This bariatric nursing case involves an overweight, elderly patient who was being taken care of in a home health setting. The Defendant company reported that the patient was doing well under their care to distant friends and relatives. At one point, a friend came to visit the patient and noticed that he was covered in sores and ulcers. An ambulance was called and the patient was taken to the hospital, where it was noted in the ER that the patient was in poor condition and was likely suffering from a systemic infection. Testing confirmed that the patient was suffering from a blood infection, and he lingered in the hospital for several weeks before passing away. It was alleged that the patient was not monitored adequately by the home healthcare providers, which led to the development of sores on his body and, eventually, to his blood infection.
Question(s) For Expert Witness
- 1. Do you have experience treating obese and elderly patients?
- 2. What are the proper ways to prevent sores and ulcers in elderly patients?
- 3. How frequently should a patient like this be monitored?
Expert Witness Response E-043852
I have experience treating elderly patients, many of whom are obese. I am an RN with a Masters Degree in Nursing Administration, with minors in Business Administration and Health Services Administration. I have been in Home Health for nearly 40 years, and I have been an Administrator in Home Health, Hospice and Private Duty for nearly 30 years. I run a national consulting firm serving clients in home health, hospice and private duty. I have served as a nurse expert witness for other home health related cases in the past. Allowing a patient’s condition to deteriorate to this level is absolutely outside of the standard of care, as is falsely reporting that the patient is doing well to friends and family. A patient in this condition likely experienced an extended period of neglect by his care providers.
Expert Witness Response E-008690
I have over 20 years of experience as an enforcement monitor for home health and hospice, and I have also served as a home health consultant for 20 years. I teach nursing LVN level as well. There are numerous ways to prevent sores in patients. The National Pressure Ulcer Advisory Council is the authoritative resource for the standards of care. A patient like this should be monitored frequently. It is unknown what his risk factors were other than the patient’s obesity and age, so a plan of care would be developed based that includes all of the relevant factors. Regardless, it is clear that no such plan was developed or implemented in this case, which is a clear case of extended neglect.