We reached a settlement on behalf of our client’s estate after he suffered a bed sore leading to a urinary tract infection, c-diff infection, and osteomyelitis, and ultimately sepsis and death.
The client was a retired railroad mechanic who was living independently in the community. While driving in a snowstorm, he lost control of his car, crossed over the center line, and hit another car head-on. He was taken to the local emergency room where a CT scan showed that he had a bleed in the brain. He was then transferred to a Level 1 trauma center where the decision was made to not do surgery. He was admitted to the rehab unit of the hospital for three weeks before being transferred to the defendant nursing home.
On admission, he was properly assessed as being at risk for developing bed sores because he had significantly diminished ability to move due to the injuries from the car accident. he also was not able to fully control his bowel and bladder and was not able to communicate well enough to let the staff know when he needed to go to the bathroom. He also had poor nutritional status on admission, further complicated by the injuries from the car accident. A proper care plan for addressing his risk of developing bed sores was not developed, and his family provided graphic testimony that he was not promptly changed after episodes of incontinence. Further, he lost weight rapidly after being admitted to the nursing home.
Shortly after admission, he developed a Stage 2 bed sore on his sacral area (near his buttocks). He was referred to the nursing home’s wound care doctor. Our investigation revealed that he was not a medical doctor, but was a podiatrist, and he was issuing orders for care outside the scope of his professional license. Our investigation further revealed that he had lost his license in another state based on allegations of sexual misconduct with a minor and had a conditional license in Illinois, but he was not complying with those conditions. Nonetheless, he was placed in charge of managing the care for the client’s bed sore.
One order he issued to treat the bed sore was the use of a Foley catheter. A Foley catheter is placed in the patient’s urethra and drains urine directly into a bag. It is sometimes useful in treating bed sores because it keeps the skin from being further exposed to urine. However, the use of a Foley catheter is discouraged in patients with less than Stage 4 bed sores because there is a high risk of developing a urinary tract infection with the use of a Foley catheter. The director of nursing testified that it was improper to use a Foley catheter on a patient with only a Stage 2 bed sore which is what our client had at the time. In this case, use of a Foley was even more problematic because the client had a crooked urethra and when he was hospitalized after the car accident, it took the help of a urologist to place the Foley catheter which was used there for a short time.
Three days after the Foley catheter was placed, the client developed a urinary tract infection. An antibiotic was ordered to treat the infection. One risk associated with the use of any antibiotic is developing an infection called c-difficile colitis, or c-diff. A c-diff infection is characterized by frequently, loose, watery bowel movements. This is a particularly bad kind of infection for a patient with a bed sore on his bottom to have because the bowel movements can soil the dressing and contaminate wound, increasing the chances that the wound will decline further and get infected.
Within a week after starting the antibiotic therapy for the urinary tract infection, he developed a c-diff infection, and the wound declined from a Stage 2 bed sore to s Stage 4 bed sore by the time the family transferred him fro the defendant nursing home to a different nursing home approximately one month after developing the initial bed sore. It is also worth noting that the staff did not recognize the decline of the wound from a Stage 3 bed sore to a Stage 4 bed sore which is also substandard care. The infections he suffered not only led to decline of the wound, but also caused him to experience significant weakness and disorientation which limited his ability to participate in and benefit from therapy to recover from the injuries from the car accident.
Shortly after he was admitted to the other nursing home, he was sent to the hospital because of concerns that the wound had become infected. This happens frequently with Stage 4 bed sores because one of the best ways to prevent infection is to have intact skin which keeps infecting organisms from entering your body and a Stage 4 bed sore represents not only a significant breach in the integrity of the skin, but also is dead tissue which bacteria feed on. Once he was admitted to the hospital, it was confirmed not only was the wound infected but he also had osteomyelitis as the underlying bone was infected also infected. He had to undergo surgery and additional antibiotic therapy to address the infections.
Patients who receive antibiotic therapy over an extended period of time, especially in a health care institution, risk developing drug resistant organisms. Unfortunately, our client developed multi-drug resistant infection. This meant that antibiotics he was being given were no longer working to kill off the organisms that were causing his infection. He suffered from septic shock and died approximately 5 months after first developing the Stage 2 bed sore.
We were able to reach a $600,000 settlement on behalf of his estate and 3 surviving children after our expert witnesses were brought in for their depositions.