Negligence Costs Woman Her Right Leg And Costs Nursing Home $10 Million Dollars

27 Jul 2007

INVERNESS, FL - August 21, 1999 - Maybe nursing homes will be paying more attention to complaints now. A jury has returned a $20-million verdict in a negligence lawsuit involving Citrus Health and Rehabilitation Center.

The panel found that Winifred Martin, 73, who lost most of her right leg after a toe infection spread out of control during a stay at Citrus Health, should receive $18-million in compensatory damages.

Jurors set the compensation for Mrs. Martin's husband, James, at $2-million.

The awards were solely for compensatory, and not punitive, damages. It is one of the largest pure compensatory awards in a medical malpractice case anywhere in the state of Florida.

Because jurors ruled that two of Mrs. Martin's doctors, who were not parties in the suit at trial, bore half the responsibility for the outcome of her medical case, the Martins cannot collect 50 percent of the total verdict. That leaves Citrus Health, and its management company, on the hook for a combined $10-million.

Because of the amount of the verdict an appeal is possible.

Mrs. Martin entered Citrus Health in late August 1996. She had just undergone hip replacement surgery at Citrus Memorial hospital and needed rehabilitation work, according to records and trial testimony.

An admitting nurse at Citrus Health discovered a 1-centimeter wound on Mrs. Martin's right big toe. As it turns out, Mrs. Martin had complained about the wound while at Citrus Memorial, but neither the hospital nor the woman's primary doctor, Herbert Cohen of Inverness, passed along the information.

On Sept. 3, state records showed, a podiatry consult was ordered, as well as other treatments. Four days later, Pasco County podiatrist Gordon Groundwater evaluated Mrs. Martin and ordered an X-ray and another test.

Two days later, Sept. 9, the antibiotic Cipro was ordered for 10 days.

On Sept. 16, the records said, medical staffers noted that the wound had grown and was "green . . . with drainage." Six days later, the chart indicated that the entire toe was red and that the open area was turning black.

"There has been no mention of notifying the physician of these changes in the condition of the resident's wound by the nursing staff," wrote Cindy Jones, a state nurse specialist who later reviewed Mrs. Martin's chart at the nursing home.

On Sept. 25, the staff noted that the toe became "more reddened and necrotic," according to Jones' report. The latter word means "localized death of living tissue."

"The physician was contacted and no resolution was documented in the nurses' notes," Jones wrote.

On Oct. 14, a surgeon examined Mrs. Martin and recommended amputation. The surgery cut Mrs. Martin's right leg above the knee, leaving a stump so short that she cannot wear a prostheses.

Jones' employer, the Agency for Health Care Administration, ruled that Citrus Health provided poor care and treatment to Mrs. Martin. That finding figured prominently in Mrs. Martin's lawsuit, which listed her doctor, the hospital and the nursing home as defendants.

Cohen paid $217,500 to settle his part of the case, and the hospital paid $50,000 more.

The case proceeded to trial against the nursing home's owner, Long Term Care Foundation of Charleston, S.C., and the management company, Diversified Health Services, a division of ServiceMaster.

During the trial jurors were shown an enlarged copy of Mrs. Martin's admitting orders at the nursing home. The admitting nurse had checked off the "circulatory" category, which was said to obligate staff to continually monitor her right foot and leg for signs of advancing infection.

Among other things, it was claimed that nurses failed to take her pedal pulse, which would have shown that blood flow to the lower extremities was cut off.

The jury apparently didn't think the nursing home staff did what was required for its resident, although the five-woman, one-man jury did decline to award punitive damages.

The jury found that the home's owner and management company each were 25 percent responsible for the harm done to Mrs. Martin. The panel assigned 30 percent of the liability to Cohen, and the remaining 20 percent to the surgeon who performed the amputation.

The assignment of percentages of responsibility by a jury has an impact upon the amount of an award that can be collected from each defendant. In this instance, 50 percent of the total award was assigned to doctors who were not parties involved in the trial.