South Carolina Nursing Home Lawyer & Attorney : Poliakoff & Associates Law Firm : Elderly Care, Senior Care

Melvin Raybon died in pain four years ago, and a DeKalb County jury agreed that the cause of his suffering was neglect at the Tucker nursing home where he lived for nine months.  The jury compensated Raybon’s daughter $1.25 million for the pain and suffering her father felt the last year of his life.  

The nursing home provided inadequate care and attention to Raybon. He was admitted in 2002 when he turned 67.  Nine months later, he had to go to a hospital for treatment of a bed sore that infected his left buttock to the bone.  Nursing assistants from the nursing home testified there weren’t enough staff to provide adequate care to Raybon.   The staff neglected him by failing to follow standard protocol of turning and repositioning him every two hours which is necessary to prevent and treat his pressure ulcers.

Raybon also suffered from malnutrition as a result of the infection, which sent his body into a death spiral that led to more bed sores and infections and finally his death in June 2004.

Kindred Healthcare was the company that owned the nursing home at the time. The facility was sold to a new owner last year.

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I found this cool website called Aboutlawsuits.com that had an article about a wrongful death lawsuit filed in Chicago alleging the nursing home's neglect caused fatal pressure ulcers or bedsores. 

The lawsuit states that Stanley “Ted” Dancy, 77, was admitted to the nursing home. However, after one month in the nursing home for rehabilitation, he was transferred to Mount Sinai Hospital, where he was diagnosed with four advanced stage bed sores, as well as malnutrition and a urinary tract infection

As a result of the injuries sustained at the nursing home, Dancy’s health continued to deteriorate and the wrongful death lawsuit alleges that the bedsores and other injuries he sustained at Washington Heights Nursing Home were the contributing factors that lead to his death on December 12, 2007.

Nursing home bedsores, which are also commonly referred to as decubitus ulcers or pressure sores, are caused by prolonged pressure on one area of the body.  This is typically caused by the staff's failure to move the residents.  This pressure results in a lack of blood flow to the skin in that area, which turn into an open would that progress to a serious and fatal infection.

When immobile residents are not repositioned for long periods of time, pressure can accumulate on one area of the skin, typically involving the thin layers of skin around the tailbone, shoulder blades, elbows or heels.  Many residents do not get moved or repositioned for days because of inadequate and incompetent staff.

Many nursing home lawsuits involve circumstances where the nursing home was not properly monitoring the resident for signs of the pressure ulcers and leaving the resident in one position for extended periods of time. Failure to properly clean the resident, change soiled adult diapers or bed sheets also increases the risk of bedsores developing and getting infected.

Injuries caused by malnutrition and dehydration are a result of a failure to provide adequate amounts of food or fluids to a resident and are linked to negligence and neglect.

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Sunrise Senior Living faces another neglect and negligence lawsuit (08/20/08 Orange County Register).  Sunrise was ordered to pay $2 million in damages after the death of a resident in May.  The family of Therese Sperry is suing Virginia-based Sunrise Senior Living which owns and operates Villa Valencia Health Care Center.

Sperry spent two weeks in Villa Valencia's skilled nursing unit in January 2007. She developed avoidable pressure ulcers on her feet that were neglected and went untreated.  The lawsuit alleges negligence by Sunrise Senior Living and says the nursing home failed to provide adequate medical staff for ailing residents - despite five health and safety citations in the last decade by state health regulators.   The most recent violations, from last year, include sexual molestation of a patient during a bath and failure to change a patient's catheter often enough to prevent infection.

After a brief hospital stay, she was sent to Villa Valencia for a week to gain strength.  Four days after her admission, she had redness on both heels, which later developed into ulcers that spread to her muscle and bone. Sperry's family immediately transferred to a different nursing home, where she was properly treated for wounds.  She endured debilitating pain until her death.

The suit argues that the facility "carried out a scheme to place 'profits over people' ... (and) intentionally underfunded and understaffed the facility in order to decrease expenses and increase profits."  Proof of understaffing arose in the trial over the death of Mary Kathleen Adams, who also developed pressure ulcers while at the center in February 2005. She died two months later.  In May, a jury ordered Sunrise to pay $2 million to Adams' family for negligence and punitive damages.

"Big corporations like Sunrise cut down on costs and staffing at the expense of patients," said Kim Valentine, one of the lawyers representing the Sperry family, and who also represented Adams.  Valentine also said court testimony showed employees were quitting because of the poor quality of care - a finding reflected in a report by the independent California Nursing Home Search. The agency found that nursing staff turnover at Villa Valencia was 82 percent in 2006, much higher than the state average of 67 percent.

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The Virginia Supreme Court recently affirmed an $850,000 verdict obtained by Jeff Downey in a nursing home case in Danville, Virginia. The case, Musgrove v. Medical Facilities of America Inc., involved pressures sores, an amputation, and death by dehydration, malnutrition and wound complications.

The Defendant asserted numerous assignments of error, many dealing with pertinent nursing home and/or malpractice issues. The Court denied the writ finding no reversible error in the judgment. Some of the issues included:

· Allowing recovery of both survivorship and wrongful death damages in the same cause of action;

· Allowing a medical expert to testify regarding nursing standards of care;

Allowing a nurse expert to testify regarding causation on pressure ulcers and other adverse outcomes;

Allowing a nurse who works part time clinically, and spends a majority of her time as a testifying expert to qualify under Virginia’s clinical practice requirement;

Allowing expert administrative testimony regarding nursing home staffing inadequacies; and

Allowng expert testimony regarding the significance of gaps in the chart.

Defendant filed some 25 motions in limine along with motions to limit expert testimony (on medical cause of death) and summary judgment on punitive damages.

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Knoxville News had an article about a nursing home resident who lost a leg due to the nursing home's neglect.    Neglect of a resident at Hillcrest-West nursing home led to the amputation of her leg last month, according to state reports quoting a doctor who consulted on the case.

The state has censured Hillcrest nursing homes for providing substandard care three times in the past two years.   Obviously the corporate managers ignored the problems and did nothing to correct them.

Now, as in the past, Hillcrest is in danger of losing federal funding if problems aren't corrected. Hillcrest-West has until May 25 to submit a detailed plan of correction, said Lee Millman, a spokeswoman for the Centers for Medicare and Medicaid Services.   During a survey conducted April 28 through May 2, the state found violations of "resident protection, administration, records and reporting, and nursing services standards."

Details in the recent state report on Hillcrest-West state that the amputee's pressure wound was at the most severe level when first noted by staff Feb. 7. The leg was amputated above the knee April 22. Doctors said the bone likely was infected and the wound was "exquisitely (intensely) painful" when manipulated.

A podiatrist said the pressure wound was the "result of neglect ... the worst wound I have seen in 12 years," and the surgeon who removed the leg concurred, the report states.   The same patient didn't get the amount of tube-fed nutrition and saline ordered by her doctor, with feedings skipped repeatedly, the report notes. Also, the family was not informed of the pressure wound and was shocked when they learned of the pending amputation, the state report said.

State inspections from 2006 and 2007 report Hillcrest-West patients found on the floor after apparently falling from beds or wheelchairs, failure to properly use restraints or alarms, patients who were unclean, and inadequate staffing.

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McKnight's has an article about diabetes in the nursing home population. One out of every four residents over the age of 65 is diagnosed with diabetes, according to a new report from the Institute for the Future of Aging Services. Researchers analyzed data representing 1.32 million nursing home residents over age 65.

Among the findings: Non-white residents were twice as likely to have diabetes as white residents; diabetic residents were younger than their non-diabetic counterparts; and the prevalence of diabetes in U.S. nursing homes was higher in 2004 compared to previous years. IFAS is the applied research arm of the American Association of Homes and Services for the Aging. Those afflicted with the disease are at a greater risk for developing other conditions that can affect their quality of life and care needs, according to researchers. Diabetics are more likely to take more medication and arrive at a nursing home with pre-existing circulatory problems. Diabetics are also 56% more likely to have a pressure ulcer upon admittance. The research was published in the February 2008 issue of Diabetes Care. To view the report, please go to http://www.futureofaging.org.

This underscores the need for better nutritional assessments and interventions requiring getting blood work and lab results on a regular basis.  This also shows why preventative measures are needed to prevent skin breakdown.

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WHEC-TV ran a story about a neglected resident who sued a nursing home for pressure ulcers, bedsores, and gangrene at Blossom South Nursing and Rehabilitation Center.  The nursing home is already facing nearly $150,000 in fines from the state for other deficiencies.

Resident Ruby Myers' right leg was amputated after gangrene had set in.  Myers broke her leg last September. Doctors put her leg into a brace that apparently caused severe pressure ulcers and open sores. The circulation in the leg was stopped.  The woman also suffered from bedsores.

D.A. Mike Green has decided to defer to the state health department for possible action but no penalty has been decided yet.   Over the last three years, Blossom South had 70 standard health deficiencies, while the statewide average was 16. And deficiencies related to "actual harm" or "immediate jeopardy" were 10 for Blossom South, compared to just one for the state average for a nursing home.

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In many of our neglect and abuse cases, the victim is unable to testify regarding the bad care because of dementia or death.  I read an article today about a man who is competent and speaking up for his rights and the rights of others at the facility where he lives.  Mr. Crawley is a competent 48 year old man who resides at Sunrise Rehabilitation & Care in Marion, N.C.   "I am not being treated like, I feel, as a human being," said Crawley. 

Crawley became a paraplegic as a result of a car wreck in 1982. His 81-year-old father, Joe Crawley Sr., can no longer take care of him and he started living at Sunrise Rehab on Oct. 15. For the first two weeks there, the staff didn't give him a bath or shower.  "I don't know what is going on here," he said. "It seems like they make a lot of errors in simple things."

Crawley said his elderly roommate will talk incoherently and constantly yell about having to urinate, and, rather than listening to him, the staff will shut the door. With the heater running, that makes the room get hot for both Crawley and his roommate. He said he has called the nurse's station to have the door opened but is ignored.

His sister said the staff once left a feces-soiled blue pad on his wheelchair for more than two hours. His father, who visits him twice a week, found it and thought his son had had an accident. He bagged up the soiled pad and took it to the nurse's desk.  "That's an unsanitary condition and that's neglect," said Pilgrim.

Crawley said he's confined in his bed 21 hours a day.   This will increase the likelihood of developing pressure ulcers. 

Crawley added he's paying $879 a month to stay at Sunrise Rehab, which leaves him with just $30 out of his monthly disability check. He wishes he could go someplace else.

"I don't know if they think I am incoherent or lost my faculties or don't know what is going on," he said. "But I do know what is going on. I need more than anything to be transferred to a place that deals with wound care."

"They are neglecting the people," said Buckner. "That is why there is a waiting list at Autumn Care."

The official Web site for Medicare contains information about nursing homes across the nation. The site states that Sunrise Rehab had 11 health deficiencies, which are above the state and national averages. One of the deficiencies included failure to "write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property."  Another deficiency found on May 10 by inspectors was failure to "give professional services that meet a professional standard of quality."

In addition, inspectors found on Aug. 30 that Sunrise Rehab failed to "make sure that residents are safe from serious medication errors" and it also failed to "make sure that the nursing home area is free of dangers that cause accidents."

See full article here.

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Here is a link to the list of nursing homes that are failing in providing good care for pressure ulcers and physical restraints.  There are over 50 nursing homes located in South Carolina on this list.  South Carolina can certainly do better.  Pages 81 and 82 list the South Carolina nursing homes on the list.

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We have numerous cases where a resident suffered horrible painful pressure ulcers because of the lack of preventative treatment.  The nursing homes always claim that the pressure ulcers were "unavoidable" due to the age of the resident.  A new comprehensive study disproves that claim.

This article discusses the purpose and success of preventing pressure ulcers from forming when nursing homes provide preventative care.

The Pressure Ulcer Collaborative project had been aiming for a 25 percent reduction in new occurrences of bedsores by encouraging health workers to use proven strategies to prevent skin deterioration.  Instead, the 150 hospitals, nursing homes and home health care agencies participating reduced new bedsores on average by just over 70 percent between September 2005 and May 2007.

Bedsores, technically known as pressure ulcers, are painful, occasionally deadly skin lesions caused by unrelieved pressure  that can cause infection and destroy tissue, muscle and bone if not properly treated.  They also can trigger depression, affect a patient's self-image and complicate treatment.

At the beginning of the New Jersey project, 18 percent of newly admitted patients developed a bedsore while receiving care. By the end, the rate had been cut to 5 percent of new patients, Holmes said.

Holmes said the preventive steps started with a prompt evaluation of each new patient, with every square inch of their skin examined and their risk of developing bedsores determined based on a standardized scale.

Hospitals then had to follow strategies to prevent development of bedsores. Options included shifting the patient to a new position every two hours, use of heel cushions and other padding for vulnerable pressure points, even use of special air mattresses that alternately inflate and deflate different areas, spreading pressure around.

Patients not eating or drinking enough water _ a common problem with older patients _ got a nutritional consultation because inadequate caloric intake or protein stores, as well as dehydration, can lead to skin tearing and breaking down.  Frequent follow-up examinations of the skin also were required, along with new ones for patients suddenly bedridden, as after surgery.

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