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A significant settlement in a disturbing case of nursing home neglect, was reported in this week’s Massachusetts Lawyers Weekly. A generally healthy, active, older women (exact age unspecified in the report), entered the nursing home for rehabilitation after a compression fracture. Darvocet, which the woman was taking for pain, has a known side effect for many people, of constipation. Despite continuing complaints of constipation, the patient was given nothing other than milk of magnesia, which was ineffective.

After she continued to complain of constipation, the woman was given a psychiatric workup, not diagnosis of the cause of the constipation, despite developing a fever. The psychiatric nurse who did the workup, informed the nursing department that the ongoing constipation had to be addressed. It was not. By the time the patient was sent to the emergency room, after nearly a week of increasing constipation-related pain, she was in septic shock. She died of a perforated bowel. The nursing home medical records obtained after suit was filed, showed that she was having regular bowel movements, raising the specter of posthumously doctored records. In light of the settlement – for $350,000 – that question will remain unanswered.

This case involved many elements familiar to plaintiffs’ medical malpractice lawyers. Monitoring of the patient’s condition, a nursing home’s fundamental obligation, was inadequate. The patient’s complaints were not taken seriously. There was a failure of both communication and leadership, in that no nursing home doctor or health professional, stepped forward to demand that the woman receive urgent care. Only when the woman was in extremis, was the gravity of her condition comprehended – in the emergency room, not the nursing home.

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