Patient Suffers Falls, Fractures, C. Diff and Dies; Nursing Home Settles

On September 17, 2009, an 87-year-old female nursing home patient began having loose stools. Over the next two months, the patient continued to suffer from C.diff diarrhea, which the nursing home failed timely to diagnose. The nursing home improperly administered Imodium to the patient in response to her diarrhea.

During the time of care, the patient was also a high fall risk based on her history of falls, unsteady gait, muscle weakness, use of assistive devices, diuretic medications, cardiovascular medication, and her C.diff diarrhea. On November 4, 2009, without assistance from the nursing home’s staff, the patient rose from her bed and walked to the bathroom, likely to exercise self-help for her chronic diarrhea. The patient had not been provided by the nursing home with a fall alarm in bed as her medical condition and safety required. The patient sustained a fall in the bathroom doorway. She immediately complained of right shoulder and left leg pain. The patient was assisted back to bed by the nursing home staff, and the patient’s family and treating physician were notified.

The patient complained of pain from the fall and advised a CNA she needed to be taken to the emergency room. When the ambulance arrived, the patient was yelling in pain. Her left leg and right shoulder were obviously deformed with swelling and bruising. On examination at the hospital, x-rays revealed fractures of the left proximal tibia and right humeral neck. The patient was placed in a sling for the right arm fracture and a long cast for the left leg fracture. The patient was not a surgical candidate due to her age and activity level, and the orthopedist advised the patient’s family that she would have a prolonged period of immobility.     On November 9, 2009, the patient was readmitted to the care of the nursing home and its physician. As a result of the fracture and the patient’s ongoing C.diff diarrhea, she was dependent on staff for all ADLs. The patient’s orthopedist shortly thereafter noted that her leg cast was “soaked with urine.” The cast was removed and replaced with a new cast. The patient’s orthopedist ordered gentle range of motion therapy. On November 21, 2009, the patient was finally tested for and diagnosed with C.diff. The nursing home facility and treating physician did not timely or properly treat the patient for C.diff, and the patient continued to receive Imodium.

On November 27, 2009, the patient was documented as being very confused and disoriented to place, time, and situation. After the nursing home staff found the patient “turned sideways and hanging off the bed x3,” she was finally provided with a bed alarm for safety. On December 10, 2009, the patient’s orthopedist noted her fractures were not healing. On January 7, 2010, the orthopedist documented continued non-union of the fractures, as well as pressure ulcers caused by the leg cast. The patient continued to deteriorate from the combined effects of the fractures and C.diff. The patient’s health continued to decline, and she died on April 2, 2010.

The family contacted us to pursue claims against the nursing home for failing to provide proper care for C. diff and fall prevention. We were able to obtain a generous award for the patient’s family through settlement, which is confidential at the nursing home’s request.