Florida Injury Lawyers Blog

Our first Nursing Home Neglect and Abuse blog dealt with the Florida Nursing Home Bill of Rights and summarized the various ways, e.g., the occurrence of bedsores, in which nursing home neglect and abuse may be manifested. Our second Nursing Home Neglect and Abuse blog discussed institutions besides nursing homes where bedsores may develop due to the institution’s negligence; these institutions include hospitals and rehabilitation centers. These blogs also addressed the often complex underlying emotional remorse and anger which the victim’s family may experience upon realizing that their loved one has been the victim of nursing home neglect.

In this blog, we focus more specifically on an actual situation where a nursing home negligence victim does not recover from serious bedsores prior to passing away, and the subsequent death certificate completed by the attesting doctor relates that the cause of death was caused by something other than the bedsores.

Let us take the case where a senior loved one develops bedsores while residing at a nursing home. The bedsores are not dealt with properly from the beginning and unfortunately develop into Stage III or possibly Stage IV bedsores. The victim’s family is very attentive and complains to the nursing home staff as soon as the bedsores are observed. Yet, the nursing home fails to take proper action to prevent bedsore evolution from a relatively minor wound into a serious and potentially life threatening situation. Unfortunately, nursing homes which are receiving limited Medicare and Medicaid funds to “house” certain residents, may be less likely to respond to family complaints, even though theoretically, all residents should be receiving the same level of care regardless of whether the nursing home is being paid through private funds or government funds. It should be noted that diabetic residents may be particularly prone to bedsores.

Let us now assume the unfortunate bedsore victim develops Stage IV bedsores and dies, either in the nursing home or in the hospital where she was transferred in the last days of her life. The doctor who completes the death certificate, though aware of the bedsores, lists heart failure, e.g., as the cause of death. The victim’s family understands that their loved one had a long term heart condition, but is reasonably certain that their elderly loved one actually died of complications typically related to Stage IV bedsores, such as sepsis.

The family members may nevertheless feel helpless in questioning the authority of the doctor who signed the death certificate. Attorneys may also be hesitant about challenging the medical examiner’s opinion because of the legal costs involved and because of the “weight of authority” generally given the attesting doctor's stated opinion.

A recent case out of the Fifth Circuit Court of Appeal in Florida, however, suggests that the legal landscape may be changing. In Marshall, etc. v. HQM of Winter Park, LLC, etc., 959 So. 2d 1207 (Fla. 5th DCA 2007), the Plaintiffs’ son had been admitted to the Defendant's nursing home facility for care relating apparently to a terminal condition. Sadly, he died the next day. The death certificate, stated that the cause of death was due to his pre-existing terminal condition.

Continue reading " Wrongful Death Cases Involving Bedsores: What if the Death Certificate Fails to Mention Bedsores as the Cause of Death? " »

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Posted In: Bedsores , Nursing Home Abuse , Nursing Home Negligence

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One of the most publicized areas of nursing home neglect involves the development of Decubitus Ulcers, more commonly referred to as pressure sores, or bedsores. The association of nursing homes with bedsores is so common that one would think bedsores only occur in a nursing home setting. That is not the case. Bedsores frequently occur in hospitals, after a serious operation requiring hospital stay. While the operation and post-operative medical care may have been excellent, patients confined to bed and can quickly develop bedsores if the nursing staff fails to turn the patients with sufficient frequency from one side to the other.

This failure to turn allows the pressure from lying in place or sitting too long on a wheelchair to cut off circulation to what the Mayo Clinic refers to as vulnerable body areas, such as the buttocks, hips and heels. Without adequate blood flow, the affected tissue dies.

Once a bedsore has developed, it should be treated rapidly or it may well progress from a superficial stage (Stage 1 bedsore) characterized as an itchy or slightly painful area of red skin to a more serious condition in which the wound becomes an open sore. This Stage 2 bedsore looks like a blister or abrasion but is still susceptible to quick healing if the treatment is prompt.

In a well-staffed and efficient hospital, the early stage bedsores will be recognized and treated effectively. However, in the absence of early intervention, “early stage” bedsores may well worsen when the patient is discharged to his or her home or to a rehabilitation facility, or even back to a nursing home.

This allusion to rehabilitation facilities points to another locus within our health system where: 1) bedsores can either originate; or 2) pre-existing bedsores from the patient's hospital stay can worsen. Without proper treatment, relatively minor Stage 1 and Stage 2 bedsores can worsen into crater-like wounds below the skin (Stage 3) and even deteriorate further into Stage 4 bedsores. Stage 4 bedsores involve a large scale loss of skin along with the possibilities of muscle, bone, tendon or joint damage. These wounds are particularly difficult to treat and can lead to infection and even death.

Since bedsores ranging from the early stages to the more serious ones occur in hospitals and rehabilitation facilities, as well as in nursing homes, why – it could be asked – is so much of the glare of publicity, and so much of the litigation focused on bedsores arising from nursing home neglect?

One answer may be that a large share of the nursing home resident population is composed of elderly people who may have been moved to such facilities by well meaning family members simply because they are too old, too enfeebled, or too lacking in cognition to be cared for at home. In a nursing home setting, many of the residents are what Mark Twain might have called “Innocents Abroad.” They need a lot of skilled care and are too often no longer sufficiently mentally acute to demand help or to verbalize their discomfort and/or pain. What makes this problem even more serious is that the resident’s close family member(s) may not have the awareness of the painful consequences that can spring from neglect in a nursing home environment. Nor may family members have the opportunity to visit frequently enough due to a variety of reasons such as geographical separation, work obligations, and/or other family obligations (such as small children ) to be able to ask the right questions and demand the answers they are entitled to under various Nursing Home Bills of Rights enacted by most states, including Florida.

Continue reading " BEDSORES: A VERY REAL INJURY " »

Posted by Troy & Schwartz | Permalink | Email This Post

Posted In: Bedsores , Nursing Home Abuse , Nursing Home Negligence

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This serves as an introduction to several forth-coming blogs which will discuss current legal issues in nursing home negligence and abuse.

It is a fact that a significant percentage of the aged population in our society is living in nursing homes. This is not, in most cases, because their sons, daughters, or spouses (if surviving at this point) are unfeeling or callous, but generally because the aged family member is too ill, physically fragile, and/or suffering from dementia or Alzheimer’s to be cared for adequately at home. For example, an aged person’s children may still be working and therefore cannot be available during the day to tend to the aged person’s needs. Or the aged person’s spouse may have health problems of his or her own and be unable to provide the care the spouse requires.

Except in situations of considerable prosperity, an aged person, requiring 24/7 care or supervision, cannot either individually or with the financial assistance of family members, afford private 24/7 nursing care in his/her home or the home of his/her children. The decision to place an elderly family member in a nursing home is a difficult one, but generally made with the best of intentions. Family members anticipate that their vulnerable loved one will receive better care by a presumably caring professional staff than could possibly be provided to the elderly family member at home.

The need for nursing homes under these life circumstances is abundantly clear. Our society has responded by providing these facilities, which are operated under state licenses. Recognizing that the nursing home operators’ profit-making motivations may conflict with their care-giving responsibilities, the State of Florida, like many other states, has enacted a comprehensive statute (“Statute”) which sets forth the Nursing Home Residents’ Rights. The statute is frequently referred to as the Nursing Home Bill of Rights.

Many of the rights set forth in the Statute are concerned with prohibiting abuse – whether mental or physical- of the residents. Other enumerated rights are focused on preventing Nursing Home Neglect, which is more common and which is characterized by the failure of the nursing home staff to provide adequate care. This inadequate care generally stems from understaffing, lack of training, and lack of proper supervisory oversight.

Continue reading " Nursing Homes: A Reality in 21st Century America " »

Posted by Troy & Schwartz | Permalink | Email This Post

Posted In: Nursing Home Abuse

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