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QMPW Wins Defense Verdict for Sarasota Nursing Facility;
Defense Firm Remains Unbeaten in 10 Jury Trials to Date

The Sarasota Health Care Center has successfully defended itself in a multi-million dollar lawsuit alleging wrongful death and negligence. The case, which was won on October 30th following a two-and-a-one-half week trial, was tried by attorneys George Quintairos, Edward Prieto and Eric Boyer of QMPW for the defense, and Mike Houtz and Alex Fiol of Morgan of Colling & Gilbert for the Plaintiff.

The Plaintiff's decedent, an 80-year-old man, was admitted to Sarasota Health Care Center on May 13, 1998 with a history of severe osteoporosis, compression fractures, congestive heart failure, dementia, cardiomyopathy, mitral valve regurgitation, weight loss issues and a suspicion of multiple myeloma. The decedent passed away at the 120-bed nursing home on March 15, 1999 as a result of acute renal failure, secondary to end-stage dementia.

The Plaintiff filed a three-count complaint as a result of the death, alleging violations of Florida Statutes, Chapter 400, Wrongful Death and Negligence. The Plaintiff also alleged that the decedent had suffered significant weight loss due to malnutrition, sustained a hip fracture and developed decubitus ulcers as a result of the center's shortage of staffing and supplies, dirty facilities, poor surveys and fraudulent charting.

The Plaintiff called two agency nurses aides who testified about an alleged pattern of consistent staffing shortages and undesirable conditions at the nursing home. Several of these agency witnesses stated that they did not like working at the center and often requested other assignments. They also stated, however, that the center's residents received good, continuous care.

An Agency for Health Care Administration ( ACHA) survey, which pertained to the decedent's decubitus ulcers, weight loss and the center's staffing shortage, was admitted into evidence. On cross-examination, the ACHA surveyor admitted that he failed to recognize in his investigations that the decedent was terminal and was a no-code or DNR patient. He also testified that he failed to notice that the decedent was significantly below his ideal body weight and that he may have suffered from multiple myeloma, an illness which could have caused the weight loss and ulcers.

The Plaintiff then retained four experts, one of whom testified that the facility failed to provide adequate nutrition and hydration, but on cross-examination admitted that a significant portion of the decedent's weight loss was attributable to recurrent upper respiratory infections that was not the fault of the health center. She further testified that the staff inappropriately measured the decedent's height, which is generally utilized to calculate caloric and protein intake.

Through cross-examination, however, it was established that the hospital staff and the decedent's attending physicians also miscalculated the decedent's height due primarily to his kyphosis. Additionally, it was proven that despite the alleged miscalculation of the decedent's height, he gained weight during the initial months of the residency period.

Pat Collins, RN, a former Director of Nursing at another nursing facility, testified that the facility failed to appropriately care plan for falls and failed to provide appropriate nutrition and hydration, adequate skin care and appropriate pain management. On cross-examination, Ms. Collins was unable to prove that the fall was preventable or whether the decedent suffered a spontaneous hip fracture prior to falling. It was proven that despite the fact that there was no specific care plan for falls during the first seven months of the residency period, the decedent did not suffer any falls during that time frame.

During the cross-examination, Ms. Collins acknowledged that the decedent initially gained weight at the facility, but then lost weight due to upper respiratory infections and persistent refusals to eat or drink. She also testified that the decubitus ulcers, which had developed at mid-spine, were related to the decedent's kyphosis.

Leonard Williams, MD, testified that the fractured hip caused the decedent's death; however, on cross-examination he admitted that the hip fracture was not a terminal condition and that the death was primarily the result of the decedent's underlying medical conditions that were present upon admission to the nursing home. Dr. Williams' testimony was the only evidence submitted as to death, which he backed away from on cross-examination.

Defense expert Arnold Blaustein, MD testified that based on his review of the decedent's medical history, the decedent had suffered from multiple myeloma, which is a rare form of bone cancer. Furthermore, Dr. Blaustein indicated that multiple myeloma causes pathological fractures (similar to those the decedent sustained on the spine), progressive weight loss, and renal failure. Dr. Blaustein also opined that the fractured hip could have been a spontaneous fracture caused by the weakening of the bone due to multiple myeloma. He noted that the initial fracture was non-displaced, but became displaced later at the hospital, giving credence to the spontaneous theory.

Quintairos, McCumber, Prieto, Wood, Boyer & Mager specializes in nursing home, assisted living facility and hospital medical malpractice defense litigation. The firm has offices in Miami, Tampa, Jacksonville, Orlando and Fort Lauderdale.

November 2001