Author Archives: Adam Peck

On April 8, 2011 upon admission to Providence Fuentes it was documented in the Fuentes medical records that she had no pressure ulcers or any history of any pressure ulcers.

9. On April 20, 2011 Fuentes developed a Stage II 1.5 cm x 1 cm Coccyx Pressure Ulcer at Providence which included serosanguinous drainage.

10. On April 23, 201, according to the Fuentes Providence medical Records,  the Fuentes Stage II Coccyx Pressure Ulcer had worsened to a Stage III and IV unstageable Pressure Ulcer.

11. On April 25, 2011 an evaluation by a Providence wound care nurse showed the Fuentes Pressure Ulcer to the Sacrococcyx as having grown to the size of 12cm x 9cm. The Fuentes Providence weekly care plan though failed to address any pressure ulcer and / or skin issues.

12. On May 5, 2011 it was noted that Fuentes had developed Dermatitis of the coccyx region at Providence progressing to an unstageable Pressure Ulcer with necrotic tissue and Slough.

13. On May 8, 201, knowing that Fuentes had an unstageable pressure ulcer with necrotic tissue and slough, unbelievably  Providence left the pressure ulcer section of the Fuentes medical records blank thus indicating no pressure ulcer issues.

14. On May 13, 2011 the Pressure Ulcer to the Sacrococcyx at Providence had worsened as it had grown to a size of 13cm x 9cm x 0.2cm. The wound also had a foul odor, boggy wound base, and was now infected down to the bone.

15. On May 16, 2011 the Pressure Ulcer to the Sacrococcyx had become despicable and had become even worse and  grown in size to 12.5cm x 13cm x 5.5 cm and now had yellow /green drainage with foul odor.

16. On May 19, 2011 Fuentes underwent a bedside Sacral Decubitus Wound Debridement, Necrotic tissue was excised.

17. On May 26, 2011 a Wound Care evaluation documented that underlying bone structures were now visible, palpable and severely infected

18. On June 3, 2011 a Wound Culture tested positive for Escherichia Coli, as a result of lack of hygiene and that her pressure ulcers were frequently contaminated and soiled with stool,  Vancomyicin-resistant Enterococcus (VRE) and MRSA infections.

19. On June 10, 2011 the Fuentes Wound had worsened at Providence as the wound bed was covered with non-viable necrotic tissue. There was viable bone visible in the center of the Wound.

20. It was noted in the Fuentes medical records dated June 16, 2011, indicate that Fuentes now has osteomyelitis of the coccyx, indicating that Fuentes now has a severe bone infection.

21. On August 2, 2011 Fuentes was transferred from Providence to a Wound Care Center for her Providence hospital-acquired Pressure Ulcer

22. Hospital residents at a high risk for the development of pressure ulcers are to be turned and repositioned ( a basic custodial duty), at a minimum, every two-hours to avoid tissue damage.  However, according to the Fuentes Providence nursing notes, Providence staff repositioned Fuentes sporadically or not at all.

FIRST CAUSE OF ACTION

[By Plaintiff Marc Fuentes, as the successor in interest to the decedent Gladys Fuentes for Elder Abuse as Set Forth at Welfare and Institutions Code §15600 et seq., against Defendants Providence St. Joseph Medical Center and Does 1 Through 200, Inclusive.]

23. Plaintiff incorporates by reference Paragraphs 1 through 22, inclusive.

24. Providence neglected Fuentes within the meaning of Welfare and Institutions Code Section 15610.57.  Providence ignored their duty and obligation to perform basic assessments, institute care plans, and provide custodial care ( e.g. repositioning and skin inspections) with respect to Fuentes’s sacral wound.  In that regard, the Providence failed to monitor Fuentes’s sacral area and to detect pressure injury before the damage was severe.

25. Providence was on notice that Fuentes needed both pressure relief and close monitoring of her skin, yet they failed to do.  Providence failed to chart the condition of the wound after it developed and failed to take any action when the wound developed.

26. Moreover,  Providence neglected to provide medical care for Fuentes’s physical and mental health needs by failing to take all the necessary steps to properly care for Fuentes’s pressure ulcer.  Providence failed to adequately inform Fuentes’s physician of the nature and extent of Fuentes’s pressure ulcer, failed to adequately and completely carry out doctor’s orders for the treatment of her pressure ulcer,  and failed to adequately and appropriately document care provided to and the condition of her pressure ulcer causing the pressure ulcers to become severely infected.

27. Providence’s neglect of Fuentes was reckless, oppressive, and malicious.  Specifically, the individuals who cared for Fuentes knew that taking the necessary precautions to prevent Fuentes from developing pressure ulcers and infections causing her harm and Providence knowingly disregarded this risk.

28. Further, Providence’s neglect of Fuentes was reckless, oppressive, and malicious, in that their failures were not merely isolated to one area of patient care, but extended to numerous patient care issues, which collective failures they clearly understood would cause Fuentes severe harm.

29. Providence is also legally responsible for the widespread neglect of Fuentes for numerous independent reasons.  First, managing agents of  Providence directly participated in the neglect of Fuentes.  Personnel who Providence vested with discretionary decision-making authority relating to patient care issues involving Fuentes were part of the team that utterly failed to properly monitor and assess Fuentes’s skin integrity, properly monitor and prevent her from suffering from Pressure Ulcers, Dehydration, Malnutrition, infections and properly monitor and prevent her from suffering unnecessary pain.  Additionally, such individuals were officers, directors, and / or managing agents.

30. Further, Providence is legally responsible for the reckless neglect Fuentes suffered because their officers, directors, and / or managing agents both directly and indirectly authorized the reckless neglect that Fuentes suffered.  Providence officers, directors, and managing agents directly authorized the reckless neglect at issue by specifically knowing that Fuentes was being neglected by Providence personnel, allowing such neglect to continue to occur, and failing to take any action to prevent the reckless neglect from further occurring.

31. Moreover, Providence is legally responsible for the reckless neglect Fuentes suffered because their officers, directors, and /or managing agents  were responsible for creating a patient care environment that inevitably led to the reckless neglect of Fuentes and other similarly situated patients in Providence facilities.  Specifically, Providence and its  officers, directors, and/or managing agents, purposively utilized insufficient staff, underpaid staff, untrained staff, and insufficiently supervised staff as part of an overall plan, design, and scheme to maximize their profits at the expense of patient care.

32. In choosing to maximize the profits by deliberately understaffing (in competency and number) their facilities, Providence knew that their plan posed a substantial and imminent to the health, safety, and well-being of the residents of their facility.

33. The conduct of Providence, as detailed above, resulted in physical harm as well as mental harm. Providence’s conduct caused Fuentes to suffer horrific pain and suffering.

SECOND CAUSE OF ACTION

[By Marc Fuentes as the successor in interest to the decedent Gladys Fuentes for Negligence against all Defendants and Does 1 Through 200, Inclusive]

34. Plaintiff incorporates by reference paragraphs 1 through 33, inclusive.

35. Providence acted negligently and recklessly with respect to Fuentes.  In particular and without limiting the generality of the foregoing, Providence failed to:

(a) follow and implement physician’s orders;

(b) monitor Fuentes’s condition and report meaningful changes;

(c) monitor and maintain personal hygiene of Fuentes;

(d) maintain accurate records of Fuentes’s conditions;

(e) take any and all necessary steps to control and /or eradicate Fuentes’s pressure ulcers and infections;

(f) treat Fuentes with respect and without abuse.

36. That the Defendants breached those duties, as alleged in this first amended complaint.

37. That the Providence’s breaches of its duties to Fuentes were the direct, actual, legal and proximate cause of Fuentes’s injuries as alleged.

38. That but for Providence’s conduct and breaches of duty, Fuentes would not have suffered the injuries as described.

39. That the injuries suffered by Fuentes were foreseeable as Providence knew or should have known that their conduct, including their unlawful scheme to increase profits at the expense of patient care caused Fuentes to suffer from health and safety hazards, would inevitably lead to injuries to their patients, including Fuentes.

40. That Fuentes, in fact, suffered injuries and damages as a result of Providence’s breaches, including but not limited to, unjustifiable and substantial physical pain and mental suffering in the form of pressure ulcers and infections and other injuries in an amount and manner according to proof at time of trial

THIRD  CAUSE OF ACTION

[By Marc Fuentes, Individually, and for Wrongful Death., against all Defendants and Does 1 Through 200, Inclusive.]

41. Plaintiff incorporates by reference Paragraphs 1 through 40 as through fully set forth word for word.

42. As a proximate result of the failure of the defendant Providence  St. Joseph  to re-position the decedent every two hours and to provide appropriate skin inspections twice per shift, decedent Gladys Fuentes incurred an infected stage four pressure sore which effect of the decedent’s infected stage four pressure sore,  the infections related thereto, the negligence and /or reckless, malicious, and oppressive neglect perpetrated by the Defendants as herein above referenced, caused Gladys Fuentes’ death on September 27, 2012.