Glen Burnie Pressure Ulcer Wrongful Death Lawsuit

Diggs v. Glen Burnie Health and Rehabilitation Center

Nursing HomeThis nursing home wrongful death claim was filed in Anne Arundel County after staff at Glen Burnie Health and Rehabilitation Center failed to provide adequate wound care. It was filed in Health Claims Arbitration on February 21, 2018, and it is the 88th medical malpractice case filed in Maryland this year.

  • Another wrongful death bedsore lawsuit against Glen Burnie Health and Rehabilitation Center in 2017

  • Yet another wrongful death lawsuit against this same nursing home after a fatal fall in 2016

Summary of Plaintiff's Allegations

An 82-year-old woman presented to Baltimore Washington Medical Center with complaints of weakness, dehydration, poor nutrition, and weight loss. At the hospital, she was diagnosed with Paget's Disease, a condition that occurs when the body overproduces new bone tissue and causes bone fragility. Her medical history also included chronic kidney disease, diabetes, asthma, gout, and high blood pressure. So she was certainly susceptible to pressure sores. This is, of course, all the more reason to keep close tabs on her, right?

Following her hospitalization, the woman was admitted to Glen Burnie Health and Rehabilitation Center (GBHRC). Both the admitting physician and the nursing staff noted that her skin was intact at the time of her admission. The woman's admission intake form also indicated a diagnosis of generalized weakness, leg weakness, and dehydration. Due to her decreased activity level, the woman needed help from the nursing staff to get out of bed, bathe, and eat.

When the woman was reassessed the next day, her strength and mobility had further declined. She was unable to bear weight and required maximum assistance for any movement. The woman also consulted with a registered dietician, who determined that she was a high risk for malnutrition and estimated her protein needs as 98 grams per day. Decreased mobility and poor nutrition are risk factors for developing pressure ulcers, so both of these evaluations supported the need for extra diligence to prevent the woman from developing a pressure wound.

After residing at GBHRC for one week, the woman was found to have an unstageable pressure wound on her coccyx. The nurse who conducted a skin evaluation the previous day indicated "no skin problems," but considering the wound's large size and moderate amount of drainage, it was unlikely that it just appeared overnight.

The next day a nurse observed that the wound had worsened, becoming inflamed with a possible abscess in the wound bed. The nurse notified the physician's assistant, but the PA never made a wound assessment. The pressure ulcer continued to grow. It was red, yellow, and black in color and developed a foul odor. The PA didn't complete a physical assessment until three days after the wound was first discovered. His exam was cursory at best, failing to indicate size, condition, stage, or any other description of the wound in the progress note.

Finally, after several days of a high temperature, high white blood cell count, and a rapidly worsening pressure wound, the woman was transferred to the hospital. At Baltimore Washington Medical Center, her wound was described as a Stage III sacral ulcer with purulent odor, greenish brown drainage, and surrounding erythema.Despite aggressive treatment at the hospital, the woman ultimately succumbed to the overwhelming sepsis and shock caused by her advanced pressure ulcer. Her cause of death is listed as sepsis, sacral ulcer infected wound, septic shock, and acute renal failure.

Additional Comments
  • At two points during her residency at GBHRC, the woman was assessed as a 17 on the Braden Scale. Patients are scored from six to twenty-three on the scale, with scores below twelve indicating a high risk for pressure scores. As a 17, the woman was negligently classified as only a mild risk, even though her low mobility and poor nutrition should have qualified her for a score of, at the most, 10. Because nursing homes use the Braden Scale to determine what types of preventative measures and nursing interventions a particular patient needs, the woman's inflated score likely had a significant negative impact on the quality of care she received.

  • The woman spent a total of twelve days at GBHRC before she was transferred back to the hospital. The nursing staff was supposed to perform regular physical examinations during that time, but the skin assessment section of the exam notes was frequently left blank. Even the doctor failed to perform a comprehensive skin assessment after she was notified about the ulcer, choosing to evaluate the woman while she was lying on her back, on top of the ulcer.

  • Likewise, the PA's evaluations were consistently lackluster. Because his first report about the woman's wound contained so few descriptive details, the claimant's attorneys speculate that the PA never actually assessed the wound himself and instead wrote his report based on the information that the nursing staff conveyed to him. The PA's subsequent reports continued to lack detail, and he also failed to recognize the significance of the woman's rapidly declining vital signs.

Jurisdiction
  • Anne Arundel County
Defendants
  • SSC Glen Burnie Operating Company, LLC d/b/a Glen Burnie Health and Rehabilitation Center
  • SMV Glen Burnie LLC
  • MDICS at Anne Arundel, LLC d/b/a Physicians Inpatient Care Specialists
  • Internal medicine and geriatric doctor
  • MDICS Rehabilitative Services LLC
  • Keystone Peer Review Organization, Inc.
  • Physician's assistant specializing in internal medicine and geriatrics
Hospitals Where Patient was Treated
  • Baltimore Washington Medical Center
NEGLIGENCE
  • Failing to define and implement interventions for pressure ulcer prevention in accordance with the woman's needs and recognized standards of practice.

  • Failing to adequately monitor the woman's skin condition.

  • Failing to provide a wound care consultation.

  • Failing to notify the woman's family about significant changes in her condition.

  • Failing to maintain an accurate record, thoroughly documenting the woman's condition.

  • Failing to conduct a comprehensive assessment of the woman's functional capacity.

  • Failing to appropriately respond to the woman's deteriorating condition and timely transfer her to the hospital.

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