November 7, 2013

Contact: Eric W. Boyer, Esq.
Managing Partner/Operations
305-670-1101 Ext. 1023

Nursing Home Negligence

Steve E. Baker

ST. AUGUSTINE, Fla. — Quintairos, Prieto, Wood & Boyer, P.A. (QPWB) attorney Steve E. Baker (Orlando) obtained a defense verdict in a nursing home arbitration where it was alleged that the nursing staff improperly reinserted the resident’s PEG-tube and began feedings without confirming its placement by x-ray. As a result, plaintiff contended that the resident developed peritonitis and required several surgical procedures to repair his injuries. The plaintiff claimed that the resident passed away as the result and sought wrongful death damages.
In March 2011, the resident was admitted to the defendant nursing home and, less than one week after his admission, he was sent to the hospital due to pneumonia. He was noted to have an overall poor prognosis and poor nutritional intake and he underwent a PEG-tube placement procedure. He was admitted back into the nursing home for further care following this hospitalization.
In April 2011, the nursing staff found the resident with his PEG-tube pulled out and blood at the insertion site. After the nurse was unable to reach the medical director, she was directed by the charge nurse to reinsert the PEG-tube. The nurse replaced the PEG-tube, noted that it was patent to the resident’s stomach, and began feedings. The resident’s family was contacted and they insisted the resident be transferred to the hospital for further evaluation.
Physicians at the hospital determined that the PEG-tube was likely in an improper position and that he may have possible peritonitis. During the surgery for the repair, the surgeon noted that the resident had a gastric injury and that bilious material was leaking from the stomach and into the peritoneal cavity. The resident subsequently underwent two additional procedures to repair the PEG-tube site but unfortunately died two weeks later with a stated cause of death of cardiopulmonary arrest, failure to thrive, and dementia.
Plaintiff alleged that the nursing home deviated from the standard of care when the staff reinserted the PEG-tube without verifying its placement by x-ray. Further, plaintiff contended that the nursing home delayed transferring the resident to the hospital for further evaluation. Plaintiff’s geriatric medicine expert opined that the resident passed away from complications of the peritonitis as a direct result of the alleged improper PEG-tube placement.
The defense argued that the resident’s gastric injury was not caused by the reinsertion of the PEG-tube by the staff, but was instead caused by the initial removal of the PEG-tube by the resident. Additionally, the defense argued that the cause of the peritonitis was from the resident’s stomach contents leaking out through the tear caused by the initial extubation. Defendant’s gastroenterology expert also opined that the plaintiff improved following the first surgical repair and that new complications arose due to the subsequent dislodging of the PEG-tube by the resident while he was in the hospital.

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