Articles Posted in Nursing Home Resident Bed Sores

Morley Sprague suffered from end-stage multiple sclerosis and had a history of urinary tract infection (UTI) and degenerative joint disease.

After a hospitalization for treatment of sepsis and a UTI, he was admitted to the North Canyon Care Center, a nursing home that offered wound care services. Within a week, his two existing pressure ulcers worsened from Stage I and II to Stage IV. Additionally, he developed a Stage IV pressure sore on his right buttock.

After he left the nursing home, he required antibiotic treatment and continued medical care for his open wounds, which did not heal. Two years after his discharge, Sprague died of sepsis resulting from an infected pressure ulcer.

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Livija Cruse, an 80-year-old woman who suffered from mild dementia, was admitted to Chicago’s GlenCrest Healthcare and Rehab Center after falling at her home. She was also immobile. Over an 8-week period, she developed a bed sore on her buttocks. Because of the bed sore, she underwent two debridements and nine months of at-home wound treatment care after her discharge from GlenCrest.

On behalf of Cruse, her attorney-in-fact sued the nursing home and the ownership entities claiming that these defendants chose not to prevent and treat the bed sore.  It was also maintained that the nursing home failed to keep her clean and dry, provide her with an appropriate mattress for her condition and place a cushion on her wheelchair. In addition, the lawsuit argued that the nursing home chose not to comply with a doctor’s order regarding her wheelchair.

The defendants countered these arguments that the facility had in fact provided the appropriate care. Before trial, the parties settled for $100,000.

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On April 13, 2016, a release from the National Pressure Ulcer Advisory Panel (NPUAP) stated that the term “pressure injury” replaces “pressure ulcer” in the NPUAP injury staging system. According to the report, a change in terminology more accurately describes pressure injuries to both intact and ulcerated skin. It was concluded that the previous staging system was confusing. A Stage I and Deep Tissue Injury described injured intact skin, while the other stages describe open wounds or ulcers.

In another change in terminology, the panel is now using Arabic numbers instead of Roman numerals in the names of stages.

A meeting of over 400 professionals was held in Chicago on April 8-9, 2016. Using what was called the consensus format, Dr. Mikel Gray of the University of Virginia guided the Staging Task Force.

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Genevieve Thompson, 74, was hospitalized and required assistance with all activities of daily living due to her long list of health problems. One of them included morbid obesity.

During her hospitalization, she developed a Stage II pressure sore, which was documented two days before she was transferred to a nursing home for rehabilitation.

About a week and a half into the nursing home residency, she was transferred back to the hospital where she was diagnosed with sepsis. She required debridement and other wound treatment for the bed sores, which by then had worsened. She required institutional care at the hospital for the next several months.

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William Dieser, 58, underwent surgery at St. Anthony’s Medical Center in St. Louis County, Mo. Several days later, he developed a black spot on his coccyx. The black spot turned out to be a Stage IV pressure sore, which required surgery and removal of his coccyx, low back, buttocks and anus. As a result, he required dressing changes and plastic surgery over the next year.

Dieser filed a lawsuit against the hospital claiming that it chose not to prevent and properly treat the pressure sore. He alleged that the hospital staff should have timely turned him and provided adequate nutrition, among other things.

The lawsuit did not allege lost time from work. After the jury deliberated, it entered a verdict of $883,000.

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Salvador Palmieri was 86 when he underwent heart surgery and then experienced complications, which necessitated prolonged hospitalization in his hospital bed. A week after surgery, a nurse noticed new bedsores on his buttocks.

The hospital’s wound care nurse recommended cleaning and dressing the wound. However, a few months later, while Palmieri was still hospitalized, he became septic.

Palmieri was transferred to another hospital where he was diagnosed as having Stage IV sacral pressure sore, sepsis and other sores on his extremities. In spite of the medical treatment given, Palmieri died of sepsis, respiratory and kidney failure. He was survived by his wife and two adult sons.

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It is not new that nursing home residents are too often at risk for abuse, neglect and injury in the more than 17,000 nursing home facilities operating in the United States. Too many times these facilities are understaffed or staffed with untrained or unskilled workers. All of this results in many reports of serious physical, verbal and even sexual abuse in Illinois nursing homes and in other states.

It has been more than a decade since there was a two-year investigative study completed that found more than 9,000 instances of abuse. The most common abuse problems are untreated bedsores followed by inadequate medical care, malnutrition, dehydration, falls, inadequate hygiene and cases of wandering residents.

The aging of adult Americans places even more stress on nursing home facilities and long-term care facilities in which the aging are most likely to be residing. The cost of maintaining a resident at a qualified nursing home is now out of reach for many families. Many times a family member or a loved one becomes unmanageable at home because of illness, injury, age, dementia or other onset of the conditions related to aging.

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As the baby boom generation ages, the population of nursing homes is also expanding. Elderly Americans and Illinois residents who reside in nursing homes are likely the most vulnerable members of this aging society. Nursing home cases should not be confused with medical malpractice cases. A medical malpractice case typically concerns particular acts of negligence, such as a failed surgery or misdiagnosis. In contrast, nursing home cases do not involve a particular or discreet act of negligence. Rather, a nursing home abuse case in Illinois involves a pattern of sub-standard care, abuse or neglect.

For example, a nursing home abuse case may involve bedsores. Bedsores can be wounds of the flesh that take form over many days, weeks or even months. A nursing home resident who is dehydrated or suffers from malnutrition would not be the result of a single wrongful act.

Many nursing home cases arise from substandard care, abuse or neglect. Often nursing homes in Illinois operate without a single on-site treating physician; instead, they have only one who may make regular rounds. At the same time, most well-run nursing home facilities provide treatment by a resident physician, a nursing home administrator, a well-trained nursing staff, CNAs, physical and occupational therapists, speech pathologists, wound care doctors, dieticians and other medical and nursing providers.

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Mary Dwyer was 87 years old when she was admitted to Harbor View Heath Care Center for a short-term rehabilitation after she had surgery. During the following three months, she lost 20 pounds and developed multiple pressure sores, including a Stage IV sacral wound. Dwyer required two surgical debridements, application of a wound vac to remove fluid from the wound and a diversionary colostomy.

She then suffered a complication, which necessitated the reinsertion of her bowels into her abdomen. Following the surgery, Dwyer died several days later and was survived by her three adult children.

Dwyer’s family filed a lawsuit against the nursing home’s corporate owners and several affiliated companies claiming inadequate nursing home staffing. Specifically, the lawsuit claimed that the defendant nursing home did not have enough certified nursing home aides available to turn her every two hours or a full-time dietician who could assist nursing home residents like Dwyer during meals. After a jury trial, the jury returned a verdict of $13.2 million for this wrongful death action.

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Sui Mee Chiu, 85, was admitted to the Arcadia Health Center for long-term care. A member of the Arcadia staff found a Stage I pressure sore on Chiu’s lower back. A care plan was then initiated by the nursing home staff. The plan included pressure-reducing measures, frequent bathing and wound care. However, the pressure sore progressed to Stage IV, necessitating 7 hospitalizations for wound care management. Chiu developed recurring urinary tract infections from her use of Foley catheters and required a year of antibiotic treatment.

Because of the antibiotic treatment, Chiu became antibiotic-resistant and died of pneumonia and respiratory failure about 15 months after the Stage I pressure sore was first discovered and diagnosed. She was survived by her two adult children.

Her family sued the nursing home and its licensee for negligence and for choosing not to implement the care plan in a timely fashion. It was claimed that had a proper treatment been implemented, Chiu’s pressure wound would have healed without a problem. The family also maintained that the nursing home chose not to keep adequate documentation regarding Chiu’s treatment at the nursing home.

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