Angela in the News
VERDICTS & SETTLEMENTS
Wisconsin Law Journal
Systemic sepsis caused by an undiagnosed MRSA infection at surgical site
resulting in multiple debridement and permanent disability to leg and an
inability to ambulate independently.
Brown County Circuit Court
G.M. v. Parkview Manor Health & Rehabilitation Center; General Star
Indemnity Company, Evanston Insurance Company and Royal Insurance Company
01 CV 2005
2002; original filing date: December 2001
Dentice of Law Offices of M. Angela Dentice, LLC, Milwaukee
W. Patrick Sullivan of Hannen, Siesennop & Sullivan, Milwaukee
Star Indemnity Company, Evanston Insurance Company, and Royal Insurance
Company of America
expert witnesses, expertise:
Dr. Henry Alba, Physical Medicine & Rehab., Milwaukee; Dr. Robert DiUlio,
Orthopedic Surgeon, Milwaukee; Dr. Michael Frank, Infectious Disease,
Milwaukee; Karen Hobart, Life Care Planner, Roseville, MN; Karla
Brabender, Nurse, Dept. of Regulation & Licensing
expert witnesses, expertise:
Wenkman, Life Care Planner, Jefferson
counsels summary of the facts:
eighty years old on Sept. 6, 2000, when he nearly completely ruptured his
left quadriceps tendon after falling at home. He underwent surgery to
repair the tendon at St. Vincent Hospital two days later. His surgical
site was wrapped in bandages, and his left leg was put in a brace. On
Sept. 10, 2000, G.M. was discharged to Parkview Manor, a skilled nursing
home, for rehabilitation. The hospital records indicated that G.M. had
no bed sores, and that his surgical site did not show any signs of
infection upon discharge. The orthopedic surgeon indicated in his notes
to Parkview that G.M. was to wear a brace on his left leg at all times
except when bathing, and that his surgical site was to be kept dry.
Coordinator at Parkview Manor testified at deposition that she indicated
on G.M.s Data Sheet upon admission that the surgical site was to be
assessed every shift. However, another nurse at the facility testified
at deposition that the directive to assess and change the dressing at
each shift was not written until September 18, six days after G.M.s
the records from Parkview Manor indicate that G.M.s surgical site was
observed on Sept. 12, and that the site was slightly red with no warmth
or drainage, the surgical site was neither observed nor assessed by the
staff at Parkview Manor for the following six days.
13, the family voiced concerns that G.M. was lethargic. That evening,
his temperature was 101.4 degrees. The doctor who was on call at the
nursing home ordered Tylenol and told the staff to watch him closely. On
the afternoon of Sept. 14, a urinalysis was ordered, but urine was not
obtained for the analysis until later that evening. The results were not
faxed to the doctor until the following day. On Sept. 15, G.M. was
lethargic, incontinent, and was having difficulty with transfers. A
meeting was held with the unit coordinator and G.M.s family, but there
was no general assessment of G.M.s condition, including his skin
integrity and his surgical site, despite voiced concerns from his
family. G.M.s condition continued to deteriorate through Sept. 17, yet
no doctor was contacted to examine G.M.
18, six days since the last time G.M.s surgical site was assessed, the
physical therapists aide removed G.M.s leg brace and noted drainage on
the bandage covering the surgical site. When she removed the bandages
from G.M.s leg, the surgical site was severely infected. She noted
drainage around the site, redness and warmth from above the knee to the
hip and groin area, seepage along the groin, and a pocket of seeping
fluid along the lateral side of the knee.
19, G.M.s family took him to his orthopedic surgeon. At this that time,
G.M.s leg was red and swollen from mid-thigh to calf with gross
purulence from the wound. When the doctor attempted to express the
infection from the knee, a pus-like substance sprayed across the room.
The nurse witnessing the procedure was so distraught by the sight of the
infection that she began crying. The infection was so severe that G.M.
was in septic shock.
surgery was performed the same day. Because of the severity of the
infection, G.M. underwent two additional surgeries to irrigate and
debride the wound.
rampant knee infection, G.M. also had a 5.5 cm fluid filled blister on
his right heel and a Stage II ulcer on his buttocks and his left
scrotum. He was also found to have 1200 to 1500 cc of urine in his
bladder. He was placed in intensive care for monitoring.
several weeks in the hospital, G.M. was discharged to Woodside Nursing
Home. It was initially thought that G.M. would need an amputation of his
leg to provide relief from the severe pain. In an effort to save his
leg, the orthopedic surgeon taught the nurses at Woodside how to express
the infection from the wound, although doing so caused G.M. severe pain.
After several months of treatment, G.M.s knee infection was under
control. However, because of the infection, the tendon in G.M.s knee
was destroyed. G.M.s knee cannot be reconnected, and is in the state of
dislocation. He was confined to a wheelchair.
2002, when Parkview manor became aware that the facility was under
investigation, the administration of Parkview Manor asked the nurses to
complete addenda regarding their assessment of the surgical site. All of
the nurses who cared for G.M. were contacted, and several of the nurses
completed addenda. Certain statements found in these addenda are
inaccurate and do not comport with the contemporaneous nursing home
records and with what the course of the infection would have been.
was initiated against Parkview Manor Health & Rehabilitation Center,
Centennial Health Care Investment Corporation, General Star Indemnity
Company, Evanston Insurance Company, and Royal Insurance Company of
defense to the claims was that the nurses did observe the surgical site
and that the infection was not observable until Sept. 18.
negligent care provided to G.M. by Parkview Manor was reviewed by the
State of Wisconsin, Department of Health and Human Services. Parkview
Manor was issued two Class B violations, the highest level of violation
one for failure to assess and monitor the surgical site, and one for the
development of the dicubiti.
past medical specials were $197,566.33. The case settled prior to trial
at mediation for $700,000.