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A Woman Falls and Suffers a Perirosthetic Left Femoral Shaft Fracture and Foot Drop during a transfer due to Nurses' Failure to Provide Maximum Assistance

Our client, an elderly lady, was admitted to a rehabilitation facility following a left hip bipolar hemi-arthroplasty for rehabilitation. Upon admission her medical history included CVA with left sided weakness, anemia, diabetes, and she was identified as being at high risk for falls. While a patient at the rehab facility, physical and occupational therapy documentation suggests that she required maximum assistance for all activities. Our client required maximum assistance to change position from sitting to standing, transferring from her bed to her chair, and transferring from her bed to her bedside commode.

It was documented in the record that our client was not eating well. She stated on the day of her fall that she had requested to return to her bed from her chair. Our client was told that she could not return to her bed until she had eaten, and she remained in her chair for more than 10 hours despite her requests to return to bed. Our client was tired and had been denied the rest that she needed because she was being punished for not eating. She requested to use the bathroom and was assisted to the commode by two of the nursing staff. Our client was dropped and fell to the floor while trying to use the commode. Immediately after the fall our client complained of femoral pain and a deformity was noted.

Three distinct versions of the story emerged during the course of this case. Our client stated that she slipped from the nurses' arms and was dropped while they were trying to help her off of the commode. In the rehabilitation facility's submission, they stated that our client asked for privacy and then attempted to stand on her own; she tripped and fell because of the pajama bottoms around her feet. Finally, the rehabilitation facility claimed in their discovery answers that our client's daughter is responsible for the fall. They stated that the daughter requested one of the nurses help her in moving the wheelchair, and when one nurse went to help, our client attempted to stand, tripped on her pajama bottoms, and fell. All three versions of the story constitute a breach in the standard of care.

A nursing expert testified that the nurses' actions were negligent in any given version of the fall. If the nursing staff had been properly lifting our client from the commode she would not have fallen. Moreover, according to the nursing expert, if either of the two situations presented by the rehabilitation facility had occurred, the staff also breached the standard of care. The nursing staff should never leave a patient that requires assistance; the staff's first priority should be to the safety of the patient. Furthermore, the nursing expert testified that had the proper maximum assistance been given then our client would likely have never fallen. Moreover, had the patient been allowed to return to bed as she had requested then the fall would have been less likely to occur as she would have received the rest that she needed.

The substandard care of the nursing staff caused our client to fall and sustain a perirosthetic left femoral shaft fracture. This fracture required open reduction and internal fixation. Our client is no longer able to participate in the activities that she so enjoyed. She used to go out with friends to play bingo, attend church, and would participate in many programs sponsored by the Council on Aging. She no longer is able to participate in any of these activities. She now needs the assistance of a walker to ambulate and is very limited in the tasks that she can perform. Additionally since her fall, our client has foot drop and needs to have someone with her at all times. She has experienced extreme pain from the fall and subsequent surgery. Todd Townsley was able to favorably resolve this case through settlement negotiations for this client. 

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