A 76-year-old female nursing home patient was transferred to Berkshire Health & Rehabilitation Center, a nursing home in Vinton, Virginia operated by Medical Facilities of America, Inc. The patient had severe respiratory disease on admission.

The nursing home permitted the patient’s oxygen saturation to dip to 63%. The patient complained of not being able to breath, but the nursing home’s staff did not contact a medical doctor. Her oxygen saturation remained low at approximately 62%, but no medical doctor was contacted in response. The nursing home was instructed to send the patient to the emergency department if her oxygen saturation could not be maintained at 85% or higher.

Later in the evening after the order was received, the patient experienced breathing problems. While on the telephone with her granddaughter, she began yelling for a nurse to help her. The nursing home staff told family the patient was fine. When family visited later in the evening, they found the patient lying in her own urine and feces. Her oxygen and breathing machine also were not turned on and she was still having trouble breathing. The patient told her daughter that no nurse had responded to her repeated requests for help.

A nursing home therapist noted that moments before the family arrived, the patient was cold, clammy, and gasping for breath, and had an oxygen saturation of 86%. The therapist alerted nurses about the patient’s condition, but the nursing home did not contact a physician.

After the family’s visit, the patient was reported to be unresponsive. The nursing home’s staff merely pronounced the patient dead without performing CPR even though the patient was a “full code” patient who specifically wanted CPR to be performed if resuscitation became necessary.

The patient was not revived. The patient’s family sued the nursing home and its corporate owner for failing to provide respiratory support as required and for failing to perform CPR. After a several-day trial in Roanoke, Virginia, a jury reached a verdict for the patient’s family and awarded the family a substantial sum.

 

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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

An elderly female nursing home patient was totally dependent upon staff for transfers. The patient was transferred using a hoyer lift, which is a full mechanical lift that suspends the patient in a sling as the patient is transferred from one seating surface to another. During a transfer with a hoyer lift, the nursing home allowed the patient to fall and sustain an impacted fracture of her left shoulder. The nursing home also failed to provide the patient with adequate meals and fluid intake to prevent weight loss and dehydration. Specifically, the patient was allowed to lose seven percent of her body weight over a 180 day period, and she continued to lose weight thereafter. The patient ultimately developed a urinary tract infection with sepsis, was admitted to a local hospital, and died there several weeks after admission.

The nursing home settled the case for a generous amount before trial. The nursing home requested confidentiality concerning the amount of the settlement.

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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

An elderly female nursing home patient was permitted to fall from her bed to the floor. The nursing home claimed it was changing the patient’s bed sheets while the patient remained in bed. The patient was turned away from the aide who was making the bed and positioned on her side at the edge of the bed. The aide was looking down, the patient began to fall, the aide did not respond to stop the fall, and the patient fell to the floor.

As a result of the fall, the patient sustained a left knee fracture and left ankle sprain. The patient’s injuries required physical therapy and occupational therapy but no surgery. The left knee fracture was treated conservatively using a knee immobilizer, and the left ankle sprain was treated with an air cast. The patient’s orthopedic injuries lasted for several months and healed without complication.

As a result of injuries sustained in the fall, the patient experienced significant pain, which in turn required increased narcotic pain medications and resulted in periodic lethargy/over sedation. Despite attempts to control the patient’s fracture-related pain, break through pain often occurred, limiting the patient’s ability to participate in activities of daily living and progress in therapy and restorative activities. The patient’s injuries also caused her to be less mobile, require additional assistance from staff for activities of daily living, and put the patient at risk of skin break down.

The patient’s leg immobilizer, which she was required to wear because of the fracture, caused a significant open pressure ulcer (also known as pressure sore, bed sore, and decubitus ulcer) to her left lower leg with drainage, inflammation, and sloughs that impeded wound healing. The leg wound required extensive wound care. The patient also experienced an increased fear of falling.

The lawsuit was filed by the family Sylvia Coleman v. Medical Facilities of America, Inc. and its affiliated business entities, which included the limited partnership that owned Lynchburg Health & Rehabilitation Center, where the fall occurred.

We claim the nursing home did not use proper fall prevention measures. Specifically, we claim the aide who turned the patient to her side on the opposite edge of the bed should have rolled the patient toward, not away, from her. In addition, the aide should have more closely supervised the patient for safety to prevent falls. Of course, the nursing home also failed simply to place the patient in a chair for safety while changing the bed sheets. The nursing home denied liability. The patient incurred medical expenses of approximately $14,000.00. After a several-day jury trial in the City of Lynchburg Circuit Court, the jury concluded that the nursing home was negligent and awarded damages in the total amount of $364,500.00. After the jury verdict, the nursing home attempted to appeal the verdict, but later dropped the appeal voluntarily.

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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

While hospitalized, a middle-aged male patient developed what was initially described by the hospital as a large bruised area on his buttock with no skin breakdown. Within one week thereafter, the hospital described the wound as a very large purple bruise on his coccyx (low back) and buttock area with sloughing. The patient also developed a large purple area over his left heel. Two days later, the patient was noted to have blood blisters on both heels, and the patient’s lower back and buttock had open blisters that had ruptured. The patient’s lower back, buttock, and heel ulcers deteriorated and each became stage IV pressure ulcers (also known as bed sores, pressure sores, and decubitus ulcers), some of which required debridement. On discharge from the hospital, the patient required one year of wound care at home. The patient’s pressure ulcers healed with no significant, observable scarring.

The hospital settled the case before trial for mid-six figures. The hospital requested that the settlement amount be kept confidential.

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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

An elderly female was, at the time of admission to the assisted living facility, a high fall risk. She required stand-by assistance when bathing, dressing, using a walker, and when toileting. She also suffered from impaired balance and an unsteady gait.

The patient was allowed to fall at the assisted living facility while being supervised by facility staff. As a result of the fall, the patient sustained a spiral distal left femur fracture will displacement, angulation, and significant comminution. The patient received open reduction and internal fixation surgery for the femur fracture, remained at the hospital for one week, and was transferred to a nearby nursing home.

At the time of the fall, the patient was taken to the bathroom by an aide to be changed. After she was toileted, the aide assisted the patient to her feet and improperly permitted the patient to support herself on a towel bar behind the bathroom door. Unfortunately, the bathroom door was left open, thereby obscuring most of the towel bar and permitting only a fraction of the bar to be used by the patient for support. The patient was also wearing only socks on her feet in a bathroom with a tiled floor.

The assisted living facility settled the case well before trial for a confidential amount in the mid-six figures.

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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

A patient was hospitalized before admission to the defendant’s nursing home. During the hospitalization, the patient had a PEG (percutaneous endoscopic gastric) feeding tube put in place. The patient was discharged to the defendant’s nursing home after surgery within one week of the surgical feeding tube placement.

Several days after admission to nursing home, the patient was observed with the PEG tube lying in his bed with the bulb deflated. When the patient’s PEG tube was noted to be displaced, the nursing home re-inserted the tube manually at his bedside without taking proper steps to ensure that the tube was returned to a safe location within the patient’s stomach. The nursing home improperly inserted the tube into the patient’s peritoneal cavity, not his stomach, and continued providing feeding formula, medication, and flushes through the misplaced feeding tube.

One-in-one half hours later, the nursing home received an order from the patient’s physician to verify PEG tube placement by x-ray. The nursing home delayed obtaining x-ray confirmation of the feeding tube placement for hours and hours, during which time the nursing home continued to provide the patient with tube feedings, medications, and flushes. The patient began grunting and was observed to express pain by grimacing. The patient’s blood pressure dropped at the nursing home and he became cool, clammy and sweaty. Fifteen hours after the PEG tube was re-inserted and feeding formula, medications and flushes resumed, the nursing home finally transferred the patient to the hospital.

On admission to the hospital the patient was noted to have shortness of breath and a painful abdomen. He was further noted to be hypoxic with a rapidly declining mental status and rapid respirations. He also demonstrated an elevated temperature, elevated heart rate, elevated blood sugar level, abnormal creatinine and acute kidney failure.

A CT scan of the patient’s abdomen at the hospital revealed that the PEG tube had been improperly re-inserted into the patient’s peritoneal cavity. The CT scan further revealed free air and tube feeding in the patient’s peritoneum. The patient declined rapidly at the hospital and, based on the severity of his peritonitis, he was a poor candidate for surgery. The patient’s family placed him on comfort measures and he died at the hospital eleven days later.

We obtained copies of the nursing home’s policies and procedures and discovered that the nursing home had been instructing staff to verify proper PEG placement by auscultation (listening for a “gurgling sound” in the stomach when air is placed through the feeding tube and aspiration (withdrawing) fluid through the feeding tube and examining fluid). We determined through a literature search that auscultation was a notoriously unreliable method of confirming proper PEG tube placement, that a “gurgling sound” can just as easily reflect a tube in a improper position as a properly placed tube, and that a “gurgling sound” alone never indicated correct placement such the feeding, medications and flushes should never have been resumed.

With respect to aspiration, the nursing home’s policies and procedures falsely provided that PEG tube placement could be verified merely by aspirating the feeding tube contents and examining those contents visually. Unfortunately, the nursing home’s policies and procedures, which were used to train staff responsible for the care of patients with feeding tubes, contained no discussion about the use of x-ray to confirm proper PEG tube placement or the use of pH paper to test tube contents to verify proper placement, both of which were reliable and inexpensive methods identified in medical literature as early as ten years prior for determining proper PEG tube placement.

We requested compensatory damages as a result of the patient’s wrongful death. We also requested punitive damages because the nursing home’s antiquated policies and procedures, inadequate training, and negligent care of the patient represented conduct the nursing home knew placed the patient at a grave risk of harm. The nursing home settled the case before trial for a confidential amount.

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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

A female nursing home patient was permitted to fall when she was left alone in her bathroom without any supervision. As an immediate result of the fall, she sustained pain during transfer from floor to wheelchair and from wheelchair to bed, facial grimacing on movement, and external rotation of the left hip and leg. The patient was later diagnosed at a local hospital with a comminuted fracture of the left femur with angulation. She was also noted to have moderate to severe pain, which required multiple administrations of morphine. She was transferred to another hospital for more aggressive orthopaedic care.

At the second hospital, the patient was noted to have “leg pain whenever she moves” and the site of the fracture was painful. The hospital described her as experiencing “marked pain with any attempt at mobilization.” The patient received closed reduction and intramedullary internal fixation of the left hip in a surgical procedure performed at the second hospital. Following surgery, she was transfused with multiple units of packed red blood cells due to post-operative blood loss anemia. Unfortunately, the transfused donor blood was contaminated with bacteria that caused the patient to experience post-operative fever in a “transfusion like reaction,” which itself required the patient to receive IV antibiotics.

The patient was discharged from the second hospital to a separate nursing home. While at the separate nursing home, the patient continued to experience severe pain as a result of the fracture. Due to fracture-related pain, the patient was noted by nursing home staff to be in tears when staff attempted to assist her physically with activities of daily living. She continued to experience pain daily thereafter, especially over the site of the fracture.

Within one month after the fall and fracture, the patient was placed on comfort care by her family. While on comfort care, the patient began to experience cognitive decline and dementia that was complicated by the left hip fracture. She became increasingly dehydrated, disinterested in eating, and relayed to her family that she was “very tired and exhausted” and “ready to die and go to heaven.” The patient died several months later.

The nursing home settled before trial for a confidential amount in the mid-six figures.

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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

A female nursing home patient required staff assistance for turning, repositioning, and transfers. The nursing home’s staff attempted to transfer the patient by lifting the patient under her arms from behind the patient’s body. The force of the attempted transfer caused the patient to sustain a comminuted left arm fracture with complete separation of the fracture fragments. As a result of the fracture, the patient’s left arm was placed in a brace and sling. Pressure caused by the brace and sling resulted in skin breakdown because the nursing home staff failed properly to pad the area around the arm’s splint.

We were able to obtain a generous settlement on the patient’s behalf in an amount the nursing home requested be kept confidential.

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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

An elderly female patient was admitted to a hospital for surgery following a hip fracture at home. On admission, the patient’s skin was intact and she had no pressure ulcers (also called pressure sores, bed sores, or decubitus ulcers). The patient was discharged from the hospital approximately one week later. At the time of discharge, the patient was documented to have three small open areas on her right buttock near the lower back. The patient was discharged from the hospital to a nursing home, which documented the patient to have open “excoriation” on her lower back. The nursing home otherwise assessed the patient as a “low risk for pressure ulcer development.”

Two days after the patient was admitted to the nursing home, the facility noted the presence of a stage II sacral wound with dimensions of 6 cm x 6 cm with red tissue and drainage. The sacral pressure ulcer deteriorated thereafter. Within a couple of weeks, the ulcer was documented as stage IV with dimensions of 10 cm x 10 cm with significant undermining. While at the nursing home, the patient’s wound continued to deteriorate and became purulent with foul-spelling drainage and tunneling. The pressure ulcer was the source of significant pain and prevented the patient from participating in therapy following the hip fracture for which she was originally hospitalized.

The patient was later transferred from the nursing home back to the hospital because the pressure ulcer had become infected. The patient had also developed a new pressure ulcer on her left hip. At the hospital, infection of the pressure ulcer was noted to have extended into the left hip hardware. The patient required multiple surgical debridements for the sacral and left hip pressure ulcers. She also experienced what was described in her medical records as “unbearable” pain in her buttock as a result of the sacral ulcer. The patient also required a wound vac and antibiotics. The patient was discharged from the hospital to a new nursing home, where her antibiotic therapy and wound care continued, she received therapy services, and where she remains today.

We claimed that the hospital and nursing home failed to provide proper pressure ulcer prevention and care. Specifically, the hospital and nursing home failed to turn and reposition the patient as often as was necessary, often left the patient positioned on existing pressure ulcers, and failed to apply and use properly the wound vac, all of which caused the pressure ulcers to develop and deteriorate.

The hospital and nursing home settled well before trial for a combined settlement in the mid-to-high six figures.

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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

A patient who was blind and an amputee was being transported by the defendant hospital’s medical transport vehicle. During the transport, the transport driver without warning slammed on the brakes and came to an abrupt stop. The patient, who was not properly secured in the back of the transport vehicle, was thrown to the floor of the transport from her wheelchair. As a result of the fall, the patient sustained a wrist fracture, a scalp hematoma, and facial abrasions.

The hospital settled before trial for a generous amount. The hospital requested confidentiality of the settlement amount.

 

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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

An elderly female nursing home patient was, on admission to the nursing home, a high fall risk. After admission of the nursing home, the patient had been permitted to fall on no less than ten separate occasions. As a result of the tenth fall, the patient sustained a right hip fracture, for which surgery was required. One month later, the nursing home permitted  the patient to fall yet again, and the fall resulted in headaches, hip pain, and a hematoma and a laceration to the back of the patient’s head. Following these final two falls, the patient experienced a decline in health, began receiving hospice care, and died several months later.

The nursing home settled this case before trial for a confidential amount in the mid-six figures.

 

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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

We recently obtained an excellent settlement in the case of an elderly female patient of a Northern Virginia nursing home who was permitted to fall on multiple occasions.  As a result of the falls, the patient sustained an intertrochanteric fracture of the right hip and a comminuted spiral fracture of the mid- to distal right femur, the latter of which required surgery to remove hardware that was surgically placed following the former.  

The patient was known by the nursing home before the falls to be a high fall risk.  However, the nursing home failed to implement with the patient basic fall safety measures like a low bed, fall mat, bed/chair fall alarms, appropriate supervision, and adequate staffing.  The nursing home also failed to act before the falls on recommendations by the facility's physical therapy department for the patient to be placed in a gerichair when  out of bed instead of a wheelchair to reduce her risk of falling.  The nursing home also medicated the patient with Percocet, a narcotic pain killer, long after the patient's physician instructed the facility to discontinue its use, which resulted in chemical sedation ("chemical restraint") of the patient.  A lap buddy ("physical restraint") was also used with the patient despite the nursing home's failure to justify its use in writing, obtain a physician’s order authorizing its use, observe the patient's use of the lap buddy every 30 minutes, release the lap buddy 10 minutes every hour, and document observation and release of the lap buddy consistently.  The nursing home also did not timely ensure the patient was diagnosed with injury by obtaining an x-ray, having her evaluated by a physician, and transferring her to a hospital.  We also learned the nursing home's staff intentionally placed all of the facility's patients to bed by 7:30 pm each night, which had the unfortunate effect also of increasing fall risk when they woke up in the early morning hours.  

The patient's hip and femur fractures and surgery resulted in limitations with weight bearing, required extensive therapy and pain medication, eliminated gains the patient experienced with therapy before the fractures, limited her ambulation to wheelchair/gerichair, caused her to become more dependent with activities of daily living, decreased muscle and motor strength, accelerated contractures and arthritis in her knees, and caused generalized deconditioning. 

The case settled in the high six figures.  The exact amount of settlement is confidential at the nursing home's request.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

A Roanoke area nursing home permitted a patient to fall and sustain a right intertrochanteric hip fracture, for which surgery was required.  On admission to the facility, the patient was a fall risk.  She had fallen at the facility eight times before the fall that fractured her hip.

  

The patient was also a victim at the nursing home of medication errors.  Specifically,  following a separate transfer from the nusing home to the hospital, the patient was diagnosed by a hospital physician with a benzodiazepine and opiate overdose.  The patient's health declined and she died approximately one year after the hip fracture and medication error.    

 

With respect to the hip fracture, the patient's family claimed the nursing home was negligent because it failed to provide the patient with basic fall prevention measures: fall alarms in bed and chair; a low bed; a fall mat; and closer supervision.  The family also claimed that if the nursing home's staff had been more attentive to the patient's condition, the medication errors would not have occurred.  

 

We were able to obtain settlement in the mid six figures on terms that, at the nursing home's request, are confidential. 
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia. 

A Central Virginia assisted living facility operated a locked dementia unit as a “safe secure environment" for patients with serious cognitive impairments due to a primary psychiatric diagnosis of dementia who could not recognize danger or protect their own safety and welfare.  

A female patient (Patient No. 1) of the assisted living facility's locked dementia unit was assaulted in her room by another patient (Patient No. 2), who kicked Patient No. 1 to the ground.  Before the assault, the assisted living facility knew Patient No. 2 had a long history of aggressive and violent behavior, the following of which are examples:

“Resident extremely agitated hitting, kicking, pulling two other residents by arms.  Almost caused other two residents to fall on two occasions.  Staff members attempting to get her to move away from others were kicked, hit, punched, and nearly knocked down on floor . . . Continues very agitated and putting other two residents at risk for injury”;

"Resident extremely agitated hitting, kicking, pulling two other residents by arms.  Almost caused other two  residents to fall on two occasions.  Staff members attempting to get her to move away from others were kicked, hit, punched, and nearly knocked down on floor . . . Continues very agitated and putting other two residents at risk for injury”;

“Resident hit her roommate with lamp . . . . . . . Resident moving and throwing furniture, spitting at aide, hitting resident”; 

"Resident at suppertime threw juice in other resident’s face and then stabbed her in the right hand.” 

Patient No. 1's family contended the assisted living facility was negligent  because it failed to discharge Patient No. 2 long before her assault on Patient No. 1, failed to supervise Patient No. 1 and Patient No. 2 before and at the time of the assault, and failed to staff the unit appropriately at the time of the assault.  As a result of the assault, Patient No. 1 sustained a hip fracture that required surgery and rehabilitation.  After her discharge from the hospital, Patient No. 1 required nursing home care until her death two years later.  Patient No. 1 died for reasons unrelated to the assault and hip fracture.

We were able to obtain a generous settlement, the amount of which is confidential at the facility's request. 
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

A demented hospice patient of a Roanoke area nursing home was permitted to gain access to and ingest a chemical floor stripper.  The nursing home knew in the months, weeks, and days before the ingestion that the patient's judgment and decision-making were impaired and that he had poor awareness of his own safety.  The nursing home also knew the patient was disoriented, confused, experienced memory problems, was unaware of safety precautions and his own limitations, had poor reasoning skills, and lacked simple problem-solving skills.  The day before the incident, the nursing home twice documented the patient was very confused.  

At the time of the ingestion, the nursing home left the chemical unsecured in the patient area in a one gallon container.  The nursing home's staff apparently intended to mix and dilute the chemical in the patient area.  The container of the chemical did not have a safety lid, was not kept in the possession of staff at all times, was not kept in a locked container, and was not otherwise secured.  In addition, neither the patient, the chemical, nor the area around the chemical was supervised.  The nursing home also did not have any policies or procedures in place to protect its patients from dangerous chemicals in resident areas. 

As a result of the chemical ingestion, the patient was taken to the hospital, where he was diagnosed with a chemical airway burn.  The chemical burn blistered the patient's lips and caused swelling in his throat.  The patient was also documented to be spitting up blood-tinged frothy sputum.  He was placed on steroids to decrease laryngeal edema and was administered antibiotics.  As a result of the laryngeal edema, the patient's larynx could not properly elevate and his airway was left open, which increased his risk of aspirating.  The patient had a prior history of partial lung removal.  He was therefore placed at a significantly higher risk of cardiac and respiratory complications arising from the injury.  The patient was not permitted to consume food or fluids by mouth for several days in the hospital, and only then was authorized to consume only small sips of liquid.  He remained unable to take oral medications. 

While at the hospital, the patient was documented to have experienced significant pain during swallowing.  Speech professionals recommended a Modified Barium Swallow Study (MBSS) because pharyngeal damage and swelling resulted from penetration and aspiration.  The patient was placed on morphine for pain.  Based on the patient's declining condition, he was discharged back to the nursing home under the care of hospice services.  While at the nursing home, the patient continued to decline.  He received Roxanol (morphine) for pain, restlessness, and shortness of breath.  The patient died within one week of the ingestion incident. 

The patient's family claimed the nursing home did not properly secure the chemical and supervise the patient.  The family also claimed the nursing home should have implemented formal policies and procedures long before the event to ensure chemical and patient safety at the facility.  The patient's family contended the patient's death resulted directly from ingestion of the chemical floor stripper.   The nursing home contended the patient's death resulted from pre-existing cardiac and respiratory failure.  The nursing home also highlighted that prior to the chemical ingestion, the patient's physician documented his life expectancy was less than six months.  We were able to obtain a very generous settlement for the patient's family. 
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

A Lynchburg area assisted living facility's patient began over a weekend to exhibit clinical symptoms that were for him highly unusual: back pain of unknown source; staying in bed; decreased appetite; and urinary incontinence.  During this time, the assisted living facility did not contact either the patient's physician or his family in response to the patient's changing condition.  When the patient's family first became aware of the changes, they requested for him to be transferred to the hospital by ambulance.  When ambulance personnel arrived, the facility's staff stated the patient had not been himself in the several days before the ambulance was called.  Ambulance personnel also noted when they responded that the patient did not know who he was, where he was, or what time it was, was unable to stand, and required maximum assistance for transfers.  The patient was admitted to the hospital and died there of sepsis within approximately 18 hours after he was admitted. 

The patient's family claimed the assisted living facility failed to recognize and obtain prompt medical attention for the patient's changing condition.  We settled the case against the assisted living facility for six figures on terms that, at the facility's request, remain confidential.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

An aide at a Richmond nursing home permitted a completely immobile bed bound patient to fall from bed.  As a result of the fall, the patient sustained comminuted spiral fractures of her right and left fumurs.   The patient did not receive surgery for the leg fractures because she was not ambulatory and the risk of surgery on both legs was too great.  The patient lived for approximately one year after the fractures and died for reasons unrelated to the fractures. 

The patient's family claimed the nursing home failed to supervise the patient propoerly to prevent the fall.  The patient's medical expenses were approximately $20,000.  The case settled for mid-six figures on terms that, at the nursing home's request, remain confidential.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.  

We recently obtained a very favorable settlement in the case of a nursing home patient who sustained rib fractures in the second of two falls on the same day.  The patient was admitted to the Roanoke area nursing home for rehabilitation following an extended hospital stay for pneumonia. 

While at the nursing home, the patient was at all times a high fall risk because of decreased strength and endurance, an unsteady gait, a limp with hip pain, confusion caused by medications, prior cardiac compromise that included an ejection fraction of 20-25%, and a documented need for close supervision and assistance by staff when ambulating.  However, according to the nursing home's fall assessment, the patient was not a fall risk. 

The patient sustained two falls on January 4, 2004.  Because the nursing home's fall assessment of the patient on admission was in error, the nursing home failed before the first fall to implement basic fall prevention measures, like increased supervision, bed and chair fall alarms, and assistance with walking.  The first fall did not result in any injury, but the nursing home did not re-assess the patient's fall risks after that fall.  As a result, no added fall precautions were provided to the patient before the second of the patient's falls that day.  The second fall occurred in the patient's room when, despite the presence in the patient's room of a member of the nursing home's staff, the patient was permitted to walk unassisted and without supervision.  The patient fell backwards against a heater in his room.

As a result of the second fall, the patient sustained fractures of the fourth through eighth left ribs with a likely pulmonary contusion.  We were prepared to prove that because of the severe pain caused by the rib fractures, the effects of narcotic pain medications required to treat the pain, and loss of ability to participate in rehabilitation, the patient's injuries resulted in loss of respiratory ability and effort, increased lung compromise, accumulation of pulmonary infiltrate, inability to clear the infiltrate, consolidation, atelectasis, and pneumonia, all of which culminated in respiratory distress and respiratory failure, which, given the patient's vulnerable cardio-respiratory status, caused his death.

The case was settled before trial for six figures.  Specifics about the settlement were made confidential at the nursing home's request.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Martinsville, Charlottesville, and across Virginia

We recently obtained a very favorable settlement in the case of a 91-year-old female patient who sustained a fall with fractures and head injury at a Roanoke area nursing home.  

While at the nursing home, the patient was at all times a high fall risk because she had dementia and attempted on numerous occasions to get out of bed without assistance.  On admission, the nursing home instructed the patient's family to hire sitters around the clock precisely because she was a fall risk.  The family reluctantly agreed.  For reasons unknown, the nursing home's staff later instructed the patient's family that sitters could be discontinued on the evening shift even though the patient remained a high fall risk during all shifts.

In the early morning hours of May 10, 2006, the patient sustained an unwitnessed fall in her bedroom. We contended the nursing home failed to take proper fall prevention measures to ensure the patient's safety before and at the time of her fall. Specifically, the nursing home did not properly supervise the patient or provide staff of sufficient numbers or location to respond timely to the patient's fall alarm.  One of the patient's privately-hired sitters was later told by a member of the nursing home's staff that the nursing home "let her fall" and "did not put the [fall] alarm on before the fall." 

After the fall, the nursing home failed to obtain immediate emergency medical assistance and treatment for the patient.  Even though the patient's fall occurred as early as 5:00 a.m., the patient did not receive a CT scan until early afternoon on the day of the fall, and she was not sent to the hospital until the late afternoon. The nursing home’s own director of nursing acknowledged the patient should have received emergency medical attention immediately after the fall, especially since she had an obvious head injury and was on anticoagulants. The nursing home also failed to have in place a policy directing staff to obtain emergency medical assistance.  The Virginia Department of Health investigated the patient's injuries and concluded the nursing home's care and treatment was deficient.  

As a result of the fall, the patient sustained impact to her face and head, lacerations to the face and right hand, bruising to the right side of her face, a right orbital fracture that included fractures to the orbital rim, floor, anterior and lateral walls of the right maxillary sinus, and the inferior wall of the right orbit, significant bruising around her right shoulder, a right clavicle fracture, and a right scapula fracture.  She also developed an intraventricular bleed and a traumatic brain injury as a result of the fall. As a result of her orthopedic injuries, the patient was permitted to bear weight on her right shoulder only as tolerated and was placed in an arm sling. She also experienced pain and increased confusion as a result of her injuries.  The patient died for reasons unrelated to the fall approximately nine months later.

The case was settled before trial for six figures.  Specifics about the settlement were made confidential at the nursing home's request.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Martinsville, Charlottesville, and across Virginia

We recently obtained a very favorable settlement in the case of an 81-year-old female nursing home patient who was allowed by the facility to fall and sustain a hip fracture.  She was also the victim of medication errors while a patient at the nursing home.

The patient was admitted to a Roanoke area nursing home on July 20, 2005 following hospitalization for a left hip fracture she sustained in a fall at home.  On admission to the facility, she was a high fall risk because she had an unsteady gait, poor/impaired coordination, poor safety awareness, short term memory loss, dementia, bladder incontinence, and a history of falls.  While a patient at the nursing home, she was allowed to fall on multiple occasions. Specifically,

• on July 22, 2005 at 4:00 pm, the nursing home's nurse’s notes reflected that the patient was found on the floor in her room "between the two beds in stocking feet". The nursing home's fall investigation documents reflect she was found lying on her back after staff responded to a loud noise and heard her yelling.  Her wheelchair was found unlocked, her shoes had been removed, and she was attempting to get into her bed when she fell.  The nursing home responded to the fall by recommending to staff that she be reminded regularly to ask for assistance;
• on July 23, 2005 at 6:15 am, the nursing home's nurse’s notes reflect the patient was found in the bathroom "on the floor after staff heard her yelling for help."  The nursing home's fall investigation documents reflect the patient was getting off of the toilet without assistance when she fell.  The nursing home's staff was instructed after the incident not to leave her unattended.  The nursing home responded to this fall by recommending to staff that the patient be provided with a personal assistance device (PAD), which is a pendant worn by the patient that permits the patient to summons help after an emergency. A PAD is not a fall alarm;
• on July 25, 2005 at 4:30 am, the nursing home's nurses notes reflect the patient was found "on the floor" of her room. The nursing home's fall investigation documents reflect she said she "had to go to the bathroom and could not wait for help." The nursing home responded to this fall by recommending to staff that the patient be provided with a low bed and a fall mat at bedside. She was also provided with a motion sensor fall alarm for her bed. No fall alarm was provided for use while she was in a wheelchair;
• on August 6, 2005, the patient was allowed to fall again, this time at the nurse’s station. The nursing home's fall investigation documents reflect that the patient was in her wheelchair at the nurse’s station, stood up to use the phone, lost her footing, grabbed her wheelchair, and fell. The string on the patient's PAD was noted to have been untied and frayed at the time of the fall.  As a result of the fall, the patient sustained a right hip fracture.

We contended the nursing home was negligent in connection with the August 6, 2005 fall by failing to supervise the patient while she was at the nurse’s station, by not equipping her wheelchair with a chair fall alarm, and by failing to ensure her wheelchair was locked.

With respect to supervision, the patient was observed before the fall only by a member of the nursing home's housekeeping staff, who saw her stand and observed her "talking on the phone in the hallway." The housekeeper took the time to ask the patient "what she was doing" and the patient responded that she was "trying to call her daughter." The housekeeper then took the time to tell the patient she "needed to sit down before she falls and gets hurt." According to the housekeeper, the patient then attempted to sit down, turned around, lost her footing, tried to break the fall by using the wheelchair, and fell to the floor. At no time during her lengthy interaction with the patient did the housekeeper summons help from nursing staff, and no one on behalf of the nursing home intervened to assist the patient safely back into her wheelchair.

With respect to the nursing home's failure to provide the patient with a fall alarm in her chair, the patient had been provided approximately two weeks before the fall on August 6, 2005 with a motion sensor fall alarm, but only for her bed.  She had not before the fall been provided with a fall alarm for use in her wheelchair. As a result, the nursing home's staff was not alerted when the patient began to rise from her wheelchair at the nurse’s station or as the patient remained standing at the nurse’s station talking on the telephone before the fall occurred. 

Finally, the patient's wheelchair had not been locked when she was left at the nurse’s station. Just prior to the fall, the nursing home's housekeeper observed that the patient was unable to stabilize herself when she turned to sit in her wheelchair. A member of the nursing home's staff later confided to the patient's family that no nurses were present to supervise the patient at the time of the fall, her wheelchair had not been locked, and the wheelchair rolled backwards when she attempted to sit in it. In addition, the nursing home's head of nursing told the patient's family the nursing home did not have enough staff to provide one-to-one supervision, the facility would make sure she was at the nurse’s station in her wheelchair so staff could supervise her appropriately.

 

As a result of the August 6, 2005 fall, the patient sustained a displaced right femoral neck (i.e. right hip) fracture. She was admitted on an emergency basis to a local hospital, where she underwent a bipolar prosthetic arthroplasty the day after the fall. She remained at the hospital through August 11, 2005, at which time she was transferred back to the nursing home for rehabilitation. She suffered significant pain and immobility as a result of the right hip fracture.

 

Upon the patient's return to the nursing home, the facility's staff administered the wrong medication to her in error.  Specifically, the patient received Chlordiazepoxide (a drug with sedative and hypnotic properties) instead of Chlorthalidone (a diuretic) in error from August 14, 2005 through August 19, 2005. The nursing home explained the error by claiming the names of the two drugs had similar spellings. The nursing home's repeated medication errors caused the patient to suffer significant lethargy, from which she eventually recovered. The patient fell again at the nursing home on August 26, 2005, but thankfully sustained no injury.  She died on August 31, 2005 for reasons unrelated to the fall.

The case was settled before trial for six figures.  Specifics about the settlement were made confidential at the nursing home's request.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Martinsville, Charlottesville, and across Virginia 

We recently obtained a very favorable settlement in the case of a 90-year-old female patient who was permitted to fall at a Danville area nursing home.  On February 9, 2007 at approximately 10:30 pm, an aide at the nursing home was changing the patient when she permitted the patient to roll out of the bed and fall to the floor. The nursing home documented in its nurse’s notes only that the patient was "found" on the floor. As a result of the fall, the patient sustained an oblique fracture of the right lower leg. 

After the fall, the patient was transferred to the hospital, where the fracture was reduced and a long leg fiberglass cast was applied.  The patient remained in the long leg cast until July 6, 2007, at which time a short leg fiberglass cast was applied.  The patient sustained abrasions to the leg caused by friction from the leg casts. The abrasions took several months to heal.  She also suffered swelling of the right lower leg, which required her to keep the leg elevated while in bed.  She also developed a pressure ulcer on her right heel from prolonged casting of the fracture. The pressure ulcer required debridement, but ultimately healed with scar tissue.

The leg fracture also caused the patient to endure significant pain. She was medicated with morphine at the hospital. Thereafter, she was prescribed oxycodone for pain. From February 17, 2007 through July 14, 2007, her pain was consistently rated at 4 to 6 on a scale of 10, with 10 being the most severe pain possible.

Due to delayed healing of the fracture and the absence of bone formation at the fracture site, the patient also required the use of a bone stimulator, which she began using on June 23, 2007. The bone stimulator was discontinued on August 7, 2007. The patient's fracture did not heal radiographically until August 7, 2007.

The patient also remained non-weight bearing on the right leg for four months through June 6, 2007. She was required to wear a fracture boot when being transferred, turned, and repositioned in bed to prevent dislocation of the fracture. Her fracture boot was discontinued on September 14, 2007.  The patient died on November 22, 2007 - nine months after the fall - for reasons unrelated to the leg fracture.

The case was settled before trial for six figures.  Specifics about the settlement were made confidential at the nursing home's request.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Martinsville, Charlottesville, and across Virginia

A 91-year-old patient of a nursing home was allowed to develop a pressure ulcer (bed sore, bedsore, pressure sore, decubitus ulcer) on her sacrum (low back).  The pressure ulcer deteriorated and she died three and one-half months later. 

On admission to the nursing home, the patient did not have any pressure ulcers.  She was, however, dependent on the nursing home’s staff for turning and respositioning due to mobility and cognitive deficits.  The patient's family contended the pressure ulcer was caused and deteriorated because staff at the nursing home did not use proper transfer techniques, which resulted in friction and shear forces on the sacrum, and did not consistently turn and reposition the patient in bed.

Within three weeks after the pressure ulcer (bed sore, bedsore, pressure sore, decubitus ulcer) was first observed, the wound was documented to have been "worsening, with more maceration seen on wound edges."  Several days later, the pressure ulcer was noted to have increased in size from 4.0 cm x 2.5 cm to 5.0 cm x 3.5 cm and 50% of the wound bed was documented to have been comprised of necrotic tissue.  

The patient thereafter was admitted for one week to a local hospital for reasons unrelated to the wound.  On admission to the hospital, the patient's pressure ulcer (bed sore, bedsore, pressure sore, decubitus ulcer) was documented to be stage II with dimensions of 7 cm x 3 cm – a 20% increase in size in the three days before her hospital admission.  When she was discharged from the hospital one week later and returned to the nursing home, the pressure ulcer (bed sore, bedsore, pressure sore, decubitus ulcer) was "unstageable" with dimensions of 5.0 cm x 6.2 cm and 80% dark brown slough.  The nursing home claimed the hospital was  to blame for the deterioration of the ulcer during the patient's hospitalization.  We contended the deterioration of the patient's ulcer was inevitable whether the patient was in a hospital or some other health care facility because the ulcer was bad and getting worse before the hospitalization.  

As the nursing home's failures to turn and reposition the patient continued, the pressure ulcer continued to deteriorate.  Within a couple of weeks after the patient's hospitalization, and despite aggressive wound therapy, the wound measured 11.0 cm x 11.0 cm, had purulent drainage (pus), an odor, and was contaminated with MRSA.  The patient was discharged from the nursing home to her own home with hospice care.  Even though pain medication was prescribed for use at home, the patient frequently experienced "breakthrough pain" from the ulcer, especially before and after dressing changes and when repositioned.  The patient died several weeks later as a direct result of sepsis (systemic infection) caused by the pressure ulcer (bed sore, bedsore, pressure sore, decubitus ulcer).  She was survived by two daughters and a granddaughter. 

The nursing home contended the patient's pressure ulcer was unavoidable because of the patient's age, poor nutritional status, and chronic end stage kidney disease.  Her kidney disease prevented her from eliminating waste products and fluid from her blood.  She had pre-existing hypoalbuminemia (low protein), which typically would have required her protein level to be supplemented.  However, if she had received additional protein, an even greater buildup of protein would have occurred because of the kidney disease and kidney failure would have resulted.  The nursing home also contended that, despite the family's claims, the patient was consistently and timely turned and repositioned  

The case settled for $400,000 well before trial.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia

A 100-year-old nursing home patient was dropped in her bathroom by a CNA, who was reportedly assisting her to toilet.  The nursing home's care plan required two care providers to be present with the patient during transfers and toileting.  Only one care provider was present when the patient was dropped. 

As a result of the fall, the patient sustained a fracture of the left femoral shaft with extreme rotation, leg shortening, and pain with movement. The fracture required removal of an internal fixation device used to repair an earlier left hip fracture and installation of a stabilizing rod and screws.  The patient remained hospitalized for ten days, after which she was returned to the nursing home.  The fracture and surgery prevented her from bearing full weight on her legs for over three months and permitted more extensive weight bearing thereafter only as tolerated.

When she returned to the nursing home, she did not receive any anti-coagulants (blood thinners) to prevent blood clots.  Within several weeks, she developed a deep vein thrombosis (DVT), or blood clot, in her thigh and was returned back to the hospital for another four days.  She was released from the hospital and returned back to the nursing home, where she remains today.  The patient recently turned 101 years old.

The case settled for six figures well before trial.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia

An elderly male patient was admitted to a local hospital in severe respiratory distress and was intubated.  When his condition began to stabilize several days later, he was transferred from the hospital's intensive care unit (ICU) to an orthopedic floor.  The next day, he fell and sustained a left hip fracture, which required surgical repair.  

He was later fitted with a brace that immobilized his left leg, and he was transferred to a nearby nursing home for rehabilitation.  While at the nursing home, he developed severe pressure ulcers (bed sores, bedsores, pressure sores, decubitus ulcers) over his lower back (sacrum), left heel, and left calf.  The pressure ulcers (bed sores, bedsores, pressure sores, decubitus ulcers) did not improve and became infected, and the patient died two months later of sepsis (systemic infection).  On the family's behalf, we filed claims against the hospital and the nursing home. 

We claimed the hospital was negligent because it failed to recognize the patient was a high fall risk and failed to take fall prevention measures that included more vigilant supervision, a bed alarm to alert staff if he attempted to rise from bed unassisted, a low/lowered bed, and a fall mat at bedside.  With respect to the sacral and heel pressure ulcers (bed sores, bedsores, pressure sores, decubitus ulcers), we claimed the nursing home was negligent because it failed to turn and reposition the patient consistently every two hours and more often as necessary while he was in bed and failed to ensure his heels were appropriately off-loaded at all times, either by floating his heels or by using heel suspension devices.   With respect to the left calf pressure ulcer (bed sore, bedsore, pressure sore, decubitus ulcer), we claimed the nursing home failed to eliminate or relieve pressure around the leg brace which resulted in friction and shear that caused the pressure ulcer (bed sore, bedsore, pressure sore, decubitus ulcer).  

The case settled approximately one month before trial in the mid six figures.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia

An elderly patient was admitted to a Central Virginia nursing home after hospitalization for respiratory difficulties she suffered at home. On admission, her blood pressure was noted to be high. She was prescribed two anti-hypertensive medications to reduce her blood pressure, and the facility administered them both. Unfortunately, the medications were administered twice when they only should have been administered once. The facility also failed to monitor her blood pressure after giving the medications.  The patient's blood pressure plummeted and caused abdominal bleeding, which was not timely recognized. As a result, the patient developed an abdominal hematoma and required urgent surgery to evacuate the hematoma.  The patient was hospitalized for a prolonged period of time and died several weeks later from complications caused by the medication error and the abdominal hematoma. The nursing home claimed its staff timely recognized complications that resulted from the medications that were administered and reported those complications to the patient's physician.  The case settled for a confidential amount in the six figures.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.  

A 94-year-old nursing home patient fell from her geriatric chair to the floor. As a result of the fall, she sustained subarachnoid hemorrhages, a compression fracture to a vertebrae in her neck, and a compression fracture to a vertebrae in her mid-back.  She died the next day.  We contended her death was a direct result of the fall. 

 We contended on behalf of the patient's family that although the patient was a high fall risk, the nursing home failed to take proper fall precautions, including better supervision of her, moving her closer to the nurse's station, and using a fall alarm on her chair.  The nursing home responded that the patient had not fallen in over one year before the fall and was being properly supervised and monitored.  The nursing home also claimed that no chair fall alarm was necessary because the patient's physician had discontinued her bed and chair fall alarms several months before the fall.  

In addition, the nursing home claimed the patient died of a stroke-like hemorrhage that occurred not because of the fall, but because of her longstanding history of hypertension (high blood pressure).  We responded that her blood pressure was under excellent control before the fall, spiked immediately after the fall, and any stroke-like conditions occurred when the patient's blood pressure spiked as a result of the trauma from the fall.  The patient was survived by several children, only one of which was significantly involved in her care just prior to death.  The case settled before trial for six figures.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.  

 

 

 

An elderly patient of a Roanoke area hospital was allowed to fall from her hospital bed.  She was found by a nurse "face down" in the floor in a large pool of blood.  The fall was unwitnessed and occurred when no staff was present with her.  The patient's family claimed the hospital failed to take appropriate fall precautions.  Specifically, the patient was not properly supervised, had not been provided a fall alarm on the bed that would have alerted staff if she  attempted to leave the bed unassisted, a low/lower bed, or a fall mat at bedside to cushion any fall.

As a result of the fall, the patient sustained a fracture of bones in the cheek.  She also suffered a subarachnoid hemorrhage (bleeding inside her skull) that was made worse because she was on blood thinners.  The bleeding increased, stabilized, and then resolved within weeks.  The patient thankfully did not suffer any neurological symptoms and had no permanent injury.  Even though she was documented to have "returned to baseline" shortly thereafter, the hospital settled for low to mid six figures.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia

We settled earlier today a case involving a 73-year old patient of a Roanoke area nursing home who was involved in an unwitnessed fall after she left her bed and attempted to walk to her wheelchair.  The fall resulted in an open comminuted trimalleolar fracture of the left ankle that required open reduction internal fixation surgery.  The patient's family claimed the nursing home should have identified their mother as a fall risk on admission and should have provided her with a low bed, a fall mat, and a bed alarm that would have prevented the fall and minimized her injuries.  The facility claimed it provided her with a low bed, a fall mat, and a bed alarm, all as reflected by the nursing home's medical records and the testimony of nurses and aides on the floor.     

The patient, who was admitted to the nursing home only three days before the fall, had been diagnosed years earlier with dementia, schizophrenia, and a personality disorder.  According to the patient's treating physician, she only had two weeks to live when she was admitted to the nursing home.  The patient died two weeks after the fall from causes unrelated to the ankle fracture.

The case settled for mid six figures.  The precise terms of settlement are confidential at the nursing home's request.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.   

We recently settled a lawsuit involving a 75-year-old nursing home patient who was hospitalized after staff at the nursing home observed that he had diminished bowel sounds, a swollen abdomen, and abdominal discomfort.  Once at the hospital, he was diagnosed with a ruptured bowel, peritonitis (infection of the lining of the stomach), and sepsis (systemic bacterial infection).  The patient died within 24 hours of the time he was hospitalized. 

The patient's family, which consisted of his sister and brother, claimed the nursing home's staff failed for over one week to observe or obtain medical attention for the patient's declining condition, which the family's experts contended should have included increasing abdominal distention (swelling), decreasing bowel sounds, increasing abdominal discomfort, and less frequent bowel movements.  The nursing home responded with testimony from experts who claimed the patient's bowel rupture was an acute, spontaneous event that could not have been predicted, prevented, or treated by the nursing home or other health care providers.  For support, the nursing home's experts relied on the absence in the weeks before the hospitalization of any mention in the facility's records of a decline in his condition.  

The case settled for mid six figures.  The precise terms of the settlement are confidential at the nursing home's request.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

  

I just finished a jury trial in Christiansburg, Virginia, which is just outside of Blacksburg and Roanoke, against the owners and operators of a Blacksburg nursing home.  The case involved a 91-year-old nursing home patient who was allowed to fall from her bed to the floor.  The fall caused her to sustain a forehead laceration that required 10 sutures.  She also sustained a non-displaced (stable) fracture of her left femur (thigh) as a result of the fall.  The fracture did not require surgery. 

The patient had severe dementia, could not walk, had contractures in both arms and both legs, and was bedbound before the fall.  She was also a hospice candidate before the fall.  She died two and one-half months after the fall for reasons unrelated to the fall.  The family pursued the case for recovery of the pain and suffering their mother sustained for the two and one-half months she was alive after the fall.  Despite medical bills of only $18,500, the jury awarded the family $310,000 with interest.  The nursing home's owners and operators offered to settle before trial for only a small fraction of the jury's verdict.  A victory for the family and this patient!    

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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.

A Richmond nursing home patient was allowed to develop stage IV pressure ulcers (bed sores, pressure sores, decubitus ulcers) on his sacrum (low back) andheel.  He also experienced an unplanned loss of 41 pounds of weight in 65 days during his two and one-half month stay at the facility.  The patient's daughter, who was his only surviving relative, claimed the nursing home did not turn and reposition her father frequently enough and did not ensure his nutritional needs were met.  The nursing home claimed the patient's pressure ulcers were the result of his long-standing poor nutritional condition and history of weight loss before arriving at the facility.  The patient's lab results for albumin and pre-albumin improved while he was a patient at the nursing home, which the facility claimed indicated he was not malnourished.  The man was discharged to another Richmond-area nursing home where he stayed for several months before going home to live with his daughter.  Once at home with his daughter, he received  home health and hospice services before he died from causes unrelated to the pressure ulcers or weight loss.  The nursing home's corporate owners and operators settled the case for mid-six figures shortly after a lawsuit was filed. 
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.     

A 70 year-old female patient developed severe pressure ulcers (bed sores, pressure sores, decubitus ulcers) on her left hip and thigh during a several-month stay at a Roanoke area nursing home.  The ulcers were 15 cm x 10 cm and 25 cm x 15 cm just before her death.  The patient's family claimed the facility did not turn and reposition their mother as frequently as it should have and did not keep her clean after episodes of bowel and bladder incontinence.  The nursing home claimed the patient's severe end stage renal disease and vascular problems caused the ulcers, and those ulcers deteriorated during her decline from medical conditions unrelated to the ulcers.  The case settled several months before trial.  The terms of settlement were made confidential at the nursing home's request.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia. 

A demented patient of a Central Virginia nursing home sustained a hand injury when staff began transferring her from a gerichair with an exposed metal tab beneath the chair's arm rest.  When the patient was lifted from the chair with a mechanical lift, the exposed tab tore two tendons on the top of the patient's hand.  The patient was taken to the hospital, the tendons were clipped, the wound was dressed, and she returned to the nursing home.  The patient had very little use of the hand before the injury due to a stroke, but lost all remaining use of the hand as a result of the injury.  The nursing home settled the case well before trial for mid six figures.

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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia. 

A nursing home patient died days after his PEG feeding tube became dislodged at the facility and was replaced by a nurse who didn't first confirm proper placement.  Instead of being placed back into the stomach, the PEG tube was inserted into the patient's peritoneal cavity. 

The facility's nurse was negligent because the tract for the feeding tube was of questionable maturity when the nurse attempted "blindly" to reinsert the feeding tube.  Endoscopic or radiographic (x-ray) guided replacement of the tube, which was not done, was required in the absence of a mature tract.  The nurse also failed to confirm proper placement of the tube either radiographically using a water-soluble contrast or by aspirating gastric contents with a syringe and testing the aspirate for pH to confirm proper intragastric position before starting to tube feed. 

When tube feeding resumed, feeding formula was pumped into the periotneal cavity and resulted in peritonitis (infection of the lining of the abdominal wall), sepsis (systemic bacterial infection of the body), and an eight-day hospitalization during which the patient died.  According to the patient's long-time primary care physician, his life expectancy at the time of the neglect was six months due to pre-existing and unrelated medical conditions.

The case was settled well before trial.  The settlement terms are confidential at the nursing home's request.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia. 

A 55-year-old patient with chronic renal insufficiency was administered Indocin (Indomethacin) in error by a Central Virginia nursing home three times daily for approximately six weeks, prompting acute renal failure that hospitalized her for several weeks.  The nursing home also, during this period, did not monitor her hydration status.  On admission to the nursing home, the patient also weighed 324 pounds and was placed on a controlled weight loss program that called for her to lose one to three pounds per month.  In the two months before she was hospitalized for the episode of acute renal failure, the nursing home permitted her to lose 48.4 pounds, or 14.9% of her body weight, all but six pounds of which was unplanned.  The case settled for mid six figures.  The settlement terms are confidential at the nursing home's request.
________________________________________________________________
Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia. 

A resident at an assisted living facility sustained a fall while being helped into the shower by the facility’s staff. The patient's family claimed the facility's staff failed to exercise proper fall prevention, which caused the fall. The patient complained of pain after the fall, exhibited bruising and swelling in his left leg, and was diagnosed at the hospital with a comminuted fracture of the distal third of the left femur.  He received open reduction and internal fixation of the fracture several days later.  The patient was immobile before the fall, was not ambulatory, used his left leg only for weight bearing during transfers, and was dependent in all other activities of daily living.  After the fall, he remained dependent in all activities of daily living, but the fall rendered him unable to use his left leg for transfers.  After discharge from the hospital, he was admitted to a nursing home, where he remains today.  The case settled for $490,000 shortly after a lawsuit was filed.
________________________________________________________________
Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia. 

Within two days of a patient's admission to the nursing home, she attempted to elope from the facility. The nursing home acknowledged the patient was at high risk for wandering and promised to make frequent visual checks on her to make sure she was safe.  The next day, the patient was documented by the nursing home to wander into other residents’ rooms, and the nursing home warned its staff she needed to be “watched carefully."  On the fourth day after her admission, the patient was permitted to elope (wander away without the knowledge of staff) from the facility.  She was found a couple of hours later at the bottom of a hill near some train tracks, where she had fallen.  The fall resulted in a comminuted fracture of her right wrist with “obvious deformity,” abrasions and contusions to the right shoulder, leg abrasions, and neck pain.  She also had significant facial bruising.  The patient was forced to endure a closed reduction of the right wrist fracture at a local hospital and continued to have significant pain for weeks thereafter.

Impairment caused by the right wrist fracture caused her to have significant problems.  Before the fall, the patient could ambulate, eat, position, and toilet herself without assistance.  After the fall, she required assistance in all of these areas.  Her injuries also prevented her from drinking enough fluids without assistance, as she had done before the injury.  Yet, the nursing home consistently failed to provide the patient with enough liquids to drink, resulting in dehydration, a urinary tract infection, and an eight-day hospitalization.  The patient was transferred to another nursing home when she was released from the hospital and died two years later of unrelaed medical problems.  The jury returned a verdict for $1 million on claims for the nursing home's negligence, fraud, and violations of the Virginia Consumer Protection Act.
________________________________________________________________
Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia. 

A nursing home patient was allowed by the facility’s aide to fall during a transfer from bed to chair.  At the time of the fall, the patient was known by the nursing home to be a high fall risk based on her age, confused mental status, visual impairment, balance problems, use of assistive devices, level of continence, and use of diuretics. The nursing home assessed the resident after the fall and did not detect any injury.  The patient complained of hip pain later in the day, but did not receive an x-ray of her hip, was not evaluated by a physician, and was not transferred to a hospital for examination until two and one-half days after the fall.  When the patient arrived at the hospital, she was “moribund,” unresponsive, and “not arousable.”  The hospital diagnosed her with a right hip fracture, as well as severe malnutrition, dehydration with possible urosepsis, hyperglycemia (“diabetes is out of control”), and renal failure.  The patient's medical condition was so poor that the hospital’s forensic nurse examiner was contacted to investigate suspected elder neglect.  The patient died six days after the fall.  The patient was survived by her only son, who claimed the facility should have used better fall prevention measures.  The case against the nursing home and its owners settled for mid six figures.
________________________________________________________________
Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia. 

Patient was admitted to a Richmond hospital for joint replacement surgery and rehabilitation. The patient developed severe pressure ulcers over both heels during rehabilitation because the hospital did not properly relieve pressure from the patient’s heels while in bed. Once the pressure ulcers developed, the hospital also applied his pressure-relieving orthotic (PRAFO) boots too tightly, which caused the pressure ulcers on his heels to deteriorate. After the patient’s discharge from the hospital’s rehabilitation department, home health personnel documented that one heel pressure ulcer was 8 cm x 7 cm, the other was 7.5 x 6 cm, and both were extremely painful. The patient was forced to undergo multiple surgical debridements of his heels over a four month period. Before developing the ulcers, the patient was able to walk independently. After the pressure ulcers developed, he was able to walk only with supervision or the assistance of another. The case settled for six figures.
________________________________________________________________
Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia. 

 

Nursing home resident was an 87-year-old diabetic who was receiving twice-daily medication for persistent hyperglycemia. One evening at the nursing home, he became suddenly and severely hypoglycemic. A nurse at the facility attempted to stabilize improperly the decedent’s blood sugar level, but did not notify the on-call physician or have the decedent transported to a nearby hospital for emergency assistance. Six hours later, the decedent died at the nursing home, reportedly as a result of a heart attack. The state agency that monitored regulatory compliance by nursing homes investigated and concluded the care provided to the decedent was “without deficiency.” At the time of the resident’s death, the decedent was recovering from recent pneumonia, had lung cancer, and required assistance with all activities of daily living. The decedent’s only statutory beneficiary was his 88-year-old sister, who asserted claims against the nursing home for failing to monitor and correct the resident’s plummeting blood sugar level. The case settled for mid six figures.

Resident was admitted to a nursing home from a local hospital following repair of a right leg fracture. On admission to the nursing home, the resident’s physician instructed that she should only be moved from her bed to a wheelchair with her right leg supported. The nursing home’s physical therapy department allowed the resident to bear weight improperly on the leg, resulting in a re-fracture with gross deformity of the right thigh. The resident required surgery to stabilize the re-fractured leg and was hospitalized until her death 19 days later. The case settled for the mid six figures.

Nursing home resident was permitted to fall on numerous occasions over a five month period, resulting in fractures of her ribs, spine, pelvis, and left hip. The left hip fracture required surgery. The resident was also allowed to develop numerous pressure ulcers (bed sores, pressure sores, decubitus ulcers) on her heels, lower back, and hip. Some of the pressure ulcers were recorded to be as large as 10 cm x 10 cm or larger. The resident did not have any pressure ulcers when she was admitted to the facility. The resident died one year after her admission to the facility. The resident’s family pursued a claim against the owners and operators of the facility, which settled the case for mid six figures.

Resident was admitted to a nursing home under the care of its medical director. Within one week of his admission, the resident had fallen six times. On the sixth fall, the resident was found on the floor by the facility’s staff, which left the resident unattended. While unattended, the resident reached for a nearby table to get up, the table fell, hit the resident on the head, and caused bilateral subdural hematomas. Fluid caused by the hematomas placed pressure on the resident’s brain. A neurosurgeon drilled holes into the resident’s skull and evacuated the hematomas while the resident was under conscious sedation. Following the head injury, he was returned to the nursing home. However, the resident became increasingly agitated and his medical condition began to deteriorate. He was transferred back to the hospital, which diagnosed the resident with severe dehydration. The resident died at the hospital. The resident’s family claimed the facility and its medical failed to supervise and assist the resident after his sixth fall and failed to ensure the resident received adequate hydration. The nursing home and its medical director settled.

An 87-year old assisted living resident fell and sustained hip and elbow fractures while walking from her bed to the bathroom. The resident was documented by the facility to be independent in her ambulation at the time of the fall and for the prior five years while she was a resident at the facility. Immediately before the fall, an aide observed that the resident was alert, stable when standing, and was walking independently. The plaintiff claimed the resident was a fall risk and should have been assisted physically and supervised visually while ambulating. The assisted living facility settled for mid six figures.

Resident was admitted to the nursing home without any pressure ulcers. Within several months thereafter, she was permitted to develop a stage IV ulcer to her left outer heel with bloody drainage and necrotic tissue, a stage IV ulcer to her left inner heel with purulent drainage and necrotic tissue, a stage III ulcer to her right heel with purulent drainage, a stage IV ulcer to her right outer ankle with a “heavy” odor and necrotic tissue, and a stage III ulcer to her right inner ankle with purulent drainage and necrotic tissue. The pressure ulcer on the resident’s left foot became infected, she developed osteomyelitis of the left foot, and died as a result of systemic infection caused by the pressure ulcers. The case settled for mid six figures.

73-year-old nursing home resident developed several stage IV pressure ulcers in the seventh month of her residency at the nursing home. She died approximately three months later of sepsis caused by the pressure ulcers. The nursing home claimed the pressure ulcers resulted from arterial insufficiency and were not preventable. The resident’s daughter was her only statutory beneficiary. The nursing home and its parent company settled the case for mid six figures.

The resident was identified as a high fall risk on admission to the nursing home. He was, by order, to wear hip pads at all times and was to be placed in a gerichair only if the chair was equipped with a tabletop. The nursing home placed the resident in a gerichair at the nurse’s station, and the resident reportedly “got up from gerichair and fell backwards.” At the time of the fall, the resident’s gerichair was not equipped with a tray and he was not wearing hip pads. The nursing home also failed to place a fall alarm on his gerichair to alert staff when he attempted to rise from the chair. The fall caused a displaced fracture of his left femur that required surgery. The resident was discharged from the hospital, was admitted to a new nursing home, and died there approximately one month later from pneumonia, which the resident’s family contended resulted from the hip fracture and surgery. The case settled for mid six figures.

Nursing home resident was to receive Lortab 5/500 every six hours for pain and 10 mg of morphine every four hours for pain not relieved by the Lortab. A nurse at the nursing home unknowingly administered fifteen times the correct dosage of morphine, resulting in a severe morphine overdose. Hours later, the resident was noted by staff to be unresponsive and severely hypoxic. An ambulance was called, and ambulance attendants administered Narcan en route to the hospital to reverse the effects of the morphine overdose. When the resident arrived at the hospital, she remained unresponsive, had cardiac ischemia, non-cardiogenic pulmonary edema, and her condition was serious. She received eight additional doses of Narcan at the hospital. While at the hospital, she remained unresponsive to verbal stimuli, was moaning, vomited, and had shallow respirations. She was placed on a BIPAP mask, and her blood gases revealed a circulating oxygen level of only 67. She was later admitted to ICU and remained there for several weeks, during which time she was noted to be excessively sedated, lethargic, and had continuing nausea and vomiting. Following her hospitalization, she was discharged to another facility, where she remains today. The nursing home settled the case for mid six figures.