Nursing Negligence Results in $793,000 Jury Verdict in Above the Knee Amputation- Rudolph v. Northwestern Memorial Home Healthcare

An elderly man required an above the knee amputation with a flesh-eating bacteria after his heel ulcer became infected . He brought an Illinois nursing negligence lawsuit against the home health service that was supposed to be monitoring his pressure ulcer. The Cook County jury awarded the plaintiff $793,644 for his suffering and disability as a result of the healthcare service’s negligence in Rudolph v. Northwestern Memorial Home Healthcare.

The medical negligence can be traced to the plaintiff’s right hip replacement in December 2000. During his recovery at the Rehabilitation Institute of Chicago, the 79 year-old William Rudolph developed a blister on his right heel that quickly progressed to a Stage III pressure ulcer. Pressure ulcers typically develop in bedridden or wheelchair-bound patients whose limbs stay in one position for extended periods, which limits the blood supply to that area. They are typically identified by stages of severity, with Stage I being the least severe and Stage IV being the most severe.

After Rudolph’s release from his inpatient rehab stay, Northwestern Memorial Home Healthcare was assigned to treat the plaintiff’s pressure ulcer. The healthcare service would make in-home nursing visits to Rudolph in order to maintain the integrity of the area around the wound, clean and treat the pressure ulcer, and prevent the ulcer from progressing to a Stage IV ulcer. In order to do so, the nursing service visited Rudolph three times per week during December 2000 and January 2001, during which time the heel wound remained a Stage III ulcer.

However, the nursing service elected to change Rudolph’s treatment plan in February 2001 and reduced his home visits to just once per week. By the end of the month Rudolph’s heel ulcer progressed to a Stage IV ulcer and then quickly developed necrotizing fasciitis a rare, but serious bacterial infection. It causes skin and tissues to break down; it is commonly known as “flesh-eating bacteria.”

Because of the quickness with which necrotizing fasciitis spreads, Rudolph underwent an above the knee amputation of his right leg in February 2001. The Cook County medical negligence complaint alleged that the leg amputation was the result of the in-home nursing service’s negligence in failing to properly assess the wound, recognize the infection in a timely manner, and its decision in reducing the number of in-home visits to one per week.

However, the defendant nursing service maintained that it was reasonable to reduce the number of in-home visits to Mr. Rudolph. The nursing service stated that not only had its nurses assessed the state of Rudolph’s pressure ulcer, but they had repeatedly instructed the plaintiff on the signs and symptoms of infection during the thirty-plus in-home nursing visits.

Yet the plaintiff failed to notify the nursing service or his attending physician when his right leg became increasingly swollen and painful. In addition, it was alleged that his heel wound itself began to have a distinct odor, which is a tell-tale sign of infection. The defense alleged that based on the information provided by the plaintiff that Rudolph was aware of his declining condition as many as seven days prior to his actual hospitalization. Therefore, while the defense argued that necrotizing fasciitis is an unforeseeable and unpreventable event, it contended that the seven day delay in treatment was a major contribution to the plaintiff’s knee amputation.

While the defense’s arguments did not convince the jury of its innocence, they did convince it of the plaintiff’s comparative fault. The Cook County jury entered a $1.5 million verdict against the nursing home service for its nurses’ negligence; however, that amount was reduced by half given the jury’s finding that Rudolph was 50% responsible for his own injury. The jury arrived at the $1.5 million figure by compiling the following awards: -$500,000 for disfigurement;
-$500,000 for past disability;
-$200,000 for future disability;
-$200,000 for past pain and suffering;
-$80,000 for future pain and suffering; and
-$107,289 for past medical expenses.

Had the jury not elected to reduce its $1.5 million medical malpractice verdict by 50% for Rudolph’s comparative negligence, the plaintiff still would not have received the full $1.5 million verdict. During the second day of the jury’s deliberations, both parties entered into a high-low agreement regarding the eventual jury award. The parties agreed that the maximum award would be set at $950,000 and the low at $250,000. Therefore, regardless of the jury verdict the defense would not have to pay out any more than $950,000 and the plaintiff would not receive any less than $250,000. Because the eventual verdict of $793,644 was within the limits of the high-low agreement it stood as is.

Kreisman Law Offices has been handling Cook County nursing malpractice cases and for individuals and families for more than 35 years in and around Chicago, Cook County, and surrounding areas, including Burbank, Harwood Heights, Chicago’s Logan Square, Naperville, and Markham.

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