$4.85 Million Verdict for Morphine Overdose

The Toldeo Blade reported a significant verdict in a recent nursing home trial in Michigan.  The family of Burr Needham,  who died in 2002 of a morphine overdose while undergoing physical therapy at Mercy Memorial Nursing Center, has been compensated $4.85 million by a jury aftera three-week trial with the jury finding that a doctor and nurses were negligent.

Mr. Needham's family filed a civil lawsuit in 2005 against the home, contending that Dr. Arun Gupta and five nurses were responsible for the overdose of the painkiller administered to Mr. Needham after he entered the center April 26, 2002. 

The Wayne County medical examiner said the May 2, 2002, death of Mr. Needham was caused by acute morphine intoxication and ruled his death a homicide. The jury determined that nursing home staff were professionally negligent in the care and treatment of the 76-year-old man.

Court records showed that the jury awarded $3 million of the judgement to Mrs. Needham for the noneconomic loss of society and companionship she experienced in the loss of her husband. 
The panel decided that Mr. Needham should get $1.5 million for the pain and suffering he experienced in the nursing home. The remaining $350,000 was awarded to the family to pay for damages that Mrs. Needham incurred, including burial costs and the loss of gifts and valuables she would have received until her death on Oct. 24, 2007.

 

Class Action on Staffing heads to the jury

Contra Costa Times had an article about the class action lawsuit against Skilled Healthcare Group Inc that has been in trial for 7 months.  The case is to insure proper staffing in nursing homes which benefit the residents and the overworked employees of the nursing home.  The main issue in the trial is how to properly count the number of hours a person works.

Skilled Healthcare, along with its subsidiary Skilled Healthcare LLC, owns 22 nursing homes currently under scrutiny.  Whether the nursing homes maintained staffing levels required by the state is at the heart of the trial, which lasted more than 100 days. California law mandates that nursing homes provide a minimum of 3.2 hours of care per resident, per day.

One of the plaintiffs' attorneys, Michael Thamer, who specializes in corporate abuse, said that the case is not about documents, but a matter of patients getting their needs met. Thamer said that if one thing controls the activities of a major corporation, it is the budget.

”The message from the top is simple: Stay beneath the budget,” Thamer said in his closing argument before making way for Wroten. “This corporate greed is what has kept the defendant from adequately staffing their facilities.”

Skilled Healthcare, which filed for bankruptcy in 2001, has been growing steadily over the past five years. The company has since bought up nursing homes in Texas, Kansas, Illinois, Missouri, New Mexico, Nevada and California.


 

Arbitration Agreement not enforced.

In Peterson v. Residential Alternatives of Illinois, Inc. , No. 3-09-0743 (June 7, 2010) Peoria Co. (WRIGHT), the 3rd District reversed the circuit court’s dismissal of the case based on an arbitration agreement.  In Peterson, the nursing home had the legal representative sign two contracts on the same day--one for nursing serives and one an arbitration agreement waiving Plaintiff's constitutional right to a jury trial.  The Court held:

 

"At the time of their agreement pertaining to nursing home care for Terhorst, the parties could have easily utilized terminology requiring arbitration, but they did not incorporate this language into the nursing home care contract. In fact, the seven-page nursing home care contract, dated November 29, 2006, specifically states that the nursing home care contract consists of seven pages. Within those seven pages, the nursing home care contract does not restrict litigation to nonjury trials or require arbitration.

We construe this silence as deliberate, intended, and consistent with both existing case law at the time of the agreement and the provisions of the Act (210 ILCS 45/3-606, 3-607 (West 2006)). Based on the circumstances of this case, we conclude that the conspicuous absence of language requiring arbitration constitutes "a contrary contention" that defeats defendant's request for this court to construe both documents executed on the same date as one agreement. See Sandra Frocks, Inc. v. Ziff, 397 Ill. at 504."

The Court concluded: " The case law provides that an enforceable contract must be premised on language that is definite and certain as to all essential terms. Academy Chicago Publishers v. Cheever, 144 Ill. 2d 24, 30 (1991). Thus, we conclude the Agreement does not contain a clearly expressed intent to arbitrate controversies arising out of the separate nursing care contract."

 

Negligence or suicide?

The Record on NorthJersey.com had an article about the trial between the family of a resident who fell to his death from a window left open on the second floor at Preakness Healthcare Center.

“Simply put, as a result of their negligence, he suffered 23 days of hell,” said attorney Angelo Bisceglie, referring to Ora Tate  Tate had been admitted to Preakness by his sister, Loretta Tinsley, on July 3, 2006. He was found by a construction worker at about 7:30 a.m. lying 16 feet below his second-floor room window on July 28, 2006. Pulmonary problems and injuries led to his death three weeks later.

Bisceglie said it was unfortunate that Tate’s room had what is known as an “awning window,” which a person of average size could fall out of as Tate did.

Preakness staffers should have known that Tate might harm himself, given his psychological condition, and been placed in a room that would have been safer.

 

Employee of the Month convicted of Elder Abuse

UPI hd an article about the trial and conviction of Cesar Ulloa who was accused of torturing residents at Silverado Senior Living.  Witnesses said Ulloa laughed as he assaulted elderly residents. Ulloa had been a caregiver at the pricey retirement home in Calabasas in the San Fernando Valley.  Jurors found him guilty of all eight counts after deliberating about 5 hours.

Prosecutors said some of Ulloa's victims suffered so much dementia they could not call for help, and witnesses said he laughed as he attacked victims. Fellow workers at provided graphic details of Ulloa's attacks. One said he jumped on the chest of a mute 78-year-old woman, then body-slammed her into a bed. Other employees said Ulloa had jumped off a dresser and landed with both knees on an elderly resident's abdomen and tried to start a fight between two other residents.

The Times said investigators began looking into Ulloa after the widow of a former Silverado resident got an anonymous call the day after her husband's funeral suggesting his 2007 death may not have been from natural causes.

Los Angeles County sheriff's deputies exhumed the body of the former resident, Elmore Kittower, and an autopsy found blunt-force trauma was a contributing factor in his death. More than two dozen broken bones, in various stages of healing, were discovered.

Ulloa had been named employee of the month.

 

Is this Justice?

The Ohio Supreme Court has enacted a monumental change that impacts doctors and patients, shifting malpractice judgments from doctors’ insurers to the taxpayers.  More info at WCPO.  The decision limits recovery, ignores the right to a jury trial, and promotes injustice and inadequate compensation. The ruling means your private doctor can make a serious medical mistake - take off the wrong leg, operate on the wrong side of your brain - and you can never sue him in a jury trial.   No other state has ruled the same way. 

The Theobald ruling was named after Keith Theobald. Theobald was a healthy, fit husband and father of two young children, when an elderly driver clipped his pickup truck as he was driving to work 11 years ago. The impact flipped the truck across all lanes of the highway into a field, crashing in a stand of trees. Rescue workers found Theobald hanging upside down in a tree. He was paralyzed from his chest down.

Theobald and his wife, Jacqueline, took the news in stride. “I remember pre-operatively we said, ‘You can still do basketball with Jake (his then 5-year-old son) and watch TV and share things with the kids. We’ll get a van and we’ll adapt it.’” Keith Theobald agreed. He felt he could still work and live a full life. “I could do about anything. The wheelchair doesn’t hold you back.”

Theobald could see and use his arms after the accident. He was alert and ready the next day when doctors at University Hospital suggested surgery might improve his back injury.

Instead, he woke up in a different world. Not only was he still paralyzed, but now he also was blind and had lost the use of his armsMedical records prove a series of mistakes during surgery led to oxygen deprivation and injuries worse than the accident had caused.

Trapped in darkness and unable to move on his own, Theobald will need round-the-clock care the rest of his life. He sued the doctors who did the surgery, only to get this devastating shock: The doctors weren't liable. They had immunity from all malpractice claims because they had students in the room with them.

In the Theobald case, the Ohio Supreme Court ruled that doctors who sign with a state university like the University of Cincinnati to let medical students learn from them, even if that just mean one student walking in the room for a second, now are considered state employees. As such, they get immunity if anything goes wrong on the job, even in their private practices.

Jacqueline Theobald says, “The state didn’t come in and take care of Keith. The university didn’t come take care of him. This doctor took care of him. We’re suing the doctor.”

But the Ohio Supreme Court said they couldn’t sue the doctor because some students were allegedly in the operating room, the doctors were teaching per their State of Ohio U.C contracts. Therefore those doctors were not liable for any mistakes. Instead, the Supreme Court ruled that the Theobalds belonged in the Court of Claims, a separate court set up in 1980 to handle suits against the state, usually against public state employees like highway workers, never before used to protect private doctors in their private practices.

The Court of Claims has no juries. Single judges, hired by the state, issue rulings for or against the state. The top award is $250,000, no matter the severity of the damages. Most importantly, the taxpayers foot the bill, not doctors’ malpractice insurers who must pay when suits are filed in county courts of common pleas.

Of course, Keith Theobald never knew to ask if a student would be watching his operation, and if so what the impact might be. But if you think doctors from now on will have to tell patients and get consent to have students in the room, you’d be wrong. The Supreme Court ruled the law doesn’t demand disclosure. No one has to inform patients they could lose their rights to sue the doctors without ever knowing it.

Keith Theobald hasn’t lost hope for a medical miracle. But in the end, he never did get a chance at even the Court of Claims the Ohio Supreme Court said he should access. That’s because the same state attorneys for U.C. who argued that’s the court where the Theobalds belonged, now argued it was too late. The statute of limitations had passed. No recovery, not even $250,000, for Keith Theobald’s lifetime injuries.

 

Typical Defense Trial Tactics

There was an interesting article in The Telegraph about the jury trial involving the wrongful death of Gerald Flannary.  The case involved claims that personnel at Rosewood Care Center in Edwardsville failed to inform the patient's doctor that he had developed a painful ulcer on his heel.

Attorney Robert Gregory told the jury in Madison County Circuit Court that his client is not claiming damages for causing the ulcer but for failing to report it to the doctor in a timely manner and lack of proper treatment.

Gregory is asking for damages for the added cost of treatment, the emotional effects on the family, the pain and suffering caused to the patient and loss of a normal life. The added cost of treatment is estimated at about $34,000. The loss of normal life means loss of what would be normal for a man living in a nursing home, Gregory pointed out.

He noted that Flannary could walk when he was admitted on Dec. 4, 2003, but did not walk after that.  A deposition in the case showed that Flannary suffered from a number of medical problems, including Alzhemier's disease.

A doctor, testifying in a deposition in the case, said the ulcer caused tissue damage down to the bone and would have been painful.

Gregory told the jury in closing arguments that Martha Flannary, Gerald Flannary's wife, contacted the Illinois Department of Public Health about the case, and that agency issued a violation. Rosewood did not appeal but offered a plan of correction, he said.

He noted that nurses who testified in the case said they could not recall talking to IDPH.

Of course, the defense made the trial about the plaintiff's lawyer, Flannery's pre-exisitng conditions (which all nursing home residents have!), and the honor and compassion of nurses in general instead of the clear violation of the standard of care. 

The nursing home's lawyer provided by the insurance company argued that Gregory was honing in on a "small detail", when the "big picture" showed that the nurses and other staff members allegedly made a detailed record of Flannary's overall condition.

"This case is supposed to be all about a lack of communication. Only a trial lawyer would say that 316 pages of medical records amounts to a lack of communication," McCubbin said.  Of course, McCubbin is a trial lawyer too.  Gregory took exception to McCubbin's repeated reference to the plaintiff's attorney as a "trial lawyer," as if to take advantage of some of the negative publicity trial lawyers have received. Gregory noted that his opponent also is a lawyer and was arguing a case in a trial. He wondered how McCubbin would describe himself. "I guess you would describe him as a corporate lawyer," Gregory said.

"His motive is money. He wants to gloss over the big picture," McCubbin said about Gregory.  Of course, defense lawyers represent clients for money too.  I never saw any defense lawyer take a case pro bono.

McCubbin also argued that staff members at Rosewood work 365 days a year caring for patients such as Flannary. He said they are dedicated to their work and to their patients. He said some of them testified that their patients "were like family members."  Many nursing home employees are great, many are not.

McCubbin argued that Flannary had a history of ulcers and blisters before and after he was admitted to Rosewood.  Those ulcers healed properly because the doctor was informed of them.

He called the investigation into the case "sloppy" because it missed some of the details available in the records.  This is a typical defense tactic.  When the investigation substantiates the abuse or neglect, they disparage the investigation.  When the investigation supports the facility, the defense lawyers praise the investigatory abilities of the State regulators.

Punitive damages for neglect

PRWeb summarized a story from the NY Post about punitive damages against a nursing home in New York.   The New York Post reported that in December 2009, a Brooklyn nursing home was found guilty of negligence in the case of a patient who developed numerous and avoidable bedsores while under the home’s care. The jury awarded the patient’s family close to $4 million for pain and suffering, plus an additional $15 million as punishment for trying to cover up the poor patient care.

Elder abuse is prevalent in nursing homes around the country, and with serious consequences for patients. Older adults who are victims of elder abuse are more than twice as likely to die prematurely as are adults who are treated properly, according to a study published in the August 5, 2009 issue of the Journal of the American Medical Association.

Mistreatment can take many different forms, including physical, emotional, psychological or sexual abuse; neglect; withholding food and water; or denying visits from family and friends.  Family members and friends of nursing home residents must be vigilant in looking for signs of possible abuse or neglect.  These can include personality changes, depression, anxiety, unexplained or unusual bruises and injuries, rapid weight loss, poor grooming, and potentially unsafe conditions.
The National Center on Elder Abuse defines institutional elder abuse as “any of several forms of maltreatment of an older person by someone who has a special relationship with the elder (a spouse, a sibling, a child, a friend, or a caregiver)” that occur in residential facilities for older persons, including nursing homes. Its website, www.ncea.aoa.gov, explains that “perpetrators of institutional abuse usually are persons who have a legal or contractual obligation to provide elder victims with care and protection (e.g., paid caregivers, staff, professionals).

Looking exclusively at falls, the Centers for Disease Control and Prevention noted that an average nursing home with 100 beds reports 100 to 200 falls each year, representing up to 75 percent of residents. Many falls were caused by environmental hazards like wet floors, poor lighting, incorrect bed height and improper wheelchair use.

A November 2009 report from the University of California, San Francisco, stated that 26 percent of the nation’s nursing facilities were cited in 2008 for poor quality of care, 44 percent of nursing homes failed to ensure a safe environment for residents, 36 percent had food sanitation regulations violations and 33 percent of facilities received deficiencies for failure to meet quality standards.

 

 


 

Arbitration decision in Colorado

McKnight's had an article about a decision in Colorado regarding the enforcement of an arbitration clause in a nursing home case.  The Colorado court ruled that a healthcare proxy does not have the authority to sign an arbitration agreement on behalf of a nursing home resident.  Under Colorado law, a healthcare proxy is only empowered to make medical decisions on behalf of another, including “provision, withholding, or withdrawal of any health care, medical procedure, including artificially provided nourishment and hydration, surgery, cardiopulmonary resuscitation, or service to maintain, diagnose, treat, or provide for a patient's physical or mental health or personal care,” the Bureau of National Affairs reported.

In the case of Lujan v. Life Care Centers of America, Colorado, Alvin Lujan signed an arbitration agreement, waiving jury trial rights, when admitting his mother, Estella Lujan, to the Life Care Centers of America nursing home. She died three days later, and a wrongful death claim was filed against the facility. Life Care Centers argued that admission to a nursing home is a medical decision and, therefore, the Colorado law applies.  But the Colorado Court of Appeals determined that the signing of an arbitration agreement does not fall under the specific definition of the authorities given to a healthcare proxy. As a result, the Lujan family had the right to sue the facility.

In October, the Nebraska Supreme Court arrived at a similar decision regarding the roll of patient surrogates
 

Fairness in Nursing Home Arbitration Act

McKnight's had another article on the Fairness in Nursing Home Arbitration Act.  This bill would prevent nursing homes from using pre-dispute arbitration agreements as a way to take away residents' rights to a jury trial. The bill is supported by both Republicans and Democrats and should be able to pass without much difficulty. 

Sens. Mel Martinez (R-FL) and Herb Kohl (D-WI) reintroduced their measure in an effort to "restore the original intent of arbitration laws [and] ensure that families will not have to choose between quality care and forgoing their rights within the judicial system."    The version of the bill introduced in the last session of Congress was approved by the Senate Judiciary Committee, but never came to a full floor vote. The bill does not prohibit the use of all arbitration agreements by nursing homes, only pre-dispute agreements.   Arbitration agreements could still be used after a dispute arises, though the bill would make them a voluntary matter.
 

 

Poliakoff & Associates, P.A., is one of South Carolina’s most respected and distinguished law firms. The Poliakoff firm began nearly 60 years ago by three attorney brothers: Matthew, J. Manning, and Bernard. With a history of believing the justice system...More...