Timeline For a Nursing Home Abuse Case

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A nursing home abuse and neglect case is a type of medical malpractice case. These types of cases are known as a complex litigation case.  The usual timeline from the date of filing a lawsuit, also known as the complaint, to settlement or trial is usually anywhere from one to three years.

You are probably asking why so long? On television programs the case goes to court within one hour. Of course, this is television, not real life.

In a real case, the attorney must first meet with the family and investigate the nursing home case.  A nursing home will not allow an attorney to question their staff, before filing a lawsuit, to determine if there is a legitimate case. Therefore, the attorney must first examine the medical records.  It may take several weeks to obtain these medical records. The attorney then begins to piece together what happened at the nursing home.

Next, if the attorney believes there are grounds for a medical malpractice case, under North Carolina law, they must have these records reviewed by an expert doctor and/or nurse.  This will usually take at least 30 days for the expert to review the records.  As you can see, we are already at about two months of time elapsed and the lawsuit has not even been filed.

If the expert doctor and/or nurse believe the nursing home staff has violated the “standard of care”, the expert will render an opinion to the attorney.  At this time the attorney begins the legal process of developing a complaint or lawsuit.  Depending on the complexity of the case, the Complaint that has to be drafted for the lawsuit to be filed may take several weeks.

Eventually the attorney files the lawsuit at the courthouse.  The deputy sheriff must then serve the lawsuit on the nursing home.  Large corporate chains own most nursing homes making it difficult, at times, to determine the appropriate party to be served.  After being served, the nursing home retains defense counsel.  The defense counsel usually files an extension to “answer” the lawsuit.  This usually takes about another 60 days.

At this time the discovery process begins.  This is when expert witnesses, such as doctors and nurses, and the staff of the nursing home are questioned under oath at what is known as a deposition. Again, depending upon the complexity of the case this could take a year to complete.  By now we are up to least 18 months since the family first met with the attorney.

Eventually the court will schedule mediation.  Mediation is an attempt to settle the case before trial. This will usually take place several months after the discovery process ends.  At mediation, both the plaintiff and the defendant meet with a mediator to try to resolve the case without the time and expense of a trial.  Many times mediation is successful and the case is settled.  Sometimes mediation is unsuccessful and the case would then proceed to trial several months later.  A typical trial may last anywhere from one to four weeks.

As you can see, the wheels of justice roll slowly. We have an imperfect and often times slow justice system but there is no doubt it is the best in the world. Knowing the timeline of a typical nursing home abuse case is important when determining how you want to move forward to obtain the justice your loved one deserves.

Who Is A Medical Expert?

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Expert witnesses play a vital role in the success of a case at trial. Typically, both the plaintiffs and the defendants will have expert witnesses that testify that either the standard of care was or was not violated. The outcome of a case may depend upon which expert witness the jury believes more. Therefore, having reliable and qualified expert witness that can assist the jury with the evidence is paramount to having a successful outcome at trial.

The role of an expert is to assist the jury in how they understand the evidence in the case. According to the North Carolina Rules of Evidence an expert is, “a witness who has specialized knowledge may be qualified as an expert witness, upon a showing of his specialized knowledge, skill, training, experience, or education, and may testify in the form of an opinion, if that will be helpful to the jury.” N.C.R. Evid. 702(a).

A medical expert comes in many forms. Typically, an attorney will have a medical expert that is familiar with and focuses on a particular practice of medicine. For example, a trial dealing with injuries suffered during birth would likely have an OB/GYN as the medical expert. An injury dealing with the spinal cord would have a neurosurgeon or rheumatologist. A case dealing with the neglect in a nursing home may only need a registered nurse as an expert.

When put in its simplest form, a medical expert is someone who can help the jury understand the medical side of a trial. The best experts are the best educators. Medical experts will usually explain to the jury what the standard of care or usual actions of the medical industry are. This, in turn, allows a jury to determine liability.

What Are the Stages of a Bedsore or Decubitus Ulcer?

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Decubitus ulcers, or bed sores ,are one of the most common forms of nursing home neglect. They are often caused when a patient is not turned on a regular basis resulting in pressure on the bony prominences of the body. The pressure reduces the blood flow to the area causing the surrounding tissue to die. Decubitus ulcers are usually located on the lower back near the tail bone, upper back near the shoulder blade area, buttocks, heels, knees, elbows, and sometimes ankles.

There are four generally accepted stages of bedsores; however, a fifth stage is sometimes used to explain exceptionally deep decubitus ulcers. The descriptions are as follows:

Stage I – A Stage I decubitus ulcers usually appears as a red spot on the skin that fails to disappear once the pressure from the area is relieved. It may appear as a small rash. Stage I decubitus ulcers can usually be eliminated with proper treatment and turning by the healthcare provider.

Stage II – A Stage II decubitus ulcer may appear as a small blister or slightly broken skin. A Stage II should be carefully monitored by the healthcare staff. The staff may provide additional conditioning of the skin and may request an air mattress to alleviate the pressure on the affected area. Stage II decubitus ulcers are sometimes unavoidable depending on the patient’s condition and co-morbidities.

Stage III – A Stage III decubitus ulcer usually appears as an open wound on the patient and looks like a crater in the skin. The skin is open and the depth is usually a quarter of an inch or more. Immediate medical attention and treatment should be provided to the patient. It depends on the overall health of the patient, but the patient’s healthcare provider may be negligent if they allow a decubitus ulcer to progress to Stage III.

Stage IV or Unstageable – A stage IV decubitus ulcer is characterized by having passed through the skin into tendons, muscles and bones. A Stage IV decubitus ulcer requires immediate wound care and usually surgery to debride or rid the wound of the dying tissue. Often a thick black, dry tissue will cover the wound causing it to be unstageable. Amputation may be necessary if the ulcer is on an extremity. One of the major complications of a Stage IV decubitus ulcer is sepsis or a whole body infection that attacks the organs of the body and which can lead to death. Usually, the healthcare provider is negligent for allowing a patient’s decubitus ulcer to progress to Stage IV.

Stage V – A Stage V decubitus ulcer can be any size and is known for the depth it has penetrated into the underlying bone and possibly other organs. A Stage V decubitus ulcer is almost impossible to heal.

If you think you have a loved one suffering from bed sores contact us immediately to see how we can help stop this unnecessary neglect.

What is Sepsis?

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Sepsis, or septicemia is a potentially fatal illness that occurs when the body reacts to infection that has spread throughout the body. Sepsis is most commonly seen in the elderly or in young children, but may occur at any age.

Symptoms

Symptoms of sepsis usually include, but aren’t limited to: fever, increased heart rate, decreased urine output, pain in joints, confusion and low blood pressure. Sepsis may be seen in patients who have had pneumonia, urinary tract infections, ruptured appendix and meningitis. It is critical that if signs of sepsis are seen to notify the appropriate medical personnel.

Causes

The most common cause for sepsis is an infection that spreads. The body’s reaction to infection is inflammation. Usually the body will create the necessary chemicals to fight the inflammation and infection. However, in patients who become septic their entire body may become inflamed causing the body to overreact. This overreaction causes small blood clots to form throughout the body. The body works harder to break up these clots but when unable to do so the body’s organs lack the necessary oxygen and begin to fail.

Treatment

Early detection of sepsis is key to survival. If identified early enough, sepsis may be treated with the use of intravenous fluids (IVs), antibiotics and removal or sanitation of the infected area and source. Without proper treatment sepsis can become severe and eventually lead to septic shock causing death.

According to the National Institute of General Medical Sciences , “every year, severe sepsis strikes about 750,000 Americans. It’s been estimated that between 28 percent and 50 percent of these people die—far more than the number of U.S. deaths from prostate cancer, breast cancer, and AIDS combined.”

If you believe a loved one has died or been seriously injured by the failure of a medical facility to properly diagnose sepsis or other illness, contact us today to see how we may be able to help.

For further information on sepsis visit:

U.S. National Library of Medicine
The Mayo Clinic