September 26, 2013
305-670-1101 Ext. 1023
JACKSONVILLE, Fla. — Quintairos, Prieto, Wood & Boyer, P.A. (QPWB) attorney Steve E. Baker (Orlando) obtained a defense verdict in a nursing home arbitration involving allegations of an in-house acquired Stage IV sacral pressure ulcer that resulted in 10 surgical debridements, as well as a heel decubitus ulcer that similarly required debridement on at least three different occasions. Plaintiff also alleged malnutrition, dehydration, sepsis, and contractures.
In September 2010, the plaintiff was hospitalized following a stroke which left the right side of his body impaired. The plaintiff had an extensive medical history, including hypertension, liver disease, and a prior history of sebaceous cysts.
The plaintiff was admitted to the nursing home with a feeding tube and multiple areas of skin breakdown which ultimately resolved.
A month into the residency, the plaintiff developed a new area of breakdown to his sacrum. By the time he left the facility two weeks later, the area was described as an unstageable necrotic pressure ulcer measuring 9.0 x 3.6 x 1.0 cm. The resident was sent to the hospital due to an elevated temperature and possible infection. There, he was diagnosed as septic secondary to an infected pressure ulcer and was noted to have a pre-albumin level of 5, which the plaintiff contended to be evidence of malnutrition.
Plaintiff alleged that the nursing home failed to prevent an avoidable pressure ulcer and that he became malnourished while at the facility. Plaintiff’s wound care expert opined that the lack of care contributed directly to the development and worsening of the plaintiff’s wound. Furthermore, she claimed that the Plaintiff was not receiving the proper nutrition based upon his lab values, which compromised the healing of the sacral wound.
The defense argued that the plaintiff’s skin breakdown was unavoidable due to a rare skin condition known as hidradenitis suppurativa (citing to an episode noted in the plaintiff’s prior medical records), as well as shearing forces associated with his therapy regimen and the elevation of his bed during tube feedings due to his risk of aspiration. The defense also argued that the plaintiff’s lab values were attributable to the depletion of his protein resources from his pre-existing wounds, infectious process from the hidradenitis suppurativa, and impaired liver function from years of alcohol abuse.