§13.5A Linking Negligence to Injuries or Death
The Case: Wilson v. Americare Systems, Inc., 397 S.W.3d 552 (Tenn. 2013).
The Basic Facts: Assisted living facility resident died from a perforated colon after severe misadministration of prescribed enemas. Daughters of resident brought claim against several defendants, including the facility’s management company. Jury found management company fifty percent at fault, and Supreme Court held that jury’s verdict was supported by material evidence.
The Bottom Line:
· After being hospitalized with constipation, resident went to live in assisted living facility with orders from her doctor to be given a laxative every morning. Despite these orders, facility records showed that resident received no more than 91 doses of the laxative in an eight month period, and only one bottle of laxative containing 15 doses had been ordered and received at the facility for resident. On May 27, 2004, resident went to see her doctor for constipation, at which point he ordered the facility to administer three to four enemas per day beginning on May 27th. Subsequently, a facility nurse gave resident one enema on May 27th, none on May 28th, and one large enema May 29th, after which the resident died of a perforated colon. 397 S.W.3d at 553-54.
· “[Jury held defendant management company to be fifty percent] at fault for failing to provide sufficient personnel at [facility].” Id. at 557.
· “[Supreme Court held that jury’s verdict was supported by material evidence. Court pointed to three showings by plaintiff.] First, Plaintiffs presented material evidence from which the jury could reasonably conclude that [management company] provided insufficient staffing to meet the needs of the residents at [facility], and that [company] was aware of the understaffing problem. [Court pointed to testimony from a nurse at the facility stating that she had informed the company’s regional operations director about the staffing problems, and testimony from said director that she had been told about and was aware that the facility was understaffed.] Id. at 559-60.
· “Second, Plaintiffs presented material evidence supported the conclusion that the lack of adequate staffing at [facility] led to lapses and deviations from the applicable standard of care. …It is a matter of reason and common sense within the jury’s fact-finding province to infer that, in an employment setting, if there is too much work required of too few employees, either the work will not get done or the quality of the work will be diminished.” Id. at 561.
· “Finally, Plaintiffs presented material evidence supporting the conclusion that the deviations from the applicable standard of care were substantial factors in [resident’s] death.” [The Court pointed out expert testimony establishing that the failure to give daily laxatives led to the constipation, which then led to the need for enemas, which were then not given as directed and led to death.] Id. at 563.