Death Secondary to Nursing Home Medication Administration Error / Prescription Mistake -- Sample Complaint in Maryland Nursing Home Wrongful Death / Survivorship Lawsuit

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As a result of their cognitive and physical disabilities, nursing home patients are often totally dependant upon the nursing home staff to provide assistance with all activities of daily living, including medication administration. 

Medication errors can result in serious medical complications and ultimately result in death.  According to the Institute of Medicine's 2000 report entitled "To Err is Human - Building a Safer Health System," medication errors result in approximately 7,000 deaths of Americans annually.  These medication errors are often preventable and result from common medication administration and prescribing errors including: administering the wrong dosage; using the wrong drug; failing to monitor and document the patient's response; and failing to follow doctor's orders.

Under Maryland law, when a nursing home resident dies as a result of nursing home negligence, two causes of action arise: (1) a wrongful death claim; and (2) a survivorship claim.

A sample redacted Maryland Circuit Court Wrongful Death/Survivorship Complaint involving claims of nursing home negligence relating to medication errors involving the drug Coumadin follows:

COMPLAINT

Plaintiffs, [insert name], individually and as personal representative of the Estate of [insert name], [insert wrongful death beneficiaries], by their attorneys, David L. Feldstein and Dever & Feldstein, LLC, hereby file this Complaint against Defendants, [insert names], and in support thereof, state as follows:

PARTIES AND JURISDICTION

 1.   At all times material to this case, Plaintiffs have been citizens and residents of the State of Maryland.  Plaintiffs [inset names] are the surviving children of the decedent, [insert name], and are wrongful death beneficiaries in this action pursuant to Section 3-904(a) of the Courts and Judicial Proceedings Article of the Maryland Annotated Code.
 2. [Insert name] is the duly appointed Personal Representative of the Estate of [insert name].  The Register of Wills for [insert County], Maryland issued Letters of Administration to [insert name] on [insert date].  The Estate of [insert name] is bringing this survival action pursuant to Section 7-401(x) of the Estates and Trusts Article of the Maryland Annotated Code.
 3. At all times material to this case, [insert Defendants] have been corporations engaging in the practice of medicine and nursing home services in Baltimore City, Maryland, and acting through actual and/or apparent agents, servants and/or employees.
 4. The venue for this claim is proper in Baltimore City, Maryland.  The amount in controversy exceeds Thirty Thousand Dollars ($30,000.00).

FACTS COMMON TO ALL COUNTS

 5. At all times mentioned and relevant herein, [insert Defendants] have owned and operated the nursing home facility known as [insert name of nursing home] located at [insert address], and have held themselves and their agents, servants and employees out to the general public as experienced, competent and capable providers of medical and nursing home services, and in such capacity owed a duty to [insert name] and the Plaintiffs to render that degree of medical care and skill which is ordinarily rendered by those who devote special study and attention to the practice of medicine and nursing home services.
 6.  At all times mentioned and relevant herein, all of the individuals at [insert name of nursing home] who participated in the care provided to [insert name] were acting on behalf of and within the scope of their employment with [insert names of Defendants]. 
 7. On or about [insert date], [insert name] suffered a fall at home and was taken to [insert name of hospital] for evaluation and treatment.  [Insert name] was diagnosed with a small pulmonary embolism and was started on Coumadin therapy for anticoagulation.
 8. On [insert date], [insert name] was transferred to the [insert name of nursing home] for continuing rehabilitation.  [Insert name] attending physician noted on the transfer summary that [insert name] could be continued on Coumadin therapy at the nursing home provided his anticoagulation would be closely monitored and as long as someone is watching him and he is not at risk for fall.
 9.  At the time of her admission to the [insert name of nursing home], [insert name] was assessed to be at high risk for falls due to his history. Despite this assessment, the staff at the [insert name of nursing home] failed to initiate proper fall precautions for [insert name], and as a result, he suffered serious falls at [insert name of nursing home] on three separate occasions.  Following his third fall, [insert name] was taken to emergency department of [insert name of hospital] where he was diagnosed with head trauma and fractures of his right hip and right femur.  Emergency room physicians examined [insert name] and found three Fentanyl patches on his body.  Fentanyl is a powerful narcotic with a potency many times that of morphine.  A single Fentanyl patch may be applied every three days after removing the old patch.  The emergency room doctors quickly determined that [insert name] had been given excessive amounts of Fentanyl at [insert name of nursing home] and ordered that [insert name] be given Narcan, a drug used to reverse the effects of narcotic intoxication.       
 10. Emergency room physicians also quickly determined that [insert name] had been given excessive amounts of Coumadin at [insert name of nursing home].  Laboratory tests showed that that [insert name]'s anticoagulation, as measured by his INR, or international normalized ratio, was 50, or approximately 20 times higher than his target range of 2.5.  This excessive anticoagulation, along with the trauma from the fall, caused [insert name] to suffer severe internal hemorrhaging. [Insert name] was promptly evaluated by a cardiologist who noted the following in his chart: "the reason for blood loss is likely the very high INR and I would recommend correcting the coagulopathy with fresh frozen plasma and transfusing to control the hematocrit.  Nevertheless, given his present condition, the chances of meaningful survival are poor, and I have communicated this to the family, who understand."
 11. Doctors at [insert name of hospital] attempted to reverse [insert name] anticoagulation by urgently transfusing multiple units of plasma and blood products, but [insert name] was simply too unstable, and he quickly deteriorated to hemorrhagic shock, kidney failure, and respiratory failure.  [Insert name] was ultimately pronounced dead at 8:29 p.m. with members of his family at his bedside.  

COUNT I  (Professional Negligence)

 12. The Plaintiffs incorporate all of the allegations contained in the above paragraphs as if those allegations are set forth in this Count.
 13. Defendants, individually and through their actual and/or apparent agents, servants and/or employees, owed Plaintiff a duty to exercise reasonable care in their treatment of him.
 14. Defendants, individually and through their actual and/or apparent agents, servants and/or employees, breached the above-described duty of care to Plaintiff, thereby deviating from the applicable standards of care, and were otherwise negligent, careless and reckless in that they, among other things:
(a) failed to adequately and timely diagnose and treat [insert name] medical conditions;
(b) failed to properly manage [insert name]'s pain medications; 
(c) failed to properly manage [insert name]'s anticoagulation therapy;
(d) failed to respond in a timely and appropriate manner to the results of [insert name] coagulation studies; and
(e) were otherwise negligent and violated the applicable standards of care.
15. As a direct and proximate result of the above-described deviations from the applicable standards of care and breaches of duty by Defendants, Plaintiff was caused to sustain serious, painful and permanent injuries to his body, including great physical and mental pain and suffering, and, ultimately, death.
16. As a further direct and proximate result of the above-described deviations from the applicable standards of care and breaches of duty by Defendants, Plaintiff, among other things, was forced to undergo medical treatment, and, as a result, was obliged to expend sums of money for medical, hospital and other care and treatment and was precluded from engaging in his normal and usual pursuits and activities, among other injuries and damages.
17. Had Defendants followed the appropriate and applicable standards of care, Plaintiff would not have suffered the above-identified injuries, damages and death.
18. The injuries and damages herein complained of were directly and proximately caused by the negligence and want of care of Defendants, with no negligence on the part of Plaintiff contributing thereto.

WHEREFORE, Plaintiffs request that a judgment be entered against the Defendants for compensatory damages in excess of Thirty Thousand Dollars ($30,000.00) and any other relief to which this Court finds them entitled.

COUNT II  (Wrongful Death)

 18. The Plaintiffs incorporate all of the allegations contained in the above paragraphs as if those allegations are set forth in this Count.
 19. As a direct and proximate result of the Defendants' above-described negligence in causing the death of [insert name], [insert wrongful death beneficiaries] have sustained, among other things, pecuniary loss, mental anguish, emotional pain and suffering, loss of society, loss of companionship, loss of comfort, loss of protection, loss of parental care, loss of filial care, loss of attention, loss of advice, loss of counsel, loss of guidance and loss of education. 

 WHEREFORE, the Plaintiffs request that a judgment be entered against the Defendants for compensatory damages in excess of Thirty Thousand Dollars ($30,000.00) and any other relief to which this Court finds them entitled.

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Please feel free to contact the nursing home neglect lawyers at Dever & Feldstein, LLC at (888) 825-9119 for a free consultation if you believe that a family member or loved one has sustained serious injury or wrongful death as a result of medication administration error/prescription mistake, bed sores (also known as pressure sores or decubitus ulcers), dehydration/malnutrition, nursing home falls, elder abuse or elder neglect.

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