Facts

On Feb. 9, 2008, Izona Harvest, 85, who had a history of multiple health issues and hospitalizations, was transported via paramedics to the ER of Long Beach Memorial Hospital (LBMH) with stroke-like symptoms. Once it appeared that Harvest as to be admitted, Dr. Gnyandev Patel, an internist, agreed to serve as her admitting physician. Patel, his associates, and various consultants followed the patient throughout this hospitalization.

Harvest was discharged from LBMH on the afternoon of Feb. 13, by one of Patel's associates and was transported and admitted to Doe Healthcare Center, a skilled nursing facility, approximately an hour later. At the time of discharge from LBMH, the plan was for Harvest to be followed by the medical director/house physician at the skilled nursing facility selected by her.

Upon Harvest's admission to the skilled nursing facility, Patel was called and asked to serve as her admitting physician. He agreed and gave the nursing staff extensive orders over the telephone. At the time of admission, Harvest was evaluated by the staff at the facility and was found to be alert and oriented. However, while ambulatory, Harvest was deemed to be at a high risk for a fall. As such, she was instructed by the staff to ask for assistance should she need to get out of bed or a chair.

On Feb. 14, at 5:30 a.m., Harvest, who had gotten out of bed without assistance in order to use the restroom, fell and injured her wrist. Patel, once contacted concerning the fall, ordered an x-ray of her wrist. The x-ray was read by a radiologist as negative and the results were relayed to Patel in the late afternoon on Feb. 14. In light of these findings, Patel ordered conservative treatment for this injury. Patel did not visit and examine Harvest at anytime during her stay at the facility.

Harvest's family became dissatisfied with the care rendered at the facility and, on Feb. 17, removed her.

The family members took her home and, within eight hours, drove her to the ER of St. Francis Medical Center with complaints of chest pain, shortness of breath and a painful wrist. While in the ER, a second x-ray of the wrist was taken and read as a fractured wrist. The wrist was casted and the patient was discharged home in stable condition on Feb. 24 by Dr. Weinstein, her long time primary care physician.

The patient was readmitted to St. Francis Medical Center from Feb. 28 to March 5 for unrelated health issues and was seen in Weinstein's office for an outpatient visit on March 7. She was re-admitted to Memorial Hospital of Gardena on March 11, where she remained until she died on March 30 of complications totally unrelated to her fractured wrist.

While at Memorial Hospital of Gardena, the patient developed a breakdown of the skin of her arm allegedly caused by the cast of her broken arm.

The plaintiffs, the decedent's four children, dismissed their medical malpractice/wrongful death claim on the first day of trial and proceeded against Patel solely on their elder abuse claim.

PLAINTIFF'S CONTENTIONS:
The plaintiffs contended that Patel provided inadequate care, treatment and management while Harvest was admitted to the facility. The plaintiffs argued that Patel failed to conduct an accurate and comprehensive assessment upon her admission to to the facility; failed to order that Harvest receive adequate supervision and devices to prevent accidents such as falls with resulting injuries and pain and suffering; failed to develop a comprehensive and interdisciplinary care plan; failed to protect Harvest from health and safety hazards; and failed to treat Harvest in any fashion before or after the fall while at the facility. The plaintiffs further argued that the radiologist misread the Feb. 14 x-ray and had Patel personally examined Harvest following the fall, he would have noticed symptoms that would have led him to conclude that she had a fractured wrist.

The plaintiffs contended that Harvest suffered from extreme and continuous pain secondary to the fall and wrist fracture up to the time of her death and that she developed ulcerations of her arm caused by the cast. The plaintiffs asked the jury to award $400,000 for pain and suffering.

DEFENDANT'S CONTENTIONS:
Patel contended that there was no evidence, much less clear and convincing evidence, that he neglected Harvest during her brief stay at the facility. Since the decedent had been seen at LBMH immediately prior to her admission to the facility, there was no reason for Patel to have seen the decedent in the 14 hours between the time she was admitted to the facility and the time that she fell. Short of writing orders for restraints, and there was simply no indication for doing so, there was nothing that Patel could have done that would have prevented Harvest from getting out of bed and falling in her room in the early morning hours of Feb. 14. Patel had a right to rely on the report of the radiologist who read the wrist x-ray as negative and it was reasonable to order conservative treatment based on the radiologists findings. The nursing staff at the facility documented that Harvest had no complaints of pain within a day following the fall. While Harvest complained to Weinstein of pain and discomfort secondary to various unrelated maladies during a March 7 office visit, it was notable that she failed to voice any complaints of pain at that time relating to her then casted wrist.

Result

Defense verdict for Dr. Patel on the elder abuse claim.

Other Information

Having entered into settlements, Doe Healthcare Center, the skilled nursing facility, and the radiologist were no longer parties to the action by the time the case commenced trail. The trial court bifurcated punitive damages. FILING DATE: Oct. 15, 2008.

Deliberation

1.5 hours

Poll

12-0

Length

six days