Anna Edwards entered Hillview Nursing & Rehab after having fallen several times at home. Doctors had recommended that she recover at a nursing home. The nursing home staff was aware of her previous falls, evaluated her and recommend that a lap buddy be used whenever she was in a wheelchair. Her doctor agreed. Some time later a quality assurance nurse from Health Systems decided Mrs. Edwards did not need the lap buddy. Over the next 18 days Mrs. Edwards fell out of her wheelchair three times. After the last fall she was rushed to the hospital. She died five days after the last fall. The nursing home was cited for deficiencies by the state Department of Health. Anna Edwards’ family sued the nursing home for the wrongful death of Mrs. Edwards.

In one of the first awards against a nursing home under the Missouri Omnibus Nursing Home Act, an arbitrator ordered a Platte City. Mo., nursing home to pay $79l,876 to the family of an 87-year-old woman who fell out of her wheelchair three times before dying from related injuries.

The February award is also believed to be the first arbitrated resolution in a wrongful death claim against a nursing home, said plaintiff attorney Jill Kanatzar.

Saying that the plaintiff’s victory shows that arbitration does not guarantee a “safe harbor” for nursing homes, Kanatzar said this case reveals that a plaintiff can get fair awards.

“I think what this shows is that if you have a good case to take to a jury, you have a good case for arbitration,” said Kanatzar, who with Tim Dollar represented the Estate of Anna Berniece Edwards.

Scott Hinkle, general counsel for the management company of Hillview Nursing & Rehab said the defendants did not wish to discuss the case in detail. He said they were “disappointed in the outcome. It is not what we anticipated but we are abiding [by] it.”

Anna Edwards fell multiple times while at the Hillview Nursing & Rehab facility.

Edwards entered Hillview in 2003, after she fell several times at home where she lived with her husband, Kanatzar said. She was examined after the falls, and doctors found she was suffering from bruises and anemia and recommended she recover at a nursing home. On Sept. 20, she checked into Hillview.

Kanatzar said the staff at the nursing home knew of the earlier falls, evaluated her and recommended she use a lap buddy whenever she used a wheelchair. Her doctor agreed.

In January 2004, a quality assurance nurse from Health Systems decided Edwards did not need the lap buddy, Kanatzar said. The nursing home’s medical director, however, said he had reservations and was afraid Edwards might fall without the aid. Finally, he agreed to try her without the lap buddy but ordered a body alarm – which would go off if she fell as an alternative safety measure.

After the lap buddy was removed, Edwards fell on February 24, 2004, hitting her head on a hallway railing. Nine days later, she fell out of her wheelchair again. Nine days after that, she fell again; this time her head hit the floor. She was rushed by ambulance to North Kansas City Hospital, where they used staples to close her lacerations.

Edwards lived for five more days. During that time, she was unable to eat or get out of bed. She was in severe pain and was heavily medicated. Her family argued that she died from the trauma, although the defendants disagreed.

Critical evidence supporting the estates arguments included testimony from nursing home nurses that the quality assurance nurse from Health Systems never consulted them about the lap buddy despite the fact that she said she had, Kanatzar said.

In addition, nursing home staff did nothing to stop the falling incidents once they began despite their own policies to assess and create an adequate prevention plan for patients who have falling episodes, Kanatzar said.

Within days of Edwards’ death, the State Department of Health and Senior Services sent an investigator to the nursing home, which was cited for deficiencies. The investigator found that the nursing home staff did not assess Edwards after each fall, allowing her to remain at risk for future falls. Testimony from the investigator was a key element in the case and was so convincing, Kanatzar said, that the plaintiffs’ team decided they did not need to call their paid expert to testify in person before the arbitrator.

Defense Argument

The defense argued that the nursing home provided quality care to Edwards and that the falls did not cause her death. A physician testified that Edwards died as a result of a respiratory infection. Health Systems also argued that it shouldn’t be held liable because it acted as the management entity and was not the operator.

The plaintiff argued that Health Systems was just trying to avoid liability and that it actually controlled the operator N&R of Platte City Inc., which provided nursing services.

The estate was awarded $525,000 for the wrongful death of Edwards. The arbitrator also awarded $50,000 for her pain and suffering, $8,641 for her economic losses and $203,000 for attorneys’ fees as allowed under the Missouri Omnibus Nursing Home Act. The plaintiff was also awarded court costs of $5,000 and the defendants, as per agreement, are responsible for the cost of the arbitration.

On Feb. 7, Judge Weldon Judah confirmed the judgment of Rich Ralston, the arbitrator.

The defendants moved to have the award vacated, but it was upheld by the court, Kanatzar said. The defendants since have satisfied the judgment in full.