Settlement of a Case Involving the Wrongful Death of a Nursing Home Resident Who Died From an Elevated Potassium Level That Was Known But Ignored by the Nursing Home
R.A. became a resident of the skilled nursing facility after having been hospitalized with dehydration and elevated potassium and creatinine levels. Upon admission to the facility, R.A. was alert, talkative, oriented, quick to comprehend, and readily answered questions. Moreover, he was able to fully bear his own weight, transfer independently, and ambulate independently with the assistance of a walker. The Medical Director of the facility was assigned as his primary physician.
Upon R.A.'s arrival at the facility, he was taking Lotensin, Spironolactone, Celebrex, and Paxil. One day after his admission, the Medical Director ordered a blood test that revealed that R.A. was experiencing an elevated potassium level of 5.9. This lab report was submitted to the Medical Director. Inexplicably, neither the Medical Director nor the skilled nursing facillity took any action to address the elevated lab. The Medical Director also failed to examine his patient or the medications R.A. was being given and their relationship to elevated potassium levels.
Just four days after being admitted to the facility, the Medical Director determined that R.A. was suffering from a urinary tract infection. This determination was made without physically examining the patient and without a urine culture. As a result of the diagnosis, the Medical Director ordered that R.A. be given Septra for a period of ten days.
After the ten day period, a second urinalysis was ordered and came back normal. Nevertheless, the Medical Director ordered that R.A. once again be medicated with Septra. Again, the Medical Director's order was not preceded by a physical exam of the patient. In fact, at no time during R.A.'s residency at the skilled nursing facility did the Medical Director see or examine his patient. He made no orders designed to increase R.A.'s fluid intake nor any order to reduce R.A.'s potassium level.
In the last ten days of his residency at the skilled nursing facility, R.A. complained of sharp pain in his abdomen, became unable to walk, his hands were trembling, and wheelchair transfers were done with extreme difficulty. Despite his deteriorating condition, the skilled nursing facility transferred R.A. to an affiliated assisted living facility. By design, assisted living facilities provide less nursing case for their patients. The same physician acted as Medical Director for both facilities and remained R.A.'s physician.
Within hours of his arrival at the assisted living facility, R.A. was shaky, unable to stand by himself, could not walk or stand straight, and needed assistance to walk and stand. No one at the facility called his physician to report this substantial change. Within days of his arrival at the assisted living facility, R.A. made multiple complaints of back pain and pain spasms. He was so shaky that he could not hold a glass without spilling its contents, he was unable to move from his chair due to shakiness, and ate very little, if any, food. He was having such difficulty speaking that he could not be understood. Despite this dramatic deterioration, R.A.'s nurses again failed to inform the physician or R.A.'s family of these substantial changes.
Less than two weeks after his transfer to the assisted living facility, R.A.'s daughters found him slumped over in his wheelchair, unable to move, and unable to speak clearly, all within view of the facility employees. The family members demanded that R.A. be immediately transferred to a local medical center. Within hours of his arrival, R.A. died from cardiac arrest due to hyperkalemia, which is an elevated potassium level. His potassium level at the time of his death was 10.0, which is a critical level.
R.A.'s daughters initiated a lawsuit in Jefferson City, Cole County, Missouri against the Medical Director, the two facilities, and the facilities' owners and operators. During the course of discovery, the Medical Director admitted in deposition that he failed to consult the Physicians' Desk Reference (PDR), which clearly identifies that many of the drugs he prescribed for R.A. were dangerous for individuals with elevated potassium levels.
A confidential settlement was reached between each of the parties before trial.
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Upon R.A.'s arrival at the facility, he was taking Lotensin, Spironolactone, Celebrex, and Paxil. One day after his admission, the Medical Director ordered a blood test that revealed that R.A. was experiencing an elevated potassium level of 5.9. This lab report was submitted to the Medical Director. Inexplicably, neither the Medical Director nor the skilled nursing facillity took any action to address the elevated lab. The Medical Director also failed to examine his patient or the medications R.A. was being given and their relationship to elevated potassium levels.
Just four days after being admitted to the facility, the Medical Director determined that R.A. was suffering from a urinary tract infection. This determination was made without physically examining the patient and without a urine culture. As a result of the diagnosis, the Medical Director ordered that R.A. be given Septra for a period of ten days.
After the ten day period, a second urinalysis was ordered and came back normal. Nevertheless, the Medical Director ordered that R.A. once again be medicated with Septra. Again, the Medical Director's order was not preceded by a physical exam of the patient. In fact, at no time during R.A.'s residency at the skilled nursing facility did the Medical Director see or examine his patient. He made no orders designed to increase R.A.'s fluid intake nor any order to reduce R.A.'s potassium level.
In the last ten days of his residency at the skilled nursing facility, R.A. complained of sharp pain in his abdomen, became unable to walk, his hands were trembling, and wheelchair transfers were done with extreme difficulty. Despite his deteriorating condition, the skilled nursing facility transferred R.A. to an affiliated assisted living facility. By design, assisted living facilities provide less nursing case for their patients. The same physician acted as Medical Director for both facilities and remained R.A.'s physician.
Within hours of his arrival at the assisted living facility, R.A. was shaky, unable to stand by himself, could not walk or stand straight, and needed assistance to walk and stand. No one at the facility called his physician to report this substantial change. Within days of his arrival at the assisted living facility, R.A. made multiple complaints of back pain and pain spasms. He was so shaky that he could not hold a glass without spilling its contents, he was unable to move from his chair due to shakiness, and ate very little, if any, food. He was having such difficulty speaking that he could not be understood. Despite this dramatic deterioration, R.A.'s nurses again failed to inform the physician or R.A.'s family of these substantial changes.
Less than two weeks after his transfer to the assisted living facility, R.A.'s daughters found him slumped over in his wheelchair, unable to move, and unable to speak clearly, all within view of the facility employees. The family members demanded that R.A. be immediately transferred to a local medical center. Within hours of his arrival, R.A. died from cardiac arrest due to hyperkalemia, which is an elevated potassium level. His potassium level at the time of his death was 10.0, which is a critical level.
R.A.'s daughters initiated a lawsuit in Jefferson City, Cole County, Missouri against the Medical Director, the two facilities, and the facilities' owners and operators. During the course of discovery, the Medical Director admitted in deposition that he failed to consult the Physicians' Desk Reference (PDR), which clearly identifies that many of the drugs he prescribed for R.A. were dangerous for individuals with elevated potassium levels.
A confidential settlement was reached between each of the parties before trial.
Return to Recent Results.