This is a review of a medical negligence lawsuit which was filed after a patient in a nursing home allegedly died as a result of dehydration and malnourishment. The patient’s legal representative claimed the nursing home breached the “standard of reasonable care” owed to the deceased, and that breach of reasonable care amounted to negligence.
Statement of Facts…
On February 1st, 2011, 84-year-old Milt Hass was admitted to Boll Nursing and Rehabilitation Center, LLC. At the time of his admittance, Hass was in a severely weakened state. He recently underwent surgery to replace his left hip socket joint.
Hass’s admitting medical chart also indicated he suffered from:
“…decreased heart rate, tachycardia, hydroephrosis bilaterally, urinary tract infection, benign prosthetic hypertrophy, gall stones, Parkinson’s Disease, depression, dementia, neurogenic bladder, decrease in iron stones, elevated right hemidiaphragm, and right bundle branch block with first degree AV block.”
When he was admitted, Hass weighed 119.2 pounds. Prior to his hip surgery Hass was ambulatory, relying on a walker to move from one point to another.
As part of standard admitting procedure, the nursing home conducted a “Swallowing Study” to gauge the level of substance Hass was able to consume. The Swallowing Study indicated Hass’s ability to consume solid food was limited. As a result Hass’s food was finely chopped before he ate.
The Senior Nursing Administrator called Judy Lobin, who would later be executor of Hass’s estate, to report the results of the Swallowing Study and the decision to change Hass’s diet.
Lobin disagreed with the decision and made clear her dissatisfaction with the change. She told the Senior Nursing Administrator Hass was able to eat solid food and communicated her concerns about the possible loss of nutrients if Hass’s diet was changed. She instructed the administrator to revert Hass back to solid food.
Lobin was told if she opposed the doctor’s (Robert Noff, MD) decision she would have to sign an Against the Medical Advice or “AMA” form. The AMA form would include Lobin’s understanding and acceptance of liability if Hass choked or became asphyxiated on solid food. Lobin never signed the form.
By February 12th, Hass’s weight dropped to 112.8 pounds. The on-call doctor ordered nutritional supplements be immediately introduced into Hass’s diet. Three days later the staff noted, “patient’s appetite suppressed. Progressive feeding problems. Symptoms include regurgitated food expelled from patient’s mouth.”
By February 17th, a little over two weeks since Hass was admitted, Hass’s weight had dropped nearly 16% to 100.2 lbs. Hass was transported to Brookville Memorial Hospital for observation and continued care. There his condition deteriorated rapidly. On February 20th Hass passed away.
Lobin blamed Boll and Noff for what she called Hass’s “unnecessary and wrongful death.” Lobin retained counsel and filed suit against Boll Nursing Home and Noff.
The Medical Negligence Lawsuit…
In her lawsuit, Lobin claimed:
- Medical Malpractice on the part of Robert Noff, M.D.
- Medical Malpractice on the part of Boll Nursing and Rehabilitation Center, LLC.
- The Untimely and Wrongful Death of Hass
- A loss of Companionship and Affection shared with Hass
Boll and Noff filed their respective General Denials and Answers to Lobin’s allegations in her medical negligence lawsuit. Boll and Noff contended they provided care for Hass which was “standard and reasonable.” They also contended every action they took to care for Hass was medically sound and consistent with the standard of care owed to all patients.
The attorneys for the defendants called Dr. Robert Noff and Boll’s Senior Nursing Administrator to testify. Both witnesses contended Lobin’s decision to feed Hass solid food was a contributing factor in Hass’s death.
Because of Lobin’s decision, they testified, Hass consistently and gradually regurgitated his food, unable to swallow much of it, and that regurgitation and inability to swallow resulted in Hass’s malnourishment and premature death.
They went on to contend that although Hass’s health was rapidly deteriorating, Noff and Boll acted reasonably and within the customary standard of care by transporting him to Brookville Memorial Hospital. Once at the hospital Noff and Boll passed the control and care of their patient to the hospital. The defendants contended the intervention of the hospital may have contributed to Hass’s death.
After hearing the admitted evidence in the case and the arguments of counsel, the Court ruled as follows:
In a medical negligence lawsuit, the elements to support a medical malpractice claim are proof a medical care provider deviated from the ‘Standard of Reasonable Care’ and the deviation resulted in harm to a patient.
Lobin failed to present admissible evidence to show the defendants took any affirmative action which was a deviation from the standard of reasonable care. Lobin also failed to present any admissible evidence to show the defendant omitted care of a type which would support a conclusion the omission was a deviation from a standard of reasonable care.
Absent proof the defendants deviated from a standard of reasonable care, or other admissible evidence to support the plaintiff’s allegations of medical malpractice, we conclude neither defendant Boll nor Noff were responsible for medical malpractice or the wrongful death of the patient Hass.
Absent a finding of medical malpractice and wrongful death we further conclude the plaintiff’s allegations of “loss of companionship and affection they shared with Hass” to be wholly unsupportable.
We find against the plaintiff and for the defendant. The plaintiff shall take nothing.
Allegations of malpractice are often difficult to prove in a medical negligence lawsuit. Since there does not exist an objective way of calculating what is the reasonable care for a patient, the burden will always fall upon the plaintiff to provide enough evidence to the Court to prove a medical professional’s behavior was clearly and unnecessarily harmful to their patient.
Even more difficult to prove is the link between alleged medical malpractice and the wrongful death of a patient. To prevail in a wrongful death case there must be a causal relationship between the specific commission of an act, or the omission of an act which can be directly linked to the death of a patient.
*This case example is for educational purposes only. It is based on actual events although names have been changed to protect those involved. Any resemblance to real persons or entities is purely coincidental.
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