This case takes place in Connecticut and involves a female with a history of spinal injury and limited mobility who developed a necrotic wound while she a patient in the hospital. On admission to the hospital the patient presented with a small wound on her lower back. Within the span of weeks the wound had increased in size and exhibited signs of significant necrosis. The patient was relocated to another hospital where the wound was surgically debrided. During her post-operative recovery in the hospital the patient became septic and nearly died. It is alleged by the defendants that the patient’s wound was not a pressure ulcer that later became infected (as the hospital claims) but instead was an infectious wound originating from the patient’s stay in the hospital.
Question(s) For Expert Witness
- 1) Do you routinely review records of patients similar to the one described in the case? Please explain.
- 2) Have you ever had a patient develop the outcome described in the case? If so, please explain.
- 3) Is it possible the patient could have had a better outcome if care had been rendered differently? Please explain.
- 4) Have you ever served as an expert witness on a case similar to the one described above? If so, please explain.
Expert Witness Response E-008307
I have taken care of many paras and quads who have developed extensive decubiti, some of which have led to deep infections and septicemia. It would be very unusual for a ‘spinal abscess’ to progress to a large decubitis ulcer. In addition, when these ulcers are debrided it is important to keep in mind that often the patient becomes bacteremic. Prevention of decubiti requires vigilance on the part of nursing staff, with frequent turning, off-pressuring, and special padding and beds. I am an ssociate professor of Internal Medicine, Infectious Diseases at a major academic medical center, with more than 20 years experience. Glad to assist.
Expert Witness Response E-000983
This case is right in my area of expertise and I am glad to assist. I have seen similar cases, classically nursing homes take abysmal care of sacral wounds. I see these wounds quite frequently on my practice and treat similar patients on a routine basis. I am glad to review records and tell you what cause was. I am glad to assist.