Nursing Home Negligence

McGowan, Hood & Felder, LLC has represented numerous clients in regard to personal injury and wrongful death lawsuits against nursing home (and assisted living) facilities. Neglect, such as the types listed below, in a long-term healthcare setting can lead to painful injuries and death.

• Pressure Sores
Pressure sores or “bedsores” are caused by unrelieved pressure, typically on the bony areas of the body, e.g. tailbone, heels, elbows, etc. in bedridden patients resulting in damage to the underlying tissue. Most bedsores are preventable. A nursing home must develop and maintain a pressure ulcer prevention program.

Preventive measures include turning and repositioning schedules, pressure relief mattresses or pads, regular skin care and assessment, proper hygiene, proper toileting, adequate nutrition, and wound care. Failure of the care planners to properly assess and plan for prevention or treatment of bedsores, as well as failure of staff to provide the care and services required by the care plan, makes it very difficult for a long term care facility to defend a bedsore case on the grounds that the pressure ulcers were unavoidable.

• Nutrition and Weight Loss
Nutrition is an essential element of nursing home care. This includes proper nutritional assessment, care planning and intervention by the health care provider. Malnutrition often precedes the onset of pressure ulcers and, according to most experts, can impact the ability of pressure ulcers to heal. Often residents are chronically ill and require special assistance to ensure proper nutritional needs are being met. This requires the nursing home to have in place proper staffing in terms of numbers and qualifications.

Nutritional care, assessment and care planning is an interdisciplinary practice. Dieticians, speech therapists, and restorative nurses should be used to address particular conditions leaving certain patients at higher risk of weight loss or dehydration. Some residents will require a specialized diet, such as mechanically softened meals, pureed food, and food supplements. Certain residents require the use of feeding tubes. Whatever the resident’s particular situation, it is the duty of the long-term care facility to ensure that the interdisciplinary care team meets its responsibilities in ensuring nutritional needs are met.

• Medication Errors
One of the most common types of negligence in any health care setting, nursing homes included, is medication error. Errors can be the result of transcription error on physician’s orders, MAR’s (medication administration record), nurses’ notes or physician’s progress notes. Medication errors can also simply result from human error in administration of the drug or in failing to follow doctor’s orders. Often, medications are not given as the physician directs and this can ultimately be proved by a close review of the patient’s chart. For example, it is not uncommon to have a facility chart that medication has been administered despite a resident not even being in the facility at the time the medication is noted to have been given.

• Falls and Fall-Related Injuries
Falls are not uncommon in the nursing home setting. Nursing home residents typically carry a variety of risk factors for falls. These falls can result in loss of physical function and decreased quality of life. Assessments for residents at a high risk for falls are a federally mandated requirement. The assessment should lead to an individualized plan of care that will set forth preventive measures for that resident’s risk of falls (or wandering, etc.).

Prevention measures include frequent monitoring, toileting schedules, use of lowered beds, removable restraints (lap belts, lap “buddies”, etc.), electronic body and bed alarms, and even specialized equipment such as electronic tethering devices that sound an alarm when a resident leaves certain areas of the building or when passing through exits from a building.

Once a fall does occur, a facility must provide appropriate and timely assessment for the injury, and generate an incident report. If the injury is serious, there should be an investigation as to the incident’s cause. Severe injuries of unknown cause must be reported to DHEC.

• Choking/ Asphyxiation
Residents with special diets or neurological damages from strokes or other medical conditions are often at increased risk of choking, particularly at mealtime. Proper nutritional assessments should include an assessment of the risk of such injuries which are most often fatal if a patient aspirates food, chokes, or asphyxiates while unsupervised at mealtime. In addition to specialized diets, the need for restorative dietary aides to assist at mealtime must be addressed and each particular resident’s needs met in order to avoid injury or death.

• Burns/Scalds
Burn injuries are more common than one might expect in long care facilities. Often, burns involve residents who are smokers and accidently ignite themselves or burns from uncontrolled water temperatures in showers or whirlpool therapy. The uncontrolled water temperature can be due to nursing home staff errors, plumbing company negligence, product defects, or some combination thereof.

• Physical and Chemical Restraints
Each resident has certain rights including quality of care and quality of life. There are federal regulations in place to ensure that these rights are not compromised by the improper use of physical and/or chemical restraints in the nursing home setting. Often the over use of physical and chemical restraints actually has the resultant effect of more falls and fall related injuries.

The problems in nursing homes will not go away in the foreseeable future. As the baby boom generation ages, the demand for nursing home care continues to grow. Nearly 17,000 nursing homes in the United States currently care for 1.6 million residents, and that number is expected to quadruple to 6.6 million residents by 2050. These staggering numbers will dramatically increase the stressors on a system already crippled by staff shortages, poor working conditions, lack of supervision, and inadequate training.

Some of the attorneys at McGowan, Hood & Felder are well versed in how to decipher nursing home records and determine whether the standard of care is being met. We have an on-staff nurse who assists with an initial impression of whether a case has merit or not. Our lawyers have been litigating nursing home cases for many years. We aggressively litigate nursing home cases and strive to provide our clients with top tier representation.

The attorneys at our firm work closely with referring attorneys to bring a case to successful resolution. The attorneys at our firm who litigate nursing home cases are constantly updating their education and ability to resolve nursing home cases. John G. Felder, Jr. of McGowan, Hood & Felder is currently litigating nursing home cases and is available for consultation by email at jfelder@mcgowanhood.com or telephone (Toll free) 1-877-644-6400.

Please visit our website at www.mcgowanhood.com for comprehensive information on nursing home abuse and neglect.

Very truly yours,

McGowan, Hood & Felder, LLC

John G. Felder, Jr., 1517 Hampton Street, Columbia, SC 29201