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Nursing Home UTI Wrongful Death Lawsuit

Robusto v. Oakwood Care Center

Intravenous AntibioticsThis nursing home wrongful death claim was filed in Montgomery County against a Silver Spring nursing home after a resident's urinary tract infection went untreated. It was filed in Health Claims Arbitration on March 6, 2018, and it is the 108th medical malpractice case filed in Maryland this year. It is the first nursing home UTI wrongful death lawsuit filed in Maryland in 2018.

Summary of Plaintiff's Allegations

The nursing and medical staff at Oakwood Care Center became aware that a resident was exhibiting symptoms of a urinary tract infection (UTI). So, unlike a lot of these UTI nursing home cases, the facility was aware of the problem.

A UTI is an infection anywhere in the urinary tract. The urinary tract makes and stores urine and removes it from the body. An infection occurs when bacteria get into the urine and begin to grow. Urinary tract infections (UTIs) are common in the general public, more common in the elderly, and even more common in nursing home residents due to their physical and/or mental conditions that require that level of care.

The woman's symptoms became more profound over the next four days, resulting in severe changes in her mental status. Oakwood staff continued to make observations about the woman that should have warranted intervention, including rising levels of creatinine, a waste product excreted by the kidneys that is one of several measures used by doctors to determine the function of the kidneys. The records also show cloudy/concentrated urine and a deepening decline in mental status. But, allegedly anyway, no one did anything to revent the progression of her UTI.

In fact, the woman's UTI was never properly diagnosed or treated while she was a resident at Oakwood. Her infection progressed to the point of septic shock with evidence of multi-organ system failure and she was transferred to Franklin Square Hospital. Unfortunately, her condition had already deteriorated to the point of no return. The woman passed away just ten days after the Oakwood staff first noticed the symptoms of her UTI.

Plaintiffs claim that new onset urinary retention is a warning sign of a UTI and required an immediate investigation. A urinalysis would have discovered this UTI. So plaintiffs' claim that prudent and attentive nursing home would have done a urinalysis and notified the physician of the results of the urine culture and sensitivity timely to prevent the delay in initiating treatment of the resident's UTI.

Additional Comments
  • I think everyone can agree that Oakwood Care Center is not a great nursing home. Nursing home malpractice cases are brought against good nursing homes and bad nursing homes. Do we see more lawsuits against nursing homes with below average Medicare ratings? Absolutely. This is particularly true in UTI cases. Most urinary tract infections can be prevented by keeping the area clean, emptying the bladder regularly, and drinking enough fluid. This does not require sophisticated medical care. But it does require the nursing home to be caring and attentive to its residents.
  • Urinary tract infection is the most prevalent infection in nursing homes. UTIs are a big risk as people get older. Many nursing home residents have bladder catheters which dramatically increases the risk of a UTI and sepsis.
  • Studies who that bacteria in the urine (bacteriuria) in nursing home patients is rampant. For women, it is somewhere between 15% to 57%. For men, the numbers are between 13% to 37%.
  • The woman was initially admitted to the nursing home due to deterioration in her health and functional status. She suffered from multiple conditions including diabetes, hypertension, hypothyroidism, anemia, thrombocytopenia, depression, tremor, vitamin D deficiency, gastroesophageal reflux, colon cancer, endometrial cancer, and basal cell carcinoma. This is a problem for the plaintiff is a lot of these cases. The nursing home will indiscriminatingly point at every other condition as a cause of the victim's injuries while also arguing that they make the UTI harder to diagnose.
  • Besides the urinary retention, the plaintiffs argue that the resident's agitated state was also a sign that a UTI was the problem
  • Montgomery County
  • Oakwood Rehab and Nursing, LLC d/b/a Oakwood Care Center
Hospitals Where Patient Was Treated
  • Franklin Square Hospital
  • Failing to timely recognize and perform diagnostic testing to confirm a UTI.
  • Failing to provide antibiotic treatment for the UTI.
  • Failing to obtain review and treatment from a urologist.
  • Failing to timely transfer the woman to a hospital once her symptoms of acute kidney injury and urinary tract infection became clear.
Specific Counts Pled Plaintiff's Experts and Areas of Specialty
  • Mary Elizabeth Schroeder, M.D., surgeon and critical care physician
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