Patient's Fall Results in Rib Fractures, Respiratory Distress, and Death; Nursing Home Settles

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.
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