In evaluating a potential case, it is critical to know the specific injuries that precipitated death or form the basis of the complaints of neglect and or abuse. We frequently are contacted by other attorneys who assume that simply because a resident died in a nursing home, they have a case of nursing home neglect. Further, it is important to understand whether the injury in question was caused by recurrent neglect over an extended period of time or was simply the result of a single event, which effectively produced injury to the nursing home resident. There are three categories of injuries generally recognized as being caused by a failure to render adequate care:

PROGRESSIVE INJURIES
SINGULAR EVENT INJURIES
DRUG-RELATED INJURIES

1. Progressive Injuries -

Injuries Caused by Continuing Failures
and Omissions of Care

The injuries listed in this category generally result from a prolonged form of neglect. These injuries have been recognized by the medical community as preventable in nearly all nursing home residents through the implementation of ordinary nursing care. They have also been the subject of successful litigation.

Decubitus ulcers - Stage III or IV
Septicemia secondary to Decubitus Ulcers or Wound Sepsis
Hypernatremic Dehydration (severe dehydration)
Protein Calorie Malnutrition (severe malnutrition)
Septic Shock
Gangrene
Osteomyelitis secondary to Stage IV Decubitus Ulcers
Septicemia secondary to long-term failures regarding urinary catheters or feeding tubes
Aspiration/Pneumonia due to improper placement of Naso-gastric or PEG tubes

This list of progressive failures is not all-inclusive. This listing only identifies the most common types of progressive injuries.

2. Singular Event Injuries -

Injuries Caused by a Singular Event

This category consists of injuries which can be causally linked to a singular event. In such cases, an efficient cause is said to exist. The distinction between the injuries identified below and the progressive failure injuries stems from the amount of time between the negligent behavior and the presence of the full-blown injury. Nursing home injuries precipitated by untoward incidents include the following:

Strangulation (resulting from the failure to either monitor restraints or the improper use or application of restraints)
Drowning
Scalding
"Wander-off" cases where death or serious injury occurs after the resident has wandered away from the facility
Falls and fractures resulting from the failure of nursing home staff to follow accepted protocols and implement necessary preventive measures
Rape and/or sexual assault
Physical abuse resulting in wounds, bruising or disfigurement

3.Drug Related Injuries

Injuries Caused by Medication Errors

Approximately 95% of all nursing home patients receive medication on a regular basis. The typical nursing home patient takes five to six medications daily. The over-use or under-use of certain medications can result in serious injury or death. Drug related injuries in a nursing home case are usually the result of: (1) inappropriate prescribing by the physician; (2) failure of the nursing home staff to follow physician's instruction by properly monitoring a specific aspect of the patient's condition prior to administering the medication in question; (3) administering medications to the resident despite the presence of adverse symptoms which require immediate physician notification; (4) over or under medicating the resident by the nursing home staff; or (5) administering Patient A's medication to Patient B. The following lists consists of drug related injuries that commonly occur in nursing home setting and are the subject of litigation:

Mental or physical deterioration secondary to inappropriate psychotropic medication administration
Digoxin toxicity
Untreated congestive heart failure
Dilantin toxicity
Insulin shock/coma resulting from inappropriate administration of insulin
Improper antibiotic therapy resulting from: (1) the inappropriate prescription and continuation of a broad spectrum antibiotic coupled with the failure to obtain culture and sensitivity or the failure to track the effectiveness of the antibiotic; or (2) the failure to adjust the antibiotic therapy in response to the sensitivity report
Severe fall resulting from the failure to monitor the effects of any hypertensive and anti-arrhythmia drugs or from negligent use of psychotropic drugs
Hyperkalemia resulting from dehydration coupled with the use of any hypertensive, diuretic and or potassium supplements
Any adverse drug reaction identified in the Physician's Desk Reference or the product literature of the drug manufacturer

Every day a nursing home resident is injured, abused or harmed due to neglectful or abusive nursing home care. Frequently, the resident and family are kept in the dark as to how the injury occurred. The injury can be indicative of the care delivery system at a nursing home and unfortunately sometimes the injury can be fatal.

If a family member is currently in a nursing home or was recently in a nursing home and was injured, you may be considering legal action. In order for us to evaluate any potential case, please complete the intake form by clicking on the icon below and submitting it to our firm. This intake form has been developed over many years of practice and includes inquires we believe are pertinent to evaluating a potential nursing home case.

Simply print out this form. Complete it and either mail it to Marks Balette & Giessel, 10000 Memorial Drive, Suite 760, Houston, Texas 77024 or fax it to (713) 681-2811.