Proving Recklessness Against Nursing Homes and Acute Care Facilities
As in a skilled nursing facility, reckless conduct certainly occurs in the acute care setting and in many of the same ways, such as poor training and understaffing. Below is a short outline of specific areas of potentially reckless conduct that plaintiffs’ attorneys and their clients should watch for in a elder / dependent adult abuse case against an skilled nursing and / or acute care facility.
Bed Sore / Pressure Sore / Decubitus Ulcer Cases:
- Failure to follow policies and procedures: The policies and procedures from an acute care facility often provide a wealth of information. Make the effort and take the time to fully familiarize yourself with the hospital’s policies and procedures regarding patient care, skin care, bed sores,wound prevention and wound care, lift teams, beds and mattresses and any other policies which may affect the care that was provided to your client. In depositions, ask each nurse, wound nurse and supervisor about his or her familiarity with the policies and procedures. Look through the medical records carefully. It is quite likely that the care provided to your client grossly failed to meet the facilities own policies and procedures on numerous occasions, and, in fact, the care providers were not even familiar with the policies and procedures. Regularly, nurses fail to request a consultation when it is required; Bed Sore skin assessments are not completed on a regular basis; wounds are not cared for as required by the policies and procedures; and charting is wholly inadequate pursuant to the policies. Ask your expert and you may very well learn that had the facility followed its own policies, the injury most likely would not have occurred. Failure to follow policies and procedures and failure to insure that the nursing staff is familiar with the policies and procedures constitutes recklessness, in that the individuals involved knew that there was a high probability that this conduct would cause harm and knowingly disregarded this risk.
- Failure to properly train nurses: The nurses’ failure to understand and have knowledge of the hospital’s policies and procedures is one example of a failure to properly train the nursing staff. Independent of the policies and procedures, you may also discover that the nurses do not have a complete understanding of skin care and wound prevention. Their provision of care may fall below the standard of care. As in cases against skilled nursing facilities, request and review the in-service training offered by the hospital.
- Failure to provide adequate staffing levels: As in a skilled nursing facility, and acute care facility will also sacrifice adequate staffing levels for budgetary concerns. You may find that your client required three people to turn him, but that it was difficult, if not impossible, to find three available people in the ICU to perform this repositioning every two hours. Hospitals also often employ Wound, Ostomy, and Continence nurses (“wound nurse”). While there is no legal staffing requirement for wound nurses, the hospital itself may have budgeted for one or more wound nurses and determined a medical need for one or more wound nurses. Yet, despite this determination, the hospital may fail to staff at this level.
- Failure to place a patient on the correct bed or mattress and/or false reliance on a mattress: A major, recurring issue in these cases is the bed and/or mattress on which the patient was placed. Certain beds and mattresses are used for lung therapy, others are recommended for pressure-relief and pressure-reduction. Hospitals and their staff often confuse the two. Many of these beds and mattress overlays rotate the patient from side to side. Many nurses mistakenly believe that this constitutes repositioning and record such repositioning in the medical chart. This is incorrect and illustrates, again, the poor training provided to nursing staff. Many experts will explain that bed rotation is not a replacement for manual repositioning every two-hours.
About the Author
Attorney Steven Peck has been practicing law since 1981. A former successful business owner, Mr. Peck initially focused his legal career on business law. Within the first three years, after some colleagues and friend’s parents endured nursing home neglect and elder abuse, he continued his education to begin practicing elder law and nursing home abuse law.