Expert Testimony Required In Lawsuit Against Nursing Home

JANUARY 24, 2000 VOLUME 7, NUMBER 30

Fred O. Thompson lived in the Embassy Rehabilitation and Care Center in Iowa. While there, he developed serious bedsores, ultimately requiring surgery to repair the damage. After his recovery, he brought suit against the nursing home, alleging negligent care. His complaint was dismissed by the Iowa courts.

Mr. Thompson was in his early 40s when he suffered a series of strokes between 1985 and 1987. As a result of those strokes, he was unable to speak or move any of his limbs. He moved into a nursing home in 1988.

Six years later, Mr. Thompson was found to be suffering from osteoporosis when he was admitted to a local hospital for treatment of a leg fracture. After a brief hospital stay, he returned to the nursing home.

Once he was back at the nursing home, staff noticed that he had developed ulcerated bedsores on his left buttock. After consultation with his attending physician, they began treatment with a special ointment, and provided an air flotation cushion. An enterostomal therapy nurse (one who specializes in dealing with pressure sores, ostomies and similar problems) was assigned to follow Mr. Thompson.

Through all of this effort, it became clear that one important component of Mr. Thompson’s treatment needed to be relief of the pressure on the affected area. His attending physician and the enterostomal therapy nurse both agreed that he needed to be moved into a new position every two hours, and that his weight should be kept off the worsening ulcers.

Unfortunately, Mr. Thompson himself refused to allow the staff to reposition him; he had a single position he preferred, and he insisted on being left in that position nearly full time. That position (head and feet both up, lying on his back) put most of his weight squarely on the affected area.

Finally, after his condition worsened to a “stage 4” coccyx ulcer, Mr. Thompson’s physician decided surgery was necessary. Surgical trimming and a skin graft were completed about four months after the bedsore was first noticed, and Mr. Thompson recovered quickly. Then he brought suit against the nursing home for failure to effectively treat his condition. He alleged both that surgery should have been undertaken earlier, and that the staff should have repositioned him despite his objections.

The trial court dismissed his complaint on the basis of pretrial motions, and the Iowa Supreme Court agreed. Mr. Thompson had apparently been unable to secure an expert witness who would testify that the nursing home’s care was substandard, and the court ruled that such testimony would be required to allow Mr. Thompson to even pursue his claim. Thompson v. Embassy Rehabilitation and Care Center, January 20, 2000.

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