Real Examples of Neglect
Ben was admitted into a Riverside nursing home for physical and occupational therapy following a hospitalization for high blood pressure. Prior to his admission, his rehabilitation potential was noted as “excellent” and his initial assessment by a physician noted his rehabilitation potential as “good.”
Shortly after admission, the nursing home doctor prescribed Bactrim DS (“double strength”) twice a day for Ben to treat a suspect urinary tract infection. The recommended dose for Bactrim DS to treat a urinary tract infection is 1 Bactrim DS per day. Moreover, Bactrim DS is contraindicated in patients with decreased renal function as it can cause acute kidney injuries. Despite knowing that plaintiff had decreased renal function, the doctor prescribed Bactrim DS twice a day for plaintiff.
Approximately 1 ½ hours after Bactrim DS was administered to Ben, the nursing home staff reported to he had a blister on his left anterior foot. A common allergic reaction to Bactrim DS is blistering. Two days later, the blister on Ben’s left foot was noted as being large, and within a week it was noted as being the “size of a fist,”
Despite being told of the worsening blister, the doctor never discontinued the Bactrim DS and never even bothered to perform an assessment on the patient. The doctor admitted that he did not like caring for patients like Ben because he did not get paid for it. When the blister worsened, the family insisted that Ben be transferred to the emergency room.
After a medical work up, physicians determined that the wound on Ben’s lower extremity was at risk for infection and that such an infection could be limb threatening for Ben. Over the following weeks, Ben's left foot became infected with black toes and gangrene. Ben was required to undergo a left above the knee leg amputation.
Necrotic Sacral Wound Causes Death in San Diego Nursing Home
In 2015, 88-year-old Margaret suffered a fall in her home and underwent surgery to repair her fractured hip. She was admitted into a San Diego skilled nursing facility for rehabilitation. Upon her admission, a skin breakdown assessment was performed rating Margaret at "high risk" for skin wounds.
A care plan was implemented, but no followed, and within 10 days Margaret had five wounds: Two on her bottom, and one on each thigh. A physician ordered a low air loss mattress for her but the nursing did not fax the request over to the medical supplier for over a week. Margaret pressure sores worsened.
Despite the fact that Margaret was not improving, and was still in need of skilled nursing care, the nursing home initiated her discharge process due to a lapse in her Medicare coverage, even though she had two additional weeks. She was moved to an assisted living facility and upon admission was deemed to need “full assist with almost everything.”
At her new facility, Margaret was essentially bedbound. Her family and friends, who visited on a daily basis, never saw staff attempt to get her out of bed, or even rotate her. As a result, her sores deteriorated. Only two days after her admission, a San Diego home health agency was engaged and on the first admission found Margaret’s wounds to be “unstageable” and reminded the staff of the importance of turning her and making sure her diaper was always changed promptly. The assisted living facility failed to comply.
When the home health nurse arrived a week later, she was shocked by what she saw. In an email recovered by Southern California Nursing Home Law Group, the nurse wrote, “I go back after last week to this! I was like whooooa…..” Her family was informed of the worsening wound and insisted that Margaret be taken to the hospital for evaluation.
Upon her admission to the ER, photographs were taken of her wounds, and she was found to have a necrotic stage IV pressure sore to her coccyx and a necrotic pressure sore to her right ischial with significant odor and drainage. Over the course of the next several months, Margaret underwent several painful debridement procedures to try and help heal her wound, but none of these treatments were successful. Margaret died two months later with her Death Certificate listing her Stage IV pressure sore as an underlying cause of her death.
Bed Sore in Assisted Living Facility Causes Premature Death
In the months before her premature death, Sharon, age 74, had moved out of her longtime family home and into an assisted living facility in San Diego, which is owned and operated by a local woman. Sharon wasn’t sick, but age and memory impairment required that she get assistance with her activities of daily living, such as getting in and out of bed. Because of her infirmities, Sharon was also at elevated risk for skin breakdown.
Despite this knowledge, caregivers at the assisted living facility and its owner, failed to take precautions to prevent Sharon from developing skin ulcers, and at one point left Sharon in her bed for more than an entire month, leading to a bedsore on her coccyx that became so deep that it exposed bone. Worse, as the bedsore deteriorated, the facility owner actively concealed the condition from the Sharon's family, falsely telling them she was qualified to treat the wound and actively discouraging them from transferring Sharon to a hospital where she could receive appropriate care.
The owner was motivated by money to keep Sharon in the facility, knowing that if she was sent to a hospital or skilled nursing facility she would not be allowed to return. As a result, Sharon did not get the life-saving healthcare she required, the bedsore worsened, and ultimately caused her death. As a result of this deficient care, assisted living facility received multiple Class “A” citations from the State of California for neglect.
Alzheimer’s Patient Wanders From Assisted Living Facility and Falls Down Stairs
Eunice was 88 years old and used a walker when she wandered undetected from the “memory care unit” of a licensed residential care facility in San Diego. She traveled nearly 75 feet to an open concrete stairway, where she tumbled down the stair and was found, hours later, with severe injury.
Caregivers testified how Eunice “got out somehow,” explained that they “didn’t know” how she could have gotten out and had no idea how long she had been outside. Later, the Executive Director of the assisted living facility, later said that the “back gate alarm” sounded and two caregivers went outside to take a look but didn't see anything.
Much of the immediate statements to the family by the facility contradicted what the nursing home put in its own Unusual Incident Report. In that report, it contended that staff members “found resident outside laying on the ground” after she “was up ambulating, lost balance and fell to the ground.” There was no mention of an alarm or of stairs, and to state that Eunice “lost balance and fell” implied that the fall was witnessed – it wasn’t.
Eunice's injuries were severe. Upon arrival to the hospital it was quickly realized that she was a true trauma patient. A CT of the cervical spine revealed an acute spinous process fracture at C4. X-rays of the left elbow revealed a complex comminuted olecranon fracture (in several pieces) and an x-ray of the left hip showed a left femoral neck fracture with shortening of the leg.
At Sharp Memorial, she was seen by several physicians. A spinal surgeon recommended closed management of the cervical fracture, which require a neck brace for many weeks. Her left elbow fracture was cast, and she underwent operative repair of her left hip fracture, requiring a unipolar hemiarthroplasty (or replacement of the hip joint). Eunice tolerated the procedure remarkably well and healed as well as anyone would expect for a woman of her advanced age. That doesn’t mean, of course, this incident did not cause her intense discomfort and pain.
Disabling Heel Wounds Acquired in Orange County Nursing Home
Despite a diagnosis of dementia, Deanna and her husband of 75 years had been living at a coastal Orange County assisted living facility, moving there in 2012. At the facility, Deanna sat in a chair mostly, but could walk to the bathroom with a walker, shower (with help), and would eat in the dining room with her husband and the other residents. She had a quality of life that allowed her independence and allowed her to share a life and a bed with her husband.
That all changed in 2013, for what was to be short, rehabilitative stay at a nearby nursing home. Upon admission, Deanna was rated as at risk for developing pressure ulcers, though she had no ulcers present, and had no history of ulcers. On her Care Area Assessments – the comprehensive assessment of Deanna performed 10 days after her admission – she is noted to be at risk for skin breakdown, and that a care plan will be developed to minimize that risk. Within a week after her admission, Deanna was moved from her regular room to a private room for isolation because of a diagnosis of C. Diff. In her new room, there is no evidence anywhere that any precautions were taken to relieve any pressure the bedridden Deanna might place on her heels. On her Care Area Assessment form it is noted that she “needs special mattress or seat cushion to reduce relieve pressure,” but there is no evidence one was ever provided.
During her second week at the nursing home, a CNA reported that Deanna had an intact “fluid filled blister” on her right heel approximately 9 x 4.5 cm in size, “R heel kept elevated.” The following day, a different staff member discovered a “blood filled blister” on Deanna’s left heel, and stated (for the first time) that she retracts her legs against “pillow and bed” despite offloading with pillows. The wounds on her heels rapidly grew and soon were unmanageable. By her third week, she could not take steps, and would scream in pain just in the transfer from bed to wheelchair. Her physical therapy was terminated, and three days later it was determined that it was too painful to continue to even try standing.
Her heel wounds became necrotic and needed surgical repair, which was extremely painful and disabling. Because of her age and her wounds, it became unlikely that she would ever walk again. She became bedbound, and her health deteriorated. She was placed on hospice care, where she resided for the duration of her case.
Multiple Falls at Vista Nursing Home Cause Need for Major Spinal Surgery
Art was a fire inspector who was still working at age 72. After decades in the profession, a bad back requires surgery, which Art underwent at Tri-City Hospital. The surgery was uneventful, and it was recommended he spend a few weeks in a rehabilitation facility for recovery and therapy. Art, and his doctors, expected him to make full recovery.
Upon admission to a Vista, California nursing home, Art was rated as being at “High Risk” for falls due to problems with standing, balance and decreased muscular coordination. He also had some post-anesthesia confusion. Caregivers failed or refused to recognize Art’s cognitive deficits and the dangers they posed. Over his first 10 days in the nursing facility, Art fell three times, each time found on the floor either by visitors, or by caregivers.
Because of the sudden decline, there was concern that Art may have suffered a stroke or injured his cervical spinal cord. MRIs were ordered for both the brain and cervical spine. The MRI of Art’s cervical spine was startling. It revealed significant spinal cord compression at C3-6 with a large disc herniation at C4-5. This cervical spine injury was believed to be the explanation for Art’s significant neurological decline the cause of which was attributed to his falls at the skilled nursing facility.
After his third fall, Art was transferred back to the hospital and was noted to have several new neurological deficits which deteriorated rapidly. Art had developed an increased weakness in his left hand, including tingling and numbness; he had decreased strength and range of motion, and decreased balance and coordination; and he had developed a severe lean to the left and backwards. Art had to undergo two additional spinal surgeries, and never fully recovered and moved into an assisted living facility permanently.
Man Dies After Acquiring Horrendous Skin Wounds in Riverside Assisted Living Facility
Harold, 76, was living at home before contracting a UTI that put him in the hospital for what was to be a temporary stay. His rehab potential was good, and the plan was to send him home after some rehab at a skilled nursing facility. Once in a nursing home, however, his condition deteriorated, and by the end of his second month he was in far worse condition than he was when he entered.
Remarkably, instead of retaining Harold, or sending him to a higher level of care, Mr. Richie was sent to a lower level of care; a residential care facility for the elderly (assisted living) that was totally incapable of caring for him. In just over a month, because of poor care, his condition deteriorated rapidly, especially his skin. By the time he was transferred to the hospital he had numerous Stage IV skin wounds and was severely malnourished. So horrendous was his condition that the hospital suspected neglect, and made a complaint to the California Department of Social Services on its own.
Harold died one month later, with decubitus ulcer and malnutrition being listed as contributing causes.
Elderly Woman Violently Shaken in Wheelchair by Caregiver Causing Femur Fracture
Esther was 92 years old when she passed away. At the time of her death, she suffered from end stage Alzheimer’s Disease, and could not walk, speak, or perform any of her activities of daily living on her own. Though she was frail, she did not require any hospitalizations in the five years prior to her death.
In the final years of her life, Esther lived with her daughter in the San Diego County that was built by Esther and her husband in 1960. Because of her advancing age and her progressing Alzheimer’s Disease, Esther's daughter retained the services of a home care agency to provide in-home care services to Esther five days a week.
Several weeks after starting care, Esther was being care for by a caregiver named Monica, who was new and untrained. Unbeknownst to the home care agency, Esther's daughter set up surveillance cameras inside the home. The recorded video showed Esther sliding down in her wheelchair, and Monica becoming frustrated as she tried to adjust Esther. Monica jerked the wheelchair back and forth, causing Esther to violently slam from side to side.
When Esther's daughter came home from work that afternoon, her mother was in bed with bloody elbows. Further examination revealed that Esther had suffered a broken femur during the event. After an examination at the hospital, the decision was made to put Esther on hospice care, and she died a few days later.
Neglected Heel Wound Leads to Above-The-Knee Amputation
Domingo grew up in Tijuana, came to the United States as a teen, and made a life for himself doing the kinds of jobs immigrants in his situation do – working in restaurants and hotels, busing tables and cleaning rooms. He know the value of hard work, and was rarely without a job. By his late 50s Domingo began to have health problems. A fall near his home resulted in a broken leg, which resulted in a surgery and suspected stroke, and by the age of 59, Domingo found himself living in San Diego nursing home.
Domingo developed a wound on his left heel that went ignored for over eight weeks. When it was finally dealt with, it was 8 x 7 cm and necrotic. He was taken to Scripps Chula Vista where doctors were aghast at his condition. Within days it was determined that his leg could not be saved and his leg was amputated above the knee.
Transportation Company Fails to Secure Wheelchair With Seatbelt and Patient Suffers Serious Injury
A 69-year-old nursing home resident in North County San Diego required transportation to dialysis three times per week. A transportation company was engaged to take her there, mainly because it could accommodate her wheelchair.
After one dialysis session, the driver assisted the patient back to the transport van, but failed to belt her in. When the van took a turn, the patient was thrown from her wheelchair inside the van and fractured her femur. Upon arrival back at the nursing home, an ambulance was called, and the patient was rushed to the hospital where the fracture was diagnosed.