Trial begins on wrongful death cases at Montana nursing homes

From The Missoulian:

Attorneys representing a Missoula family in a wrongful death case told jurors on Feb. 19 that a pair of local nursing homes were negligent when they failed to provide adequate health care for an elderly man.

Ralph Seewald was 87 in November 2005, when he died of complications from a blood infection that occurred after he fell and broke his neck. The accident happened during a transfer from his wheelchair to the toilet, and left him bedridden. He then developed severe pressure ulcers that worsened over a period of months, and led to gangrene in his leg.

Both the wheelchair transfer and the treatment of his bed sores were inadequate, the lawsuit alleges, and fell outside the standard of care promised to the family, and for which they were paying $5,000 a month.

The lawsuit, filed in Missoula District Court, names as defendants Riverside Health Care Center; Village Health Care Center; the Goodman Group, which is the parent company that operates both Missoula nursing homes; and Dr. Raymond Howard, the physician assigned to oversee a portion of Seewald's care.

The suit seeks relief for negligence, medical malpractice, wrongful death, deceit, breach of contract, fraud, and other prayers for relief, and lists Seewald's son, Roger, as the plaintiff.

"This case is about negligence," said plaintiff's attorney Adam Duerk in his opening statements. "It is about a failure to do one's duty in the face of needed care by the most vulnerable members of our community."

The lawsuit alleges that the Seewald family was never notified of Ralph's deteriorating health condition, and that the nursing home "concealed the full extent of Ralph's pressure ulcers and other indicators of his declining health status from family members who were authorized to make medical decisions for him."

After Seewald died, a nurse at Village Health Care Center told plaintiff's attorneys that she was instructed to alter the man's medical records to create the appearance of a more consistent level of care than he received. The altered charts showed that the dressings on his pressure ulcers were changed on a regular basis, when in fact the care was sporadic.

"Under the dressings, the ulcers grew," Duerk said. "They began to change color. They began to smell. They began to turn black."

When Seewald was admitted to St. Patrick Hospital in October 2005 for a scheduled surgery to repair his neck, doctors discovered that the bed sores were so severe he had contracted the blood infection gangrene. His leg would have to be amputated, they said, or he would die. He was admitted to hospice and died less than a month later.

"The end of all our lives, we hope, will be a happy sunset," Duerk said. "The facts of this case will show that this was not a happy ride into the sunset. No one should have to die that way in Montana."

Through the lawsuit, Roger Seewald is seeking compensation for pain and suffering, mental anguish, severe emotional distress, grief, sorrow, medical and funeral expenses, loss of companionship, and other damages caused by the defendants' negligence. He is also seeking punitive damages.

The civil case got underway Friday morning before District Judge John Larson, with the process of jury selection taking up most of the day. A jury of eight men and four women was selected by approximately 4 p.m.

Because of the time constraints, attorneys for three of the four defendants did not have time to deliver their own opening statements, but emphasized throughout the day that their clients provided adequate health care.

Attorney Max Davis, representing Riverside Health Care Center, said many of the allegations laid out in the lawsuit - that staff at the nursing homes did not follow Seewald's official plan of care, for example - were misleading.

The lawsuit explains that Seewald had signs of dementia and was wheelchair bound when he arrived at Riverside Health Care Center in December 2004, and his plan of care required two attendants using a gain belt to assist him with all wheelchair transfers. But on many occasions, Ralph was transferred by just one attendant and no gain belt, the lawsuit alleges, and numerous falls were documented under those circumstances.

On May 23, 2005, when Ralph fell and cracked a vertebrae in his neck, he was being transferred by a single attendant who was not using a gain belt. It was her second day on the job.

But the lawsuit does not include details about Ralph's insistence that a gain belt not be used, according to Davis, nor does it discuss the progress he had been making in physical therapy, which led to Riverside's decision to approve single-attendant transfers.

"We think that at the end of the day, you'll determine that the care Ralph Seewald received at Riverside was adequate," Davis said. "Any of the damages the plaintiff is seeking, for lots and lots of money, cannot be laid at my client's feet."

Opening statements from the remaining three defendant's will continue at 8:30 a.m. on Monday. The trial is expected to last all week.