Nursing Home Administration Expert Witness Advises on Neglected Patient’s Bedsores

A nursing home administration expert witness advises on a case involving an elderly female patient who on August 14, 2014, fractured her pelvis. A pelvic x-ray revealed a left parasymphysis pubis fracture not involving the acetabulum. She was hospitalized as an inpatient on August 18, 2014. On August 22nd, she had her first physical therapy session in the Delaware hospital. During therapy she put little weight on her left lower extremity due to pain, yet she performed ankle pumps, hip abduction and adduction, long arc quads and marching for 5-10 repetitions. Physical therapy would consist of gait training, bed mobility, transfer training, balance training and therapeutic exercise.

The patient was significantly limited due to pain in her left groin and required minimum to moderate assistance for transfers with little ambulation due to painful weight bearing. The therapist felt the patient would benefit from continued physical therapy services and recommended rehabilitation at a skilled nursing facility prior to discharge home. On August 31st, the patient was transferred to a nursing home where she relied on staff for assistance with bed mobility, transfers, toilet use and personal hygiene. Shortly after admission, she described pain in her hips at 10/10 on the pain scale and was given Morphine Sulfate. While a resident at the nursing facility, she was often left in her bed for hours at a time in excruciating pain. At times, the sheets on her bed were tucked in at the edge of her bed so that her ankles and feet were pressed downward and inward for extended periods of time. The patient developed a sacral coccygeal decubitus ulcer and severe bilateral plantar flexion contractures.