amputations, defendants relied upon ankle brachial indexes and Doppler studies conducted prior to the amputations which revealed the resident had no blood flow below either knee. The defendants’ vascular surgeon expert explained this process to the jury and demonstrated through the use of visual aids how the disease of PAD prevented blood flow from reaching the resident’s lower extremities. According to post-trial juror interviews, the jurors were most impressed by a restorative nurse aide who testified and demonstrated to the jury what type of therapy she provided to the resident in an attempt to reduce the risk of pressure ulcers developing.

     At the end of the five-day trial, the jury rendered a unanimous verdict.

Author: Web Master
Related Link: http://wilkins-law.com
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