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Part 3 of 4 – Failed Pressure Ulcer Care

The staff’s failures continued even after Plaintiff developed said pressure ulcer, in that they failed to provide proper care and treatment to the pressure ulcer, and as a result, it became progressively worse. Staff first documented Plaintiff’s pressure ulcer on 7/20/06. A treatment order was obtained and the care plan was updated accordingly. However, as before, the care plan interventions were not consistently implemented by staff. For example, staff still was not keeping Plaintiff’s skin clean and dry after each incontinent episode. Staff still was not turning and repositioning Plaintiff every two hours. And staff failed to notify Plaintiff’s physician to obtain a new treatment order when her pressure ulcer became worse.Significantly, nowhere in the chart is Plaintiff’s right buttock bedsore staged. It is not staged in the wound care records, nor in the nurse’s notes, nor in Defendant’s transfer sheet at the time of discharge. The pressure ulcer should have been documented in the MDS assessments, which would have required staff to stage the pressure ulcer. However, the only MDS assessment in the chart was the one completed around the time of admission (when Plaintiff had no pressure ulcers). All subsequent MDS assessments were missing from the chart. However, Plaintiff’s right buttock pressure ulcer was staged by the nursing home that she transferred to when she left Defendant’s facility. The new nursing home performed a complete body check on the Plaintiff on 8/25/06, which is the day she transferred out of Defendant’s facility. The new staff documented Plaintiff’s right buttock pressure ulcer as a stage III. Defendant’s failure to document the stage of Plaintiff’s pressure ulcer, thereby concealing its severity, was not only egregious, it was reckless and wanton and constituted a conscious disregard or indifference to Plaintiff’s right to adequate and appropriate healthcare.Plaintiff’s stage III pressure ulcer was severe and it was painful. It was painful for her when she laid in her bed, and it was painful for her when she sat in her wheelchair. The staff, however, was not adequately monitoring Plaintiff’s pain from her decubitus ulcer; there is no documentation in her chart documenting this pain or treating it.Hillsborough County nursing home attorney
Plaintiff also fell several times while at Defendant’s facility, which falls could, and should have, been prevented had the staff provided proper care. Defendant’s staff knew that Plaintiff was a fall risk, and they also knew she had poor balance and poor safety awareness, according to their own admission assessments. Notwithstanding the same, staff failed to address Plaintiff’s fall risk in the initial care plan, or the 5/16/06 care plan, or the 5/24/06 care plan. Defendant’s staff finally addressed fall risk in a 5/31/06 care plan update. At that time, staff documented that Plaintiff continually attempted to get out of bed and out of her wheelchair without the assistance of staff. This is documented throughout the nurse’s notes as well. As a result, alarms were applied to Plaintiff’s bed and her wheelchair. Staff, however, repeatedly failed to respond, or failed to timely respond, to Plaintiff’s alarms when they sounded. The nurse’s notes document, for example, that the family complained to staff that Plaintiff’s alarm would go off, but no staff ever came to assist her. The nurse’s notes also document Plaintiff’s roommate in the hallway calling for staff when Plaintiff’s alarm went off, again because staff failed to provide assistance when the alarms sounded. In addition to failing to respond to Plaintiff’s bed and chair alarms, the staff also repeatedly failed to assist her to the bathroom as needed. Plaintiff was unable to toilet herself and required the assistance of staff. She did not get that assistance. Further, staff failed to monitor Plaintiff sufficiently, given her known risk for falling and suffering injury.

Continue reading: Part 4 of 4 Several Falls >>