(Please note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this elder abuse/medical malpractice case and its proceedings.)
INTRODUCTION
This is an action for professional negligence, and ostensibly, for elder abuse, with a claim for punitive damages. The plaintiff, Allison Brown, has brought this action through her daughter and guardian ad litem, Nancy Smith. The defendants are Medical Center, Inc. (hereinafter “MC”) and Universal Health. This action arises from care and treatment provided to Ms. Brown at MC, where Ms. Brown is still a patient.
This case involves two allegations: negligent care resulting in the development of a pressure sore, and an alleged failure to monitor on October 10, 2006, leading to a respiratory arrest.
FACTS
On July 25, 2006, plaintiff Allison Brown was brought by ambulance to the ER at the Campus of MC. She had been undergoing dialysis when her family noticed that she was unable to speak, and it was noted that she had right-sided deficits. She arrived at 1645 that day, and at 1700 was being evaluated by the ER physician. She was alert and intermittently verbal, and had an abnormal neurologic examination, including an inability to move her right arm or either leg. A stat CT was ordered. It revealed the presence of an old right frontal lobe infarct (i.e. an old stroke). She was also determined to have had a new stroke. The plan was to admit her to the hospital and to provide supportive care and further evaluate her condition.
On July 26, 2006 the initial nursing assessment was done of the plaintiff. At the time of her admission she was noted to have redness on her right buttock. She was also non-verbal by this point, and had a left facial droop. She was also seen by neurologist Joan Green M.D. on July 26. Dr. Green noted the plaintiff’s ability to speak had deteriorated since the day before, and when she saw plaintiff she was nonresponsive, and did not follow commands. She suspected a left hemisphere stroke, and recommend a MRI and carotid ultrasound.
On July 27, 2006, an MRI of the brain was obtained. This study revealed a non-hemorrhagic infarct in the left frontal lobe (i.e. the new stroke, this one in the left frontal lobe). In addition, extensive white matter changes and old infarcts were also noted to be present. On July 27, 2006 she was seen by the neurologist, Dr. Sam Lee, and he noted the evidence of old infarcts in the CT and MRI, and felt that she likely had bilateral frontal lesions.
Because of her end-stage renal disease she was started on dialysis, and physical therapy and occupational therapy was also ordered for her. Initially there was some thought given to her being transferred to an acute rehabilitation unit. However, her condition never got to the point where she could be transferred. (See Part 2 of 11.)
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