Nursing Homes Abuse Blog - By Jonathan Rosenfeld

The Journal Carrier reported on a recently filed Illinois lawsuit against Jacksonville Convalescent Center involving the death of an 87-year-old man at the facility.  According to reports, the lawsuit was filed based on the poor care provided by the nursing home contributed to the patients death.

Despite having multiple medical conditions such as: prior strokes, hypertension, diabetes and dementia that put the man at an increased risk for falling, the facility allegedly failed to implement the necessary safeguards and he subsequently fell and fractured his hip which necessitated a surgery.

In addition to the fall and resulting injury, the lawsuit further alleges that the facility failed to prevent the development of a diabetic ulcer on the patient's ankle that ultimately resulted in severe medical complications such as gangrene and osteomyelitis. 

Development of gangrene and osteomyelitis in wounds

Few medical conditions are as debilitating and de-humanizing that gangrene and osteomyelitis. Gangrene is a condition that results when the tissue and skin die and decay and toxins form killing the area surrounding the wound.  Osteomyelitis is an infection in the bone that generally forms in the area surrounding a wound.

Particularly in patients with diabetic ulcers and decubitus ulcers, medical personnel need to be diligent when caring for the patients wounds.  Strict adherence to the doctors orders is necessary to maximize the ability of the wound to heal.  Certainly, except for the most extreme circumstances, the development of gangrene and osteomyelitis are indicative the facilities failure to provide adequate care.

Related:

If bed sores are not timely treated, can gangrene develop?

Can bed sores cause osteomyelitis?

Are all ‘sores’ considered to be ‘bed sores’?

Nursing Home Injury Laws: Illinois

'Under-staffing' and 'under-funding' are just several of the underlying reasons alleged to contribute to the development of a patient's bed sores (or decubitus ulcers, pressure ulcers or pressure sores) during an admission to a Missouri nursing home.  

The nursing home negligence lawsuit, filed by my colleague Attorney David Terry, is filed on behalf of a deceased nursing home patient and alleges the nursing home (Parkwood Skilled Nursing and Rehabilitation Center) and its various management companies operated the facility in a manner where money necessary for essential patient-care services was diverted away from the the facility to the benefit of the facility owners.

The subject of the lawsuit, Nellie Wilks, was an elderly woman who was admitted to Parkwood Skilled Nursing and Rehabilitation Center on July 7, 2008.  At the time of her admission, Ms. Wilks suffered from various medical conditions and was very much dependent on the staff at Parkwood for providing care for her daily living needs.  Despite her maladies, Ms. Wilks did not have any type of pressure sore on her body.

Also at the time of her admission, the staff at Parkwood conducted an assessment of Ms. Wilks needs and determined her to be at risk for developing bed sores, due to her limited mobility, incontinence of bowel and bladder and need for staff assistance with all of her daily living needs.

The failure on the part of the staff at Parkwood (as well as the owners' failure to provide staff with the means to do their job) to properly implement Ms. Wilks' plan of care is alleged to be responsible for the development of a stage IV pressure sore on Ms. Wilks' sacrum. The wound's advanced nature, necessitated a medical procedure known as a diverting colostomy and extensive medical care until her death on October 26, 2008.

The lawsuit against Parkwood specifically alleges the facility failed to provide adequate care to prevent the following:

• Pressure sores
• Malnourishment
• Development of a urinary tract infection
• Osteomyelitis
• Severe pain

Sadly, many nursing home patients are currently suffering horrible pain and embarrassment due to bed sores.  The overwhelming majority of bed sore cases are the result of the facilities failure to properly implement plans of care.  In cases where a bed sore developed during an admission, facilities can be held responsible for the resulting pain and loss of dignity and medical expenses.  

Our nursing home attorneys are available to discuss your situation with you and advise you of your legal rights.  All consultations are confidential and no fee is ever charged unless there is a recovery for you. (888) 424-5757

Related:

Nursing Home Resident Dies From Improperly Treated Pressure Sores During Short Rehab Stay

New York jury awards $19m to family of man who developed advanced bed sores during nursing home admission

Lawsuit Claims That Nursing Home's Negligence Resulted In Patient's Decubitus Ulcers

Angela Thompson v. Parkwood Skilled Nursing and Rehabilitation Center (pdf)

Bed Sore FAQ's

In times of need, locating necessary information regarding the legal rights and resources for nursing home patients can be difficult and imposing.  In this respect, we are proud to introduce a new resource for patients, families and practitioners looking for a concise compilation of information regarding nursing home laws.  Nursing Home Injury Laws, provides every states':

• Nursing Home Laws
• Medical Malpractice Laws
• State Resources
• Applicable State Code
• Common Nursing Home Injuries
• Glossary
• Recognized Books & Journals
• Nursing Home FAQ

Additionally, we will be posting regular updates regarding important developments relevant to nursing home care within each state.  Here is a link to Nursing Home Injury Laws.

One of the nursing home negligence cases my office is currently investigating involves the death of a man related to complications related to amyloidosis.  Turns out, the man was suffering from an advanced bed sore on his coccyx (also called pressure ulcers, pressure sores or decubitus ulcers) that had progressed so far that the bone in the area had become infected (osteomyelitis).

Elderly nursing home residents, especially those suffering from other diseases such as bed sores, have a higher risk of developing amyloidosis, a disease which can damage various tissues and organs.  This can cause dangerous complications in residents who are already weak from advanced age or underlying disease.

Amyloidosis is a group of diseases caused by abnormal deposits of amyloid protein (usually produced by cells in bone marrow) in the body’s tissues and organs.  The disease frequently affects the heart, kidneys, liver, spleen, nervous system, and gastrointestinal tract.  The amyloid protein can deposit in a localized area (localized amyloidosis) or affect tissues throughout the body (systemic amyloidosis).  Amyloidosis is diagnosed for testing for the amyloid protein in a biopsy of involved tissue. 

Systemic amyloidosis is classified into three major types:

• Primary (AL) amyloidosis
• Secondary (AA) amyloidosis
• Hereditary or Familial (ATTR) amyloidosis

Primary amyloidosis, the most common form of amyloidosis, occurs when a plasma cell in the bone marrow spontaneously overproduces a particular protein portion of an antibody.  AL can affect many areas (heart, kidneys, liver, spleen, nerves, intestines, skin, tongue, blood vessels) and can occur with bone marrow cancer (bone marrow cancer), but is a disease entity of its own.

Secondary amyloidosis occurs as a result of another illness (multiple myeloma, chronic infections including tuberculosis and osteomyelitis, or chronic inflammatory diseases including rheumatoid arthritis and ankylosing spondylitis).  It usually affects the kidneys, spleen, liver, and lymph nodes.  Treatment for AA is usually treating the underlying illness.

Familial amyloidosis is a rare form of inherited amyloidosis that is an inherited autosomal dominant disease (meaning that the offspring of a person with the condition has a 50% chance of inheriting it).  ATTR usually affects the liver, nerves, heart, and kidneys. 

The signs and symptoms of amyloidosis depend on the tissues or organs affected.  The symptoms result from abnormal functioning of the organs and tissues involved.  They may include:

• Swelling of ankles and legs
• Numbness or tingling in hands or feet
• Severe fatigue
• Weakness
• Significant weight loss
• Loss of appetite
• Shortness of breath
• Irregular heartbeat
• Diarrhea or constipation
• Protein in urine
• Feeling full quickly
• Enlarged tongue
• Difficulty swallowing
• Swelling
• Skin changes (thickening or easy bruising)
• Purplish patches around the eyes

 Risk factors for amyloidosis including:

• Age – older than 65
• Other diseases – having chronic infections or inflammatory disease or osteomyelitis
• Family history – history of amyloidosis
• Kidney dialysis – large, abnormal proteins can build up in the blood

The severity of the disease depends on which organs and tissues are affected.  The disease can result in dangerous complications including kidney damage, heart damage, and nervous system damage.  Kidney damage can result when amyloidosis affects the kidneys.  Kidney problems frequently translate to damage with the bodied blood filtering system, allowing protein to leak from the blood into the urine.  This may result in kidney failure. 

Heart damage can also occur when amyloidosis affects the heart.  This reduces the heart’s ability to fill with blood between heartbeats, meaning less blood is pumped with each beat.  Nervous system damage can also occur when amyloid protein deposits affect the nerves.  This can result in numbness, tingling, or difficulty controlling blood pressure. 

There is no cure for amyloidosis, but treatment may help manage the signs and symptoms of the disease, limit further production of amyloid protein, and treat any underlying disease.  Several treatments of primary amyloidosis are being studied including medicine and peripheral blood stem cell transplantation. 

Nursing home residents suffering from painful pressure sores are at an increased risk for amyloidosis.  Should a pressure sore patient develop amyloidosis, they run the risk of organ tissue damage and increased risk of amyloid protein deposits.  Also, paraplegic patients suffering from sepsis as a result of pressure sores also face complications stemming from amyloidosis. 

Sources:

Mayo Clinic: Amyloidosis

Boston University: Amyloid Treatment and Research Program

Amyloidosis Foundation

Pressure sores: aetiology, treatment and prevention (Colin Torrance)

Related:

Bed Sore FAQ

Bedsores: Are You At Risk?

In For Rehab. Out With Bedsores.

"The Nursing Home Says My Dad's Bedsores Were Unpreventable..."

Bed Sore Resources