MIAMI – QPWB Miami Partner David Perez, West Palm Beach Hub Managing Partner Edward Prieto, and Miami Associate Dalton Clouser secured a complete defense victory in a high-exposure healthcare litigation matter involving nursing home negligence and medical malpractice claims. Despite a pre-trial demand of $950,000.00 and a trial demand of $750,000.00, the defense team successfully obtained a directed verdict on the medical malpractice count, and the jury returned a total defense verdict on the negligence count, resulting in a final award of $0.00.
Overview of the Case
The litigation arose from a residency at a subacute care rehabilitation facility. The Plaintiff, an 88-year-old female, was admitted to the defendant facility for short-term rehabilitation following a fall at home that resulted in a hip fracture requiring surgical repair.
Approximately nine days into her residency, the Plaintiff was found on the floor of the facility but sustained no injury. Ten days later, she was found on the floor a second time in her room, positioned between her wheelchair and the toilet. Subsequent X-rays revealed a secondary, extensive fracture of the hip that required a second, more complex surgical intervention. The Plaintiff alleged that the facility’s substandard care directly resulted in both falls and the subsequent re-fracture, leaving her permanently unable to ambulate.
Key Difference-Makers
- David Perez – Partner, Miami
- Edward Prieto – Managing Partner, West Palm Beach
- Dalton Clouser – Associate, Miami
Administrative Support
- Alexandra Cabrera – Summer Law Clerk, Miami
Claims Made Against Our Client
The Plaintiff filed a two-count complaint alleging nursing home negligence and medical malpractice. Opposing counsel centered their trial strategy on claims of systemic care failures, arguing that the facility failed to specially tailor a care plan to the Plaintiff’s unique needs and failed to update her protocols or escalate intervention measures after the first uninjured fall occurred nine days into her stay.
Furthermore, the Plaintiff’s counsel heavily attacked the facility’s charting and record-keeping practices. They claimed that the documentation within the facility chart was inaccurate, inconsistent, and entered late by healthcare providers, which they argued led to a systemic lack of continuity of care and improper treatment.
A major component of their argument focused on a specific charting entry noting that the Plaintiff spoke English, when she allegedly spoke only Russian. Opposing counsel argued this language barrier caused a severe communication breakdown between the resident and healthcare staff, directly preventing her from voicing her needs and precipitating the second fall.
Regarding the mechanics of the second incident, the Plaintiff claimed that the facility staff failed to properly and timely supervise her, alleging she was inappropriately left in her room completely alone for an excessive and inappropriate amount of time following the completion of her lunch.
Finally, to maximize potential economic, non-economic, and future medical damages, the Plaintiff asserted an exceptionally high prior level of function. Opposing counsel claimed that prior to her initial home accident, the Plaintiff was entirely independent with all activities of daily living, was able to ambulate flawlessly without any form of assistive device, and maintained an active lifestyle consisting of cooking, laundry, gardening, and regularly hosting sleepovers with friends in Miami Beach.
Defense Strategy
In response to the plaintiff’s claims, the defense team executed a strategy centered on statutory care limits and comprehensive medical record tracking.
First, regarding the communication and supervision claims, the defense highlighted that effective communication was clearly occurring; the Plaintiff had actively and successfully participated in physical therapy, progressed in her goals, and cooperated with daily care for nearly three weeks. The defense established that the second incident was entirely unavoidable and unpreventable. The Plaintiff had simply attempted to rise from her wheelchair to use the bathroom independently without utilizing her call bell to request assistance. The defense educated the jury on Florida law, which strictly prohibits the use of physical restraints on residents, demonstrating that the facility could not have legally or physically prevented the resident from making the sudden, voluntary decision to stand.
Second, the defense dismantled the supervision and timing claims. The nurse on duty testified that resident rounds consistently took approximately 15 minutes. The defense successfully neutralized opposing counsel’s arguments when the Plaintiff’s own nursing expert conceded on the stand that a 15-minute rounding interval was entirely appropriate and within the standard of care.
Third, the defense targeted plaintiff credibility by meticulously analyzing thousands of pages of historical medical records spanning a ten-year period. Perez, Prieto, and Clouser unearthed prior medical charts and the facility’s initial physical therapy intake records showing that the Plaintiff’s daughter had previously reported her mother used a rolling walker for five months prior to the accident due to an unsteady gait caused by a suspected stroke. During a rigorous cross-examination, the Plaintiff’s daughter refused to acknowledge these historical facts, failed to admit she waited two days to take her mother to the hospital after the initial home fall, and denied a history of prior and subsequent falls, despite being confronted on the stand with multiple independent medical records proving she was the exact individual who reported these issues to healthcare providers.
Impact on Final Outcome
The defense’s intense preparation and strategic alignment of historical medical documentation completely eroded the credibility of the Plaintiff’s case. By the conclusion of the presentation of evidence, the defense successfully obtained a directed verdict from the court on the medical malpractice count.
Following deliberations on the remaining nursing home negligence count, the jury completely rejected the Plaintiff’s arguments regarding liability and causation, returning a total defense verdict and a final judgment of $0.00.
Unique Aspects of the Case
The most unique element of this litigation was navigating the physical absence of the underlying plaintiff. Due to ongoing health issues, the Plaintiff was unable to attend the trial, and her daughter sat in as her representative throughout the proceedings.
Predicting the Future
This victory underscores QPWB’s capability to successfully defend long-term care facilities and medical providers against high-exposure negligence claims. Notably, the conclusion of this matter illustrates the firm’s standard of diving deep into historical data to reveal critical pre-existing medical facts, providing future clients with a strong defense against unsubstantiated liability claims.
Key Actions in This Case
- Meticulous Historical Document Mining: Audited thousands of pages of decade-long medical records to unearth and prove a pre-existing unsteady gait and ambulatory restrictions, directly dismantling claims of total prior independence.
- Standard of Care Neutralization: Leveraged admissions from the Plaintiff’s expert witness to establish that the facility’s 15-minute nursing rounds were entirely appropriate and legally compliant.
- Language Barrier Refutation: Demonstrated consistent resident physical therapy progression and successful daily communication over a three-week period to systematically disprove the alleged impact of a charting language error.
- Proving Unavoidable Causation: Established that the incident was entirely unpreventable under Florida law, demonstrating that the resident suddenly chose to attempt an independent transfer without using her call bell, while the facility is strictly prohibited from utilizing physical restraints.
About QPWB
Quintairos, Prieto, Wood & Boyer, P.A. is one of the fastest growing law firms in the United States providing a different focus on what it means to provide responsive service to clients and team members. With a national presence of 57 offices and a comprehensive scope of over 130 practice areas, QPWB delivers legal representation in litigation, regulatory, and corporate matters to a diverse range of industries. This scope and rapid expansion has attracted unique legal talent from all different backgrounds and experiences which has made them the largest minority-owned law firm in the country.