Ohio Jury Awards $1 Million, Including Punitive Damages, in Nursing-Home Pressure-Sore Death

Published December 4, 2015 · Verdicts & Settlements

Earlier this month, a Cuyahoga County jury returned a $1 million verdict against a Cleveland-area nursing home over the death of a resident who fell from her wheelchair, suffered a fracture that went undiagnosed for two days, and then developed infected Stage IV pressure sores. More than half of the award, $560,000, was punitive damages. The case, Lang v. Beachwood Pointe Care Center, was tried in the Cuyahoga County Court of Common Pleas, and I want to walk through what has been reported about it, because it illustrates exactly how a nursing-home neglect case is proven and why punitive damages were on the table.

What the family alleged

According to published reports of the verdict, the resident was a woman with end-stage kidney disease who used a wheelchair because of weakness from a stroke and who required dialysis several times a week. She lived at the facility with her husband, who also used a wheelchair.

The reports describe the sequence this way. Staff did not bring her to the dining room, so her husband towed her wheelchair himself. At a doorway her chair caught on the frame and she fell to the floor. She had broken a bone, but the fracture went undiagnosed for two days, until staff at her outside dialysis center noticed something was wrong and sent her to the hospital. After she returned to the nursing home, she developed multiple pressure sores, including two Stage IV wounds on her buttocks, the most severe classification, in which the wound extends through the skin and tissue to muscle or bone. The sores became infected, she developed sepsis, and she died.

The family's lawsuit alleged that staff failed to assist her as her care plan required and allowed her to be moved unsafely, that the facility failed to diagnose her fracture promptly, and that it failed to prevent and properly treat the pressure sores that led to the fatal infection.

What the jury awarded

The jury awarded $440,000 in compensatory damages and $560,000 in punitive damages, for a total of $1 million. I was not involved in the case, and the figures are as reported; the facility may still challenge the verdict in post-trial motions or on appeal.

Why punitive damages were available

Compensatory damages pay for what the family lost: the resident's suffering before her death and the family's loss of her companionship. Punitive damages are different. They exist to punish and to deter, and Ohio law makes them hard to get.

Under R.C. 2315.21, a plaintiff must prove by clear and convincing evidence, a higher standard than the usual greater weight of the evidence, that the defendant acted with malice. In this context malice does not require hatred. Ohio courts have long defined it to include a conscious disregard for the rights and safety of other persons that has a great probability of causing substantial harm. The statute also requires that the trial be split in two if any party asks: the jury first decides liability and compensatory damages, hearing nothing about punitive damages, and only if it finds for the plaintiff does it hear the punitive-damages evidence in a second phase. That is evidently what happened here, with the compensatory verdict first and the punitive award following.

Ohio also caps punitive damages. In most cases the court may not enter judgment for punitive damages greater than two times the compensatory award. A $560,000 punitive award on $440,000 in compensatory damages is well within that limit. The statute separately directs a jury deciding punitive damages against a nursing home to consider the facility's ability to pay, whether the amount is enough to deter future misconduct, and the facility's ability to keep providing care.

Why would a jury find conscious disregard in a case like this? Because the hazards were known and documented. A resident who cannot move herself has a care plan that says so. A resident at risk for skin breakdown has a repositioning schedule. When the facility's own records establish what was supposed to happen, and the facility's own staff admit they knew the risks, a jury can conclude that the failures were not an isolated lapse but a choice, made day after day, to let a resident go without the care the facility had promised. That is the line between negligence and malice, and nursing-home cases cross it more often than most.

The statute behind the claim

Ohio's Nursing Home Residents' Bill of Rights, R.C. 3721.13, guarantees residents adequate and appropriate nursing care, a safe environment, and prompt responses to reasonable requests. R.C. 3721.17 gives a resident, or the resident's estate and family, a cause of action for violations, with compensatory damages on proof of negligence and punitive damages under the same R.C. 2315.21 standards discussed above. Where the resident has died, a wrongful-death claim on behalf of the family is brought alongside it. We explained how these claims fit together, and what families should document, in our August post on nursing-home falls and neglect.

Attorney fees

One more feature of punitive-damages cases is worth knowing. When a jury awards punitive damages, Ohio law permits an award of the plaintiff's reasonable attorney fees as well, and the statute says those fees are not counted against the cap on punitive damages. We discussed the attorney-fee rule in an earlier post about drunk-driving verdicts. The practical effect is that a defendant whose conduct is found malicious may end up paying the cost of being sued, which is as it should be.

What this result shows about case value

Nursing-home defendants and their insurers routinely argue that a frail, elderly resident with serious pre-existing illness had little life expectancy and therefore little "value" to a jury. This verdict is a reminder that jurors do not see it that way. A woman on dialysis in a wheelchair is entitled to the same care she was promised as anyone else, and the suffering of a person left with bone-deep wounds is not discounted because she was already sick. The family's loss of her was real, and the jury said so.

It also shows what evidence wins these cases: the care plan that required assistance, the two-day gap before the fracture was found, the wound staging that documented how far the sores had progressed, and the hospital records that told the truth about her condition. None of that evidence comes from the family's memory. It comes from the facility's own chart and the outside providers' records, which is why obtaining them immediately matters so much.

The arbitration clause caveat

A verdict like this one is possible only because the case reached a jury. Many Ohio nursing homes include arbitration agreements in their admission packets, which, if enforced, send the family's claims to a private arbitrator instead. Those clauses are not always binding, as our local court of appeals held in the Westerfield case, but whether yours is depends on who signed it and under what authority. Bring the entire admission file to your lawyer.

What this means for you

If a parent or spouse developed pressure sores, suffered an unexplained fall, or died of an infection in a nursing home, you may be looking at more than a negligence claim. Facilities that knew the risk and did not staff for it face punitive damages and attorney fees, and juries in Ohio are willing to impose them. The records that prove conscious disregard exist today. Request them in writing now, photograph any wounds, and talk to a lawyer before the facility's explanation becomes the only version of events on paper.