Nursing Home Defense Verdict

Quintairos, Prieto, Wood & Boyer, P.A. (QPWB), is proud to announce that the firm won another nursing home defense verdict on Friday, October 22, in Tampa, Hillsborough County, Florida. This case was tried in front of Judge Bauman by QPWB attorneys Pete Mollinelli and Edward Prieto for the defense, with Michael Moore and Jonathon Blakley of Roetzel & Andress, P.A. on behalf of the Plaintiffs.

Plaintiff’s decedent was a resident of Plaza West Nursing Home in Sun City Center from September 26th through October 6th, 2001. The decedent was admitted with a history of a recent fracture of the patella, arteriosclerotic heart disease, chronic atrial fibrillation, left ventricular hypertrophy, hypertensive cardiovascular disease, chronic obstructive pulmonary disease and cardiomegaly. The decedent was on chronic coumadin.

The Plaintiff filed suit under the new Chapter 400 resident’s rights statute, alleging statutory violations, negligent survival claim, and wrongful death. The Plaintiff further alleged that staff at Plaza West failed to give the decedent coumadin as ordered by the physician and failed to regularly assess the decedent in accordance with the care plan which resulted in an undiagnosed embolus, gangrene, and death.

Prior to the decedent’s admission to Plaza West for rehabilitation, the decedent was living independently in her own home where she had fallen and fractured her patella, after which she had a 3 day stay at South Bay Hospital before being transferred to Plaza West. The decedent received physical and occupational therapy at Plaza West and was care planned for risks associated with deep vein thrombosis. The care plan required shift checks for pedal pulses, color, temperature, homen’s signs, and pain. The facility staff only documented on one occasion on September 27th that they were assessing the decedent in accordance with the care plan. In addition, the medication administration records indicated that they did not give the blood thinner coumadin on September 26th, September 28th, and September 29th.

On October 6th at 12:30 p.m. nurses at Plaza West noted that the decedent had a very discolored right foot. The decedent was sent out to the hospital where she was diagnosed with an embolus and gangrene of the right foot. An embolectomy was performed which failed to restore blood flow to the foot. An above the knee amputation was recommended but refused by the family. The decedent was made a comfort measures only patient and ultimately died on October 13, 2001.
The Plaintiff called four family members who testified about the condition of the foot, which they described as black and foul smelling. The family also took photographs of the foot in the morning on October 7th depicting an extremely discolored, black, necrotic foot. These photographs were admitted into evidence over Defense objection.

The Plaintiff called Ms. Joan Bezon, ARNP as their nursing expert. Ms. Bezon testified that it was a deviation from the standard of care not to follow the physician’s orders with regard to the administration of coumadin. Dr. Bezon also testified that staff at Plaza West failed to regularly assess the decedent for the development of deep vein thrombosis or an embolus. On cross-examination Dr. Bezon admitted that she could not testify within a reasonable degree of medical certainty whether the alleged failure to give coumadin resulted in the development of the clot and subsequent embolus.

The Plaintiff also called Dr. William Blackshear as their vascular expert who testified that the failure to give coumadin resulted in a sub-therapeutic INR value thereby making it more likely than not that the decedent developed a clot after September 29th, causing the embolus in the right leg. Dr. Blackshear also testified that based upon the photographs and records from South Bay Hospital, the embolus developed on October 3rd or 4th and went undiagnosed and treated for over 48 hours. On cross-examination Dr. Blackshear admitted that the clot could have formed at any time when the decedent was sub-therapeutic, and could also have ocurred even if she had been fully coagulated.

The Defense called the physical therapist, certified occupational therapist, and nurses who cared for the decedent from October 3rd through October 6th. All Defense witnesses testified that they routinely checked for signs of DVT, but that not all checks and assessments were documented in the decedent’s chart.
The Defense did not call a nursing expert, but instead utilized the testimony of the decedent’s treating physician, who was also the medical director, who testified as to her underlying medical conditions and the lack of any violation of the standard of care. The Defense also called Dr. Russell Sampson as their vascular expert who testified that no physician could state within a reasonable degree of medical probability exactly when the clot or embolus developed and/or whether the development of the clot and embolus was the result of any deviation of the standard of care.

The Plaintiff’s demand prior to trial was $700,000. The Defense’s last offer was $300,000. At trial the Plaintiff asked for $2,400,000. The jury was out for less than one hour before rendering a complete defense verdict.

Quintairos, Prieto, Wood & Boyer, P.A. (QPWB), is proud to announce that the firm won another nursing home defense verdict on Friday, October 22, in Tampa, Hillsborough County, Florida. This case was tried in front of Judge Bauman by QPWB attorneys Pete Mollinelli, Peter Sotolongo and Edward Prieto for the defense, with Michael Moore and Jonathon Blakley of Roetzel & Andress, P.A. on behalf of the Plaintiffs.

Plaintiff’s decedent was a resident of Plaza West Nursing Home in Sun City Center from September 26th through October 6th, 2001. The decedent was admitted with a history of a recent fracture of the patella, arteriosclerotic heart disease, chronic atrial fibrillation, left ventricular hypertrophy, hypertensive cardiovascular disease, chronic obstructive pulmonary disease and cardiomegaly. The decedent was on chronic coumadin.

The Plaintiff filed suit under the new Chapter 400 resident’s rights statute, alleging statutory violations, negligent survival claim, and wrongful death. The Plaintiff further alleged that staff at Plaza West failed to give the decedent coumadin as ordered by the physician and failed to regularly assess the decedent in accordance with the care plan which resulted in an undiagnosed embolus, gangrene, and death.

Prior to the decedent’s admission to Plaza West for rehabilitation, the decedent was living independently in her own home where she had fallen and fractured her patella, after which she had a 3 day stay at South Bay Hospital before being transferred to Plaza West. The decedent received physical and occupational therapy at Plaza West and was care planned for risks associated with deep vein thrombosis. The care plan required shift checks for pedal pulses, color, temperature, homen’s signs, and pain. The facility staff only documented on one occasion on September 27th that they were assessing the decedent in accordance with the care plan. In addition, the medication administration records indicated that they did not give the blood thinner coumadin on September 26th, September 28th, and September 29th.

On October 6th at 12:30 p.m. nurses at Plaza West noted that the decedent had a very discolored right foot. The decedent was sent out to the hospital where she was diagnosed with an embolus and gangrene of the right foot. An embolectomy was performed which failed to restore blood flow to the foot. An above the knee amputation was recommended but refused by the family. The decedent was made a comfort measures only patient and ultimately died on October 13, 2001.
The Plaintiff called four family members who testified about the condition of the foot, which they described as black and foul smelling. The family also took photographs of the foot in the morning on October 7th depicting an extremely discolored, black, necrotic foot. These photographs were admitted into evidence over Defense objection.

The Plaintiff called Ms. Joan Bezon, ARNP as their nursing expert. Ms. Bezon testified that it was a deviation from the standard of care not to follow the physician’s orders with regard to the administration of coumadin. Dr. Bezon also testified that staff at Plaza West failed to regularly assess the decedent for the development of deep vein thrombosis or an embolus. On cross-examination Dr. Bezon admitted that she could not testify within a reasonable degree of medical certainty whether the alleged failure to give coumadin resulted in the development of the clot and subsequent embolus.

The Plaintiff also called Dr. William Blackshear as their vascular expert who testified that the failure to give coumadin resulted in a sub-therapeutic INR value thereby making it more likely than not that the decedent developed a clot after September 29th, causing the embolus in the right leg. Dr. Blackshear also testified that based upon the photographs and records from South Bay Hospital, the embolus developed on October 3rd or 4th and went undiagnosed and treated for over 48 hours. On cross-examination Dr. Blackshear admitted that the clot could have formed at any time when the decedent was sub-therapeutic, and could also have ocurred even if she had been fully coagulated.

The Defense called the physical therapist, certified occupational therapist, and nurses who cared for the decedent from October 3rd through October 6th. All Defense witnesses testified that they routinely checked for signs of DVT, but that not all checks and assessments were documented in the decedent’s chart.
The Defense did not call a nursing expert, but instead utilized the testimony of the decedent’s treating physician, who was also the medical director, who testified as to her underlying medical conditions and the lack of any violation of the standard of care. The Defense also called Dr. Russell Sampson as their vascular expert who testified that no physician could state within a reasonable degree of medical probability exactly when the clot or embolus developed and/or whether the development of the clot and embolus was the result of any deviation of the standard of care.

The Plaintiff’s demand prior to trial was $700,000. The Defense’s last offer was $300,000. At trial the Plaintiff asked for $2,400,000. The jury was out for less than one hour before rendering a complete defense verdict.