Nursing Home Patient Falls Numerous Times, Breaking His Hip

This case involves an elderly patient who suffered from brain trauma and fell at a rehabilitation center. The patient presented to the ER with a subarachnoid hemorrhage with intraventricular hemorrhage from ruptured aneurism, with signs of hydrocephalus. He underwent coiling of the aneurysm with ventriculostomy placement and was soon stabilized. He was discharged approximately a month later to a rehabilitation center. Three days into his stay, a nurse in the facility saw that he had suffered from another subarachnoid hemorrhage and an aortic arch aneurysm. He was sent immediately to the hospital and stabilized. Afterwards he was re-admitted to the same rehab facility. During his stay he fell numerous times, eventually breaking his hip. The patient claims that the call bell was non-functioning and the staff was unresponsive. The patient is still suffering from neurological issues. The plaintiff alleges the rehab facility and its personnel did not perform their due diligence in investigating his condition, only to discover he suffered from another brain bleed 3-days after the fact. The plaintiff also alleges they failed in their duty to safely monitor the patient or take precautions to prevent him from falling and exacerbating his neurological condition.

Question(s) For Expert Witness

1. Do you routinely treat patients similar to the one described in the case?

2. Should there have been a neurological test to ensure there was no brain bleed?

3. Do you believe this patient may have had a better outcome if the care rendered had been different?

Expert Witness Response E-000779

I have treated many patients with traumatic brain injuries. Fortunately, in all my years of practice I have never had a patient suffer a fall that resulted in a brain bleed whilst under my care. The patient should have undergone neurological evaluation given his past medical history of subarachnoid hemorrhage. I believe that more immediate attention was warranted given the patient's clinical picture. I have reviewed similar cases in the past involving falls in rehab patients. I have over 30 years of experience in long term nursing.