Even though a fall care plan was implemented on admission to address her fall risk the resident fell five times in the facility. After the last fall she was taken to a hospital emergency room where a subdural hematoma was diagnosed. She never re-turned to the nursing facility where she fell. She died ten months later.

    The California Court of Appeal ruled the case could go forward even though the son, as personal representative of the probate estate, filed suit after the statute of limitations had ostensibly expired. His mother's head injury rendered her legally incompetent, which meant the final months of her own life before she passed did not count toward the statute of limitations.

    The Court faulted the facility for the fact the patient's falls were not documented by the nurses in their progress notes and apparently not even passed on to the next nursing shift in daily reports.