Assisted Living Director Refused Pleas to Send Resident to Hospital.
Lewis & Roberts represented the family of a 67 year old woman with early onset dementia that was a resident of an assisted living center in the western mountain area of North Carolina. The resident complained of constipation and stomach troubles one Sunday morning and requested to be sent to the hospital. The morning staff contacted the woman's son, who lived an hour away, to tell him that his mother was being sent to the hospital. The circumstances were complicated because the weather was cold and icy, roads were in poor condition, and the son would have to drive over the mountains to the nearest hospital. The staff then contacted the facility's director to advise of the hospital transfer. The director immediately refused the transfer and called the resident's son to tell him that "everything was ok" and there "is no need" for his mother to be taken to the hospital. Because of the severe weather, the son returned home. The assisted living director was not medically trained.
Over the next 6 hours the resident continued to complain of worsening conditions and made repeated requests to be taken to the hospital. Four staff members, including the facility's head nurse, made over six calls to the director asking they be allowed to send the resident to the hospital - every request was denied. The staff members all explained in their depositions they took no further actions because they feared losing their jobs. The director even called the facility herself to make sure that staff members did not act on their own to send the resident to the hospital. Finally, after the second shift came on duty, more calls were made to the director about the resident. Before the director finally agreed to have EMS called to transport the resident to the hospital, the resident coded on site. The staff administered CPR as the EMS crew arrived. The resident was taken to the hospital where she died shortly after arrival because of an untreated bowel obstruction and sepsis. During depositions of staff members we learned that a policy was posted at the facility stating "When in Doubt, Send Them Out." In spite of the posted policy, we learned that a second unwritten policy existed that no resident was to be sent to any hospital without director approval.
The facility was investigated by North Carolina for the incident and fined $10,000 - the maximum allowable fine. The case included a unique insurance policy for the facility known as a "wasting policy." In a wasting policy, the maximum benefits payable to an injured party are reduced dollar for dollar for every dollar spent defending the case. Therefore, for every bill sent to the insurance company for the costs spent in defending the case, an equal amount was less available for compensation to the lost family member. The case eventually resolved with a settlement for the residents family to compensate them for their loss.