Angela in the News


VERDICTS & SETTLEMENTS

Wisconsin Law Journal

January 21, 2004

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MEDICAL MALPRACTICE:  $700,000

Injuries claimed:  Systemic sepsis caused by an undiagnosed MRSA infection at surgical site resulting in multiple debridement and permanent disability to leg and an inability to ambulate independently.

Court:  Brown County Circuit Court

Case name:  G.M. v. Parkview Manor Health & Rehabilitation Center; General Star Indemnity Company, Evanston Insurance Company and Royal Insurance Company of America

Case number:  01 CV 2005

Verdict or settlement:  Settlement

Original amount sought:  $1,000,000

Award:  $700,000

Date of incident:  Sept. 5, 2000

Disposition date:  Oct. 21, 2002; original filing date: December 2001

Plaintiffs attorney (firm):  M. Angela Dentice of Law Offices of M. Angela Dentice, LLC, Milwaukee

Defendants attorney (firm):  W. Patrick Sullivan of Hannen, Siesennop & Sullivan, Milwaukee

Insurance carrier:  General Star Indemnity Company, Evanston Insurance Company, and Royal Insurance Company of America

Plaintiffs expert witnesses, expertise:  Dr. Henry Alba, Physical Medicine & Rehab., Milwaukee; Dr. Robert DiUlio, Orthopedic Surgeon, Milwaukee; Dr. Michael Frank, Infectious Disease, Milwaukee; Karen Hobart, Life Care Planner, Roseville, MN; Karla Brabender, Nurse, Dept. of Regulation & Licensing

Defendants expert witnesses, expertise:  Jacqueline Wenkman, Life Care Planner, Jefferson

Plaintiff counsels summary of the facts:  G.M. was eighty years old on Sept. 6, 2000, when he nearly completely ruptured his left quadriceps tendon after falling at home.  He underwent surgery to repair the tendon at St. Vincent Hospital two days later.  His surgical site was wrapped in bandages, and his left leg was put in a brace.  On Sept. 10, 2000, G.M. was discharged to Parkview Manor, a skilled nursing home, for rehabilitation.  The hospital records indicated that G.M. had no bed sores, and that his surgical site did not show any signs of infection upon discharge.  The orthopedic surgeon indicated in his notes to Parkview that G.M. was to wear a brace on his left leg at all times except when bathing, and that his surgical site was to be kept dry.

The Unit Coordinator at Parkview Manor testified at deposition that she indicated on G.M.s Data Sheet upon admission that the surgical site was to be assessed every shift.  However, another nurse at the facility testified at deposition that the directive to assess and change the dressing at each shift was not written until September 18, six days after G.M.s admission.

Although the records from Parkview Manor indicate that G.M.s surgical site was observed on Sept. 12, and that the site was slightly red with no warmth or drainage, the surgical site was neither observed nor assessed by the staff at Parkview Manor for the following six days.

On Sept. 13, the family voiced concerns that G.M. was lethargic.  That evening, his temperature was 101.4 degrees.  The doctor who was on call at the nursing home ordered Tylenol and told the staff to watch him closely.  On the afternoon of Sept. 14, a urinalysis was ordered, but urine was not obtained for the analysis until later that evening.  The results were not faxed to the doctor until the following day.  On Sept. 15, G.M. was lethargic, incontinent, and was having difficulty with transfers.  A meeting was held with the unit coordinator and G.M.s family, but there was no general assessment of G.M.s condition, including his skin integrity and his surgical site, despite voiced concerns from his family.  G.M.s condition continued to deteriorate through Sept. 17, yet no doctor was contacted to examine G.M.

On Sept. 18, six days since the last time G.M.s surgical site was assessed, the physical therapists aide removed G.M.s leg brace and noted drainage on the bandage covering the surgical site.  When she removed the bandages from G.M.s leg, the surgical site was severely infected.  She noted drainage around the site, redness and warmth from above the knee to the hip and groin area, seepage along the groin, and a pocket of seeping fluid along the lateral side of the knee.

On Sept. 19, G.M.s family took him to his orthopedic surgeon.  At this that time, G.M.s leg was red and swollen from mid-thigh to calf with gross purulence from the wound.  When the doctor attempted to express the infection from the knee, a pus-like substance sprayed across the room.  The nurse witnessing the procedure was so distraught by the sight of the infection that she began crying.  The infection was so severe that G.M. was in septic shock.

Emergency surgery was performed the same day.  Because of the severity of the infection, G.M. underwent two additional surgeries to irrigate and debride the wound.

Besides his rampant knee infection, G.M. also had a 5.5 cm fluid filled blister on his right heel and a Stage II ulcer on his buttocks and his left scrotum.  He was also found to have 1200 to 1500 cc of urine in his bladder.  He was placed in intensive care for monitoring.

After several weeks in the hospital, G.M. was discharged to Woodside Nursing Home.  It was initially thought that G.M. would need an amputation of his leg to provide relief from the severe pain.  In an effort to save his leg, the orthopedic surgeon taught the nurses at Woodside how to express the infection from the wound, although doing so caused G.M. severe pain.  After several months of treatment, G.M.s knee infection was under control.  However, because of the infection, the tendon in G.M.s knee was destroyed.  G.M.s knee cannot be reconnected, and is in the state of dislocation.  He was confined to a wheelchair.

In October 2002, when Parkview manor became aware that the facility was under investigation, the administration of Parkview Manor asked the nurses to complete addenda regarding their assessment of the surgical site.  All of the nurses who cared for G.M. were contacted, and several of the nurses completed addenda.  Certain statements found in these addenda are inaccurate and do not comport with the contemporaneous nursing home records and with what the course of the infection would have been.

A lawsuit was initiated against Parkview Manor Health & Rehabilitation Center, Centennial Health Care Investment Corporation, General Star Indemnity Company, Evanston Insurance Company, and Royal Insurance Company of America.

 The defense to the claims was that the nurses did observe the surgical site and that the infection was not observable until Sept. 18.

 The negligent care provided to G.M. by Parkview Manor was reviewed by the State of Wisconsin, Department of Health and Human Services.  Parkview Manor was issued two Class B violations, the highest level of violation one for failure to assess and monitor the surgical site, and one for the development of the dicubiti.

 G.M.s past medical specials were $197,566.33.  The case settled prior to trial at mediation for $700,000.