Leg Fractures, Head Injury: Lawsuit Against Nursing Home Dismissed, No Proof Of Medical Causation
Legal Eagle Eye Newsletter for the Nursing Profession
July 1999
Quick Summary: The family had no medical proof the resident died from head trauma rather than respiratory failure as indicated on the death certificate.
A civil negligence case alleging healthcare malpractice must contain:
Proof that the defendant’s act or omission failed to meet the requisite standard of care;
Proof that the act or omission was performed negligently; and
Proof of a cause-and-effect connection between the negligent act or omission and the injury sustained by the patient.
A civil case alleging breach of contract must contain:
Proof of a mutual agreement between the parties;
Proof of mutual obligations arising out of the agreement;
Proof something of value has been exchanged;
Proof one side has performed its obligations; and
Proof of monetary loss resulting from breach of the contract by the other side.
MISSOURI COURT OF APPEALS, 1999.The Missouri Court of Appeals recently rejected the "sudden onset doctrine" as a basis for a family’s wrongful death lawsuit against a nursing home.
According to the "sudden onset doctrine," when medical consequences follow shortly after an adverse event, a lay person can draw conclusions about cause-and-effect without the benefit of an opinion from a medical expert.
In this case, the resident was dropped in transfer. There was no dispute about that. She was taken to the hospital and examined, and no head trauma was detected. She was returned to the nursing home and died five days later. The cause of death was ruled respiratory failure.
The family, however, wanted to claim that head trauma from the incident where she was dropped was the cause of death. The family went to court with no medical testimony establishing the incident as the cause of the resident’s death, and the case was dismissed.
The family also pointed to two incidents, years earlier, as evidence of negligence, where the resident was discovered to have leg fractures and taken to a hospital for evaluation and treatment. However, for each of these incidents there was no medical proof of causation, or proof linking the fractures to any negligent handling by the nursing home’s staff. In the court’s judgment these incidents were also insufficient to establish grounds for the family’s lawsuit against the nursing home.
The court ruled the family could not sue for breach of contract either. There was documentation the family was notified of both leg fractures and of the incident where the resident was dropped, notification of such incidents being the only contractual obligation the nursing home had toward the family rather than the resident. Brickley v. Nursing Home, 988 S.W. 2d 592 (Mo. App., 1999).