Nursing Home Abuse Lawyer Blog

Connie Jean Beckerman, a former bookkeeper at Perry Oaks Nursing and Rehabilitation Center in Perryville, Missouri has pleaded guilty to stealing from the facility's residents.

Beckerman reportedly stole more than $14,500 between September 2006 and October 2007 by forging the nursing home administrator's signature on checks written for cash. Most of Beckerman's victims were Medicaid residents at the facility.

Beckerman pleaded guilty to one count each of forgery, stealing by deceit, and abuse of a person receiving health care funds by taking the funds. Her sentencing is set for August 13, 2010.

A careless teenage prank is being blamed for the death of a 101 year-old nursing home resident.

Mildred Ellefon was injured when a car crashed through a wall at Palisade Manor, a nursing home in Garretson, South Dakota. Ellefson initially was treated at a local hospital and returned to the facility, where she later died.

The accident happened as three people were waiting on the parking lot of the nursing home for a friend to get off work. The eighteen year old driver, Clarrissa Kutil, decided to play a trick on the two sitting on the trunk of the car and revved the engine. She accidentally shifted the car into reverse and crashed through the wall of the facility. She was cited for careless driving and no driver's license but could face more charges.

Five people have been charged in connection to a deadly 2008 retirement apartment house fire in Vallejo, California that killed three men after authorities determined that the fire alarm system at the facility was faulty.

The owners of Casa De Vallejo, Ruben Islas and Jules Arthur, were charged with two counts of elder abuse causing death, two counts of manslaughter, and one count of elder abuse in connection to the deaths of three men living at the facility. Three others are also facing charges in connection to the deaths: Martha Islas-Enriquez, CEO of Vallejo Housing Partners, Jeremy Turner, Director of Construction Management, and Michael Hagigeorgio, the project manager for the fire alarm installation at the facility. Currently, four of the five people have been taken into custody and are being held on $250,000 bail each.

The August 15, 2008 fire was determined to be accidental and started with a "careless and negligent act(s)", not limited to smoking near oxygen tanks". Fire investigators found that 68 year-old Robert Bennett, who lived in Room 606, either fell asleep, became intoxicated and lost consciousness, or suffered a incapacitating medical event and died. Bennett's room was the origin of the fire that displaced more than 100 residents and caused $6 million in damages at the seven story complex probably suffered 'a medical event' in Room 606. The coroner found that Bennett's blood alcohol level was 0.28, more than three times the legal limit. Seventy-four year-old John Argente and sixty-one year-old Harold Fortune also died in the fire.

Reportedly, the manual fire alarm system was being upgraded at the time of the fire to add strobe devices and a new fire alarm control panel.

Just one year after being warned that it needed to secure areas in its dementa unit to prevent residents from having unsupervised access, a ninety-three year old Florida assisted living resident died from severe burns of the esophagus after drinking sodium hydroxide solution.

Michael Gruen, who suffered from the late stages of Alzheimer's, lived at Homewood Residence at Delray Beach, an assisted living facility in Delray Beach, Florida. Early in the morning on December 28, 2009, Gruen managed to enter a satellite kitchen at the facility through a split door while facility staff were busy with another resident. While one half of the door was locked, Gruen reportedly reached around and unlocked the other half to enter the kitchen. There, he was found standing over the dishwashing detergent container but couldn't tell facility staff if he had swallowed anything. By the time paramedics arrived, Gruen was lying on a couch, drooling. He died eighteen hours later from severe burns to his esophagus.

The question facing this facility is how a resident suffering from dementia could have access to this dangerous product if the area was to be secured and they had already been warned by the state. A Homewood Resident parent company spokeswoman said that there was no way staff could have predicted the events that led to Mr. Gruen's death. Really? People suffering from dementia wander and open doors. People with dementia put things in their mouths that they shouldn't. Sounds predictable to me.

The facility faces a $10,000 state fine related to the incident.

A surprise inspection yesterday at an Illinois nursing home yielded an unusual find: a Missouri fugitive.

Illinois Attorney General Lisa Madigan, accompanied by St. Clair County Sheriff Mearl Justus, Illinois State Police officials, officials from the Illinois Department of Public Health, the Illinois Department on Aging, and the Illinois Department of Professional Regulation, made the unannounced inspection at Virgil Calvert Nursing & Rehabilitation Center in East St. Louis, Illinois on Thursday, June 24, 2010 around 10:00 a.m. The facility experienced problems earlier this year with health and safety issues.

During a review of resident backgrounds at the facility, investigators uncovered that resident Rothford Darden, 61, was wanted on an active Missouri drug warrant. Darden was taken into custody by St. Clair County Sheriff's Deputies. According to Attorney General spokeswoman Cara Smith, "He knew he was wanted. He seemed perfectly able-bodied. These nursing homes have been turning out to be the perfect place for hiding out. We've found wanted people in every one" (that has been checked so far). According to Madigan's office, in the twelve facilities inspected to date, 61 people under active warrants were living in the facilities and 17 arrests were made immediately at the facilities.

By law, nursing homes are required to perform background checks on their residents and staff and make arrangements if housing residents with criminal histories, such as sexual offenders and others who could harm fellow residents.

An Illinois nursing home faces a lawsuit filed by the administrator of a deceased resident's estate for negligence. The Lincoln Home, a nursing home facility located in Belleville, Illinois, reportedly violated the rights of resident Wealthie Lee Lockett during her the time of her residency, January 18, 2008 through the date of her death on December 18, 2008.

Annie McClatchery, the administrator of Ms. Lockett's estate, filed a lawsuit on May 25, 2010 in St. Clair County Circuit Court against The Lincoln Home and Weiss Management Group. During Ms. Lockett's residency, she sustained a comminuted left femur fracture and other injuries, as well as mental anguish and emotional distress.

The suit seeks in excess of $100,000 plus attorney's fees and costs.

Registered nurse Angela Almore was charged with second degree murder on June 7, 2010 after a nursing home resident in her care died.

Almore, a registered nurse employed at Britthaven of Chapel Hill in North Carolina, reportedly gave a dose of unprescribed morphine to 84 year-old Rachel Holliday, an Alzheimer's resident who later died. The medical examiner attributed Holliday's death to pneumonia from asphyxiation and reported that the levels of morphine in her system likely contributed to her death.

Almore was also charged with six counts of felony patient abuse after other Britthaven reportedly became lethargic and had to be hospitalized. Testing revealed that all of the affected residents had morphine in their systems, although none of them had been prescribed the drug.

The investigation continues.

A Wisconsin woman has been charged with two counts of burglary and two counts of intentionally subjecting an at-risk person to abuse in connection with the theft of narcotic medications from a nursing home resident.

Emily Stibbe, a former employee of Colony Oaks Care Center who was fired on January 5, 2010, reportedly entered the nursing home on multiple occasions and removed Fentanyl patches from a resident. The resident reported that Stibbe entered his room on January 19 to see if his Fentanyl patch was working. She did not come back and when the resident asked about the pain patch, he was told that a staff member did not take it. Stibbe reportedly had entered the man's room on January 17 and took his patch.

On January 22, the resident was ready for Stibbe. The resident grabbed Stibbe and yelled for someone to call 911. Stibbe nearly pulled the man from his bed attempting to get away. The resident was bruised from the incident.

Stibbe admitted the thefts to police and admitted to having a drug problem.

All four charges Stibbe faces are felonies. Each burglary count carries a maximum penalty of 12.5 years in prison and $25,000 in fines. The abuse counts carry maximums of $10,000 in fines and 6 years in prison.

Angela Broihahn, a former Wisconsin nursing home aide, was charged with six counts of patient abuse, one count of attempted patient abuse, and four counts of possession of narcotic drugs in connection to reportedly stealing pain medication patches from three residents at St. Mary's Care Center.

On March 11, 2010, facility Director William Bender caught Broihahn red-handed with three Fentanyl patches in her purse, all with the initials of the nurses who had placed them on the residents.

Reportedly, one resident complained to a facility nurse that an employee she did not know would visit her often, rub her back and was "huggy". On March 6, a nurse found that a pain patch placed on a resident the previous day was missing. A few days later, the same thing happened again.

Patches were reportedly stolen from a 63 year-old terminally ill resident. A third resident, an 88 year-old woman, told police that "Angie" was trying to take her patches on March 9, but she stopped her.

Fentanyl patches are three day pain patches that must be administered by a nurse. They take up to 24 hours to reach maximum effectiveness and 24 hours after the patch is removed, the pain medication has left the body.

PRESSURE RELIEVING DEVICES AND THEIR EFFECT ON BED SORES

Sixth in series

Over the past several days, Jonathan Rosenfeld and I have outlined several of the most common ways bed sores develop in nursing home residents and hospital patients. In this last entry of the series, we focus on pressure relieving devices. As we have seen, there are numerous ways caregivers can help alleviate or prevent bed sores. Proper hydration and nutrition are important as is preventing the development of contractures and keeping residents clean and dry. Patients at risk for developing bed sores or with existing bed sores, must also be turned and repositioned at least every two hours pursuant to federal regulations. When not being repositioned, it is still important to do everything possible to protect the patient from developing bed sores. That is where pressure relieving devices may be utilized.

 USE A PRESSURE-REDUCING MATTRESS, BED, OR WHEELCHAIR. Use of a pressure-reducing mattress, bed, or wheelchair can help alleviate pressure to areas susceptible to the development of pressure sores.

 MATTRESSES. There are many mattress options, such as foam, air, gel, or water. Frequently, physicians suggest the use of low-air-loss beds or air-fluidized beds. Low-air-loss beds use inflatable pillows to support the individual while air-fluidized beds uses thousands of silicone beads to suspend the individual. A physician will be able to direct you to the best option for your loved one.

Early stage bed sores are often treated by mattress overlays, such as eggcrate, Derma Tech, Silicore, Alternating Pressure System, and multi-zoned, or special mattresses designed to help heal or prevent bed sores.

The eggcrate overlay is a 4” foam bed pad is probably the cheapest option available. It is typically placed on top of the mattress for additional protection for pressure points. Foam overlays less than 4” do not provide enough protection from pressure to prevent pressure sores (provides comfort only). Keep in mind that foam products lose their effectiveness after only a few months and need frequent replacing.

A Derma Tech overlay is a foam mattress overlay. It is considered a higher quality product than an eggcrate overlay and may do a more effective job of preventing or treating existing bed sores. The Silicore overlay is a mattress overlay that is designed to prevent skin breakdown before it occurs. It is made of siliconized hollow core shafts that do not collapse when pressure is applied. Again, this is a higher technology than foam and may be more expensive.

An Alternating Pressure System mattress overlay is a mattress system overlay that may help nurses from having to turn and reposition the resident every two hours. However, it still requires supervision and should not be used as an excuse to ignore the resident. A physician should be consulted with respect to the turning schedule for those utilizing the Alternating Pressure System mattress. The APS mattress overlay employs changing air pressure to improve the patient’s circulation, which is critical for those at risk for bed sores. The pad consists of uniform air tubes that inflate and deflate approximately every four minutes.

A lateral turn/rotation mattress is useful for patients who require frequent repositioning. These mattresses automatically turn patients laterally to assist in changing their body position.

 WHEELCHAIRS. Pressure-release wheelchairs are designed to tilt to redistribute pressure in wheelchair-bound people. If your loved one does not have a pressure-release wheelchair, a caregiver will need to manually change the individual’s body position every fifteen minutes. Pressure relief air chairs are mattress pads designed to fit into wheelchairs or onto a chair for pressure sore relief while seated. The air chair pad is especially useful for those patients who are not bed-bound but have difficulty ambulating on their own. If a nursing home resident is at risk for bed sores, but prefers to be mobile, an air chair pad may be just the thing.

 PADDING: Mattresses, mattress overlays and wheelchair pads are all good things, but sometimes, they do not address some of the areas most at risk for developing bed sores. To that end, podus boots, posey comfort pads, and sheepskin wrist, elbow and heel pads are used to help alleviate pressure on bony projections, such as hipbones, elbows, wrists, and ankles.

What do pads, overlays and mattresses all have in common? They are designed to prevent the development of bed sores and or treat bed sores once they have occurred. Nursing homes often fail to do the necessary assessments on their residents to determine whether they are at risk for bed sores. Worse yet is when they do the assessments, but fail to implement the strategies necessary to prevent the development of bed sores. Sadly, the failure to implement is often the result of budgetary restrictions forced on the nursing home facilities by the corporate offices or the lack of proper training. Without utilizing the technologies, nursing home residents and hospital patients are substantially more likely to develop potentially life threatening bed sores.

Family member tips

If your loved one is at risk for developing bed sores or currently has bed sores you should:

• Talk to the nursing home and insist that your loved one receive all proper pressure relieving devices
• Visit the nursing home regularly and at different times. If the device is in use, insist that it be used
• Talk to the Director Of Nursing if you notice proper pressure relieving devices not being consistently used for your family member

In the fifth of our series on 6 common causes of bed sores, Chicago attorney Jonathan Rosenfeld focuses his attention on turning and repositioning. If a nursing home resident or hospital patient is prone to the development of bed sores, that patient must be turned and repositioned regularly. Jonathan addresses that issue in detail today on his nursing home abuse blog. To read his important entry, go here.

After a lengthy investigation, the Missouri Department of Health and Senior Services (DHSS) uncovered serious violations after investigating allegations of physical, sexual, and verbal abuse of residents at K. F. Jammer Manor, a Missouri veterans' nursing home located in University City.

The DHSS began investigating the facility in April 2010. According to a recently released 21-page report, one resident made two allegations of rape, but facility staff failed to call police or call the hotline, as required by law. The resident affected called 911 and reported the incidents. The same resident alleged that she and a facility housekeeper were involved in a sexual relationship. According to the report, "During an interview the Director of Nursing said the resident alleged he/she had a sexual relationship with Housekeeper #1. Due to the resident's allegations, staff moved the housekeeper to the facility's other location. The Director of Nursing did not report any allegation of rape or a sexual relationship because, according to the report, she did not believe they happened.

In another instance, a staff member sent a text message to another staff member about a manger who reportedly gave a resident $3.00 in exchange for oral sex. According to the Director of Nursing, she did not tell anyone about the message, talk to the resident, investigate the alleged message, or do anything related to the message.

The same investigation found that facility staff failed to protect two residents who were spit on, had hair pulled, had water thrown on them, and were constantly called racially charged names or degrading names.

The Veterans Administration (VA) began moving its 36 residents from the facility back in April 2010, when the allegations were first reported. Currently, there are two residents remaining at the facility. The VA assisted its residents in finding other facilities. Of the two residents remaining, one resident desired to stay, but now that resident's legal guardian has requested a move to a different facility. The second resident is in the process of relocation.

The University City Police are investigating the allegations of rape. The Director of Nursing is no longer employed at the facility.

This is part 4 of a series Jonathan Rosenfeld and I are doing regarding 6 common causes of bed sores in nursing home and hospital patients. Today, we are discussing contractures.

What are contractures? People who are physically inactive for long periods of time are at risk for developing contractures. Obviously, many nursing home residents suffer from inactivity due to mental infirmities or physical limitations. As a direct result of physical inactivity and the failure to regularly move a limb or joint through its full range of motion, muscle fibers begin to break down and joints begin to stiffen, which can lead to the affected limb slowly pulling toward the body and becoming rigid. It is not uncommon to see nursing home residents with contracted hands, arms, or legs, oftentimes leaving them in the "fetal position" making it very difficult to give them the care they require.

Are contractures preventable? Contractures are very painful and the process of restoring a person's range of motion can be excruciating. Consequently, prevention is substantially better than restoration. Sadly, many nursing home residents who suffer from contractions do so because some nursing home facilities lack a sufficient number of staff members or the staff members fail to provide the proper preventive measures. To prevent contractures, the nursing staff should properly assess the resident's risk for contractures and implement an individualized care plan. The purpose of the care plan is to make all nurses aware of the methods to use for that particular resident to prevent the resident from developing contractures. Periodically, the resident should be re-assessed and an updated care plan prepared, if needed.

Using the following methods can help prevent or lessen the severity of contractures:

EXERCISE

Range of motion exercises are arguably the most important weapon in preventing contractures. For residents in nursing homes, facility staff need to take the time to properly exercise and stretch the limbs and joints of immobile residents. Passive range of motion exercises (those which involve gently rotating the at-risk body parts clockwise and counterclockwise) should be performed at least twice a day. For example, to prevent hand contractures, each finger should be gently stretched and rotated as far as possible. Properly trained nurses and nurse aides should understand the dangers of contractures, the simple exercises that can be done to prevent them and the short amount of time it takes to perform these exercises. Nurse aides can perform some of these exercises while bathing the individual or while changing their clothes. Physical therapists, obviously, are more aware of the dangers of contractures and the exercises used to prevent them. For those residents at risk of developing contractures, nurses should seek assistance from the physical therapy staff.

POSITIONING

The position of nursing home residents is crucial. If a nursing home resident can sit in a chair, staff should make sure that the resident is properly seated with their feet resting comfortably on a flat surface, such as a foot lift. Dangling feet can lead to "tip-toe" contractures. To prevent leg contractures, the resident should not be allowed to sleep with her legs in a bent or twisted position. Rather, pillows or cushions should be placed between the legs to help prevent contractures.

SPLINTING

Splinting devices can be very useful in helping prevent painful and debilitating contractures. Examples of such devices include special boots and wrist splints can be used to help prevent fingers and toes from drawing up and stiffening. Knee and elbow braces are also an option to help keep those joints from stiffening in place, but will still allow the resident free range of motion.

Contractures can develop quickly and frequently affect the hands, feet, legs, and arms. In the event of a person who has severely contracted, restoration, if possible, can take up to one year and can be an excruciating process of the affected person. Splinting devices can help prevent your loved one from having to go through the pain of trying to reverse contractures.

If you have a loved one who is at risk for contractures or who has contractures, what should the nursing staff do?

According to nurse Suzanne Frederick, "Nurses should follow the nursing process by properly assessing the resident's risk for contractures and implementing an individualized care plan to prevent and/or treat the limited range of motion or contracture. Once a resident is recognized as at risk for contractures through proper assessments, the nursing staff should implement a range of motion exercise program for the resident based on his/her functional ability. The consistent implementation of the range of motion exercise program should be documented in order to evaluate the resident's response to this treatment."

In addition to common sense nursing practices, nursing homes should follow the federal regulations that apply to residents who have or who are at risk for contractures. For example, federal regulation 42 CFR §483.25(e)(2) states:

"Based on the comprehensive assessment of a resident, the facility must ensure
that -- A resident with a limited range of motion receives appropriate treatment and
services to increase range of motion and/or to prevent further decrease in range of
motion."

If you have a loved one who is at risk for contractures or who has contractures, what should you do?

• Insist that your loved one receive stretching exercises twice daily.
• Insist that all necessary preventive devices are used.
• Visit often and make sure that staff members are attentive to the needs of your loved one.
• Be respectful, but firm that your loved one receives the care they deserve.

Unlike some problems and physical limitations that can be easily reversed, contractures are an especially troublesome issue given the difficulty associated with reversing the process. Family members should not hesitate to ensure that their loved ones receive the care they need and are required.

In the third installment of our series on 6 Common Causes of Bed Sores, Chicago attorney Jonathan Rosenfeld addresses the important issue of how the lack of cleanliness and incontinence contributes to the development and worsening of bed sores. He also provides 4 important tips to caregivers on how to keep a resident clean and how to reduce the danger to a resident who may be prone to episodes of incontinence.

This is the second in a six part Series I am doing with Chicago, Illinois attorney Jonathan Rosenfeld on 6 common causes of bed sore development.

Some studies have shows that 35 to 85 percent of nursing home residents are malnourished. The causes vary as to why so many nursing home residents suffer from malnourishment. In most cases, the cause of malnourishment is not that nursing homes don't provide proper diets; in most cases they do. Rather, the root cause appears to be an inadequate level of food intake by the nursing home resident. So, what causes nursing home residents to take in less food than they need? Cognitive and physical impairments can certainly affect a resident's ability to eat. Swallowing disorders (dysphagia), poor oral health, medications, and changes to taste and smell can all contribute to a lack of desire to eat. However, many of these impairments can be overcome with an attentive and active nursing home staff. For example, a 1988 study of nursing home residents determined that 55% had some degree of dysphagia that affected their food intake. Yet, only 22% of those residents had been assessed by the nursing home and referred for evaluation to a speech therapist. In short, nearly 80% of those in the study found to have mild to profound dysphagia were not recognized by the nursing home staff as having any correctable problems with respect to nutrition intake. While the two may seem polar opposites, insufficient staffing within nursing homes can also have a direct effect on nutrition deficiencies of nursing home residents.

In many nursing homes, staff members fall woefully short of standards set forth in the Nursing Home Reform Act of 1987 (also known as the Omnibus Budget Reconciliation Act of 1987 or "OBRA"). While the law requires that the nutritional needs of nursing home residents be met, oftentimes, the results simply do not match the requirements.

It is well known that the lack of adequate nutrition can result in malnourishment which, in turn, can lead to a host of physical and mental problems, including increasing the risk of developing bed sores. (For more general information on bed sores, visit Terry Law Firm, LLC or visit Jonathan Rosenfeld's Nursing Homes Abuse Blog.) In fact, according to nutritionist Janet McKee of Nutritious Lifestyles, Inc., "Involuntary weight loss of 4% or greater is correlated with negative outcomes and the development of pressure ulcers in the geriatric population." When a person becomes malnourished, they tend to lose body fat, which provides a barrier between the skin and bone in our bodies. That barrier allows blood to freely flow throughout the body. When the body fat disappears and pressure is placed on that area of the body, the flow of blood is inhibited. When blood flow is depressed, the skin begins to die, creating the beginnings of a bed sore.

How Can Bed Sores Caused By Nutritional Deficiencies Be Treated?

When nutritional deficiencies are the likely cause of a bed sore, the best way to treat the problem is to fix the problem. Obviously, when a resident has developed a bed sore, the bed sore must be treated by a health care provider proficient in wound care. Nutritionally, there must be a thorough review of the resident nutritional needs, taking into account the nutrients being lost through the wound itself. Janet McKee states that "adequate protein intake is an essential component for skin integrity and pressure wound healing. Accordingly, protein recommendations to promote healing are 1.2 - 1.5 grams protein per kilogram of current body weight." Only the nursing home facilities can arrange for the resident to receive a full nutritional assessment so the bed sore can be properly healed.

One of the big fallacies surrounding bed sores is that once you have one, it is virtually impossible to heal. That is simply not true. With proper nursing care and nutrition, even deep, Stage IV bed sores can be healed.

An Illinois nursing home faces a lawsuit in St. Clair County Circuit Court after a resident died while in their care.

The lawsuit was filed May 4, 2010 by Shirley McManus against Caseyville Nursing and Rehabilitation Center and Caseyville Property alleging that Newton J. McManus, Jr. died after the facility failed to provide adequate care, failed to protect him from abuse and neglect, failed to notify his physician of significant changes in his condition, failed to institute a regular treatment program to address his pressure sores, and failed to ensure that he maintained his body weight.

Newton J. McManus, Jr. was admitted to Caseyville Nursing and Rehabiltation Center on May 8, 2008 and developed ischemia, a condition characterized by pain, gangrene, and non-healing wounds. Additionally, Mr. McManus developed a urinary tract infection, decubitus ulcers, and suffered from malnutrition and dehydration. He died on May 31, 2008, not even a month after his admission to the facility.

Shirley McManus is seeking a judgment of more than $150,000 in addition to attorney's fees and expenses.

Beginning on Monday, June 7, 2010, Jonathon Rosenfeld and I will do a series of blog entries on 6 common factors that result in bed sores. Bed sores are devastating injuries that commonly affect elderly residents in nursing homes and hospitals. In most cases, bed sores can be prevented. However, prevention measures take time, patience, and persistence, all of which require attentive caregivers. All too often, nursing home owners are unwilling to provide the budget necessary to have a sufficient staff that can tend to the needs of nursing home residents, including measures necessary to prevent the development of bed sores.

The six factors that we will address are:

(1) Dehydration
(2) Nutrition
(3) Incontinence/cleanliness
(4) Contractures
(5) Turning and repositioning
(6) Lack of pressure relieving devices

Throughout this blog series, bed sores may be referred to as pressure sores, pressure ulcers, and decubitus ulcers. Keep in mind that each of those terms are usually used interchangeably when discussing bed sores. Bed sores are typically discussed by stages. Stage 1 is the earliest stage of a bed sore and the easiest to correct. Essentially, a Stage 1 bed sore presents as a red spot on the skin, usually over a bony prominence. Stage 2 bed sores usually present as a shallow open wound with a pink bed. If caught quickly, Stage 2 bed sores can easily be healed. A Stage 3 bed sore is an open wound where subcutaneous fat can be visualized. While a Stage 3 wound can have tunneling and undermining, bone and tendons are typically not yet visible. Stage 4 bed sores are the most serious and most difficult to heal. With a Stage 4 bed sore, one can often see the bone in addition to tunneling, eschar and slough. For pictures and more information on bed sores in general, visit the Terry Law Firm website here or Jonathon Rosenfeld's Nursing Home Abuse blog here.

It was a good day for the plaintiff's attorneys present in Judge Andreas Matoesian's courtroom on June 2, 2010.

Doug Mendenhall represented the family of Jane Schwartz, a Rosewood Care Center of Alton resident who was severely injured in a fall at the facility in which she broke her wrist and hip. A lawsuit was filed in Madison County, Illinois after her death by Clifford Emons, the Special Administrator of Schwartz's estate, to preserve the statute of limitations.

The 2004 case went to jury trial in September 2009. The jury only considered the damages portion of the case after Judge Matoesian struck the defense's pleadings and directed the verdict in favor of the plaintiff. The jury subsequently awarded $5,000 for negligence and $15,000 violations of the Nursing Home Care Act.

Plaintiff's attorneys asked for $87,625 in fees and $11,943.82 in court costs. The fees were based off of an hourly fee of $275. Defense counsel Dennis McCubbin argued that a $99,000 fee would set a bad precedent to award such a fee in a case with such a small jury award. According to McCubbin, plaintiffs would refuse to settle cases knowing they could obtain "outlandlishly larger" attorney's fee awards if they drug their feet and suggested that Judge Matoesian award attorney's fees only in the amount of the jury damages award or at most twice that amount.

Judge Matoesian stated that Illinois' Nursing Home Care Act and its fee provisions were designed to encourage attorneys to take the often difficult cases. "It should not be based on a percentage," according to Matoesian.

A fifth Minnesota nursing home resident has been burned by a portable heater. In all five instances, the nursing home facility was found to be negligent by the State of Minnesota.

In January 2010, a hospice resident at Benedictine Health Center in Duluth, Minnesota suffered second degree burns after the calf of her leg rested on the heating element of a portable heater. The resident died that day, but her death was not attributed to her wounds.

Also in January 2010, a resident at Redeemer Health and Rehab, a nursing home facility in Minneapolis, Minnesota, was burned after physically contacting a radiator. He was taken to the hospital with second and third degree burns and died approximately four weeks later.

In December 2009, a Gracepointe Cross Gables West nursing home resident burned three fingers on a heat register located one inch from his bed,

In January 2009, a Alzheimer's resident at Golden Living Center - Meadow Lane suffered first and second degree burns after lying on top of a radiator at the facility. She died nine days later, but her death was not attributed to her injuries.

In November 2009, a dementia resident at Emmanuel Nursing Home in Litchfield, Minnesota was discovered with her leg hanging over the edge of her bed. The leg had contacted electric heat register and the blisters on her left foot "nearly doubled the height of the foot".

Sixty-five year old Anita Ramirez was admitted to LifeHouse Parkview in Bakersfield, California after being cared for at Bakersfield Heart Hospital for blood pressure problems for treatment for a bed sore. Ramirez's bed sore required her to be turned every two hours and have an IV antibiotic. Within two weeks of her admission, something was obviously wrong and her daughters called police.

With police assistance, Ramirez was released from LifeHouse and taken to the emergency room at the Heart Hospital for treatment. After an examination, physicians reportedly determined that Ramirez was suffering from burns all over her body. According to her daughter, Patricia Dias said, "She literally has no skin left on parts of her body." Her daughter further said, "The doctor said this should have been looked at a long time ago...They believed that it was a reaction to all the antibiotics she's been on for the last year."

Ramirez is in critical but stable condition at San Joaquin Hospital burn center. A detective with the Bakersfield Police Department will be assigned to investigate the case.

On July 1, 2009, emergency responders received a call about a dependent adult at an unlicensed board and care home in Solano County, California.

Sixty-two year old Charles Frank was a ward of the state and reportedly died at Sutter Solano Hospital from starvation and dehydration. His autopsy found evidence of severe neglect.

On May 26, 2010, after an investigation, the care home's manager and business owner were arrested. Patricia Ronquillo and Gene Bambo were booked into the Solano County Jail on $25,00 bail each. Police expect to make more arrests in the case.