Articles Posted in Relevant Nursing Home Case Law

Maryland nursing homes have a responsibility to provide a safe environment for residents. But how far does this responsibility go towards others? In a recent case, the plaintiff sued a nursing facility he was shot by a resident. He argued that the facility had a duty to warn others of the danger the resident posed, as her mental health provider.

The Facts

According to the court’s opinion, the resident was living at the defendant facility at the time, which was a therapeutic community residence. The resident had a history of mental illness, including multiple admissions for psychiatric care, restraining orders prohibiting her from contacting certain persons, and a criminal record, which prohibited her from possessing a firearm or other weapons. The resident went to a shooting range and shot the owner of the shooting range in the head and stomach. The owner survived but sustained serious injuries that required constant medical attention for the rest of his life.

The plaintiff claimed that the facility knew or should have known that the resident posed a serious risk of danger to third parties, and had a duty to warn him. The court determined that the facility did not have a duty to prevent the resident from harming the plaintiff. The court explained that the general rule is that there is no duty to act to prevent harm to third persons. The court noted that mental health professionals in that state have a limited duty to take reasonable action to protect identified third parties that their patients have threatened serious physical harm. However, the court found that in this case, the resident had only told the facility that she wanted to go target shooting “as a way for her to deal with aggression.” Accordingly, this did not make the owner part of a determinate and identifiable class that faced a particularized threat, and the facility did not have a duty to protect him or warn him.

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Maryland nursing home plaintiffs often have to wrestle with the impact of nursing home arbitration agreements. Massachusetts’s Supreme Court will soon decide whether wrongful death plaintiffs in nursing home lawsuits can be forced into arbitration. Many nursing home residents sign arbitration agreements when admitted into a nursing home, which can later limit their ability to bring claims against the nursing home. A recent lawsuit challenged the enforceability of such agreements against a resident’s heirs in bringing wrongful death claims in court.

In this case, a federal appeals court considered whether arbitration agreements can bar a resident’s heirs from later bringing wrongful death claims in the state. The resident had been admitted to a nursing home, and when she was admitted, her daughter signed an arbitration agreement for her as her representative. The agreement stated that any dispute covered by the agreement would be resolved “exclusively by an [alternative dispute resolution] process that shall include mediation and, where mediation is not successful, arbitration.” The agreement also stated that it applied to the resident and “all persons whose claim is or may be derived” through the resident, including the resident’s heirs, representative, executor, and others.

After her mother died while in the care of the defendant nursing home, the daughter later brought a wrongful death suit against the facility, claiming that it was responsible for her mother’s death. The nursing home argued that the claim had to be resolved in arbitration, pursuant to the arbitration agreement the daughter signed on her mother’s behalf. It further argued that the daughter’s claim was derivative of the resident’s claim, and that her claim was bound by the agreement. The daughter argued that she was not bound by the agreement because her claim against the nursing home as a beneficiary in a wrongful death claim is independent of her mother’s claim.

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Maryland nursing homes often include a clause in their pre-admission paperwork indicating that the parties agree to arbitrate any claims that may arise in the future rather than file a case through the traditional means. However, arbitration can be detrimental to nursing home residents, and residents should not assume that they will be precluded from pursuing a personal injury lawsuit based on a signed arbitration contract.

There are several ways that a Maryland arbitration agreement can be held to be invalid and unenforceable. A recent opinion issued by a state appellate court illustrates the concept of “mutuality of assent,” which is essentially the requirement that both parties know what they are agreeing to when a contract is signed.

The Facts of the Case

The case did not deal with a nursing home lawsuit, but it is relevant because it shows how courts interpret arbitration contracts. According to the court’s opinion, the contract at issue involved a “home service agreement,” by which the defendant would pay for and arrange to complete home maintenance on the plaintiff’s homes in exchange for the contract term price of $1050.

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One of the most controversial topics in Maryland nursing home lawsuits is the applicability and enforcement of arbitration agreements. An arbitration agreement is merely an agreement between parties to submit any disputes that may arise between the parties through arbitration, rather than through the court system.

What Is Arbitration?

Arbitration is a way to resolve claims between parties that does not involve a judge or a jury. Instead, the claim is presented to an arbitrator who hears evidence and arguments from both sides and decides the case.

Arbitration is different from traditional litigation for several reasons, including:

  • the procedural rules governing when a claim must be filed and how quickly the claim is heard are determined by the arbitrator;
  • the rules of evidence that are applied in an arbitration proceeding may be different from the rules that would apply in court;
  • for the most part, an arbitrator’s decision is final, meaning that it cannot be appealed by either party in the event of an unfavorable outcome; and
  • the decisions of an arbitrator are usually kept secret.

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Nursing home residents and their families often sign admission agreements when a resident enters a nursing home. These agreements frequently contain arbitration provisions, which can have a significant impact in a Maryland nursing home lawsuit.

The U.S. Supreme Court recently heard argument on a case concerning arbitration provisions. The issue before the Court was how courts should decide whether a claim is required to be resolved through arbitration. If two parties have signed a contract that includes an arbitration provision, a later dispute may arise on whether a particular dispute falls within the arbitration provision.

Disputing the Validity of Arbitration Provisions in Nursing Home Agreements

Arbitration provisions are increasingly common in nursing home agreements. If a nursing home resident or a family member signs a contract with an arbitration provision, there may still be a way to keep the case in court. An arbitration agreement can force a matter to be resolved in arbitration, which can have present serious drawbacks for plaintiffs. For one, the arbitrator’s decision is final, meaning that a plaintiff cannot appeal an adverse ruling. However, the arbitration provision itself is not always enforceable.

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Legal claims against a Maryland nursing home generally fall into three categories: abuse, neglect, or medical malpractice. Medical malpractice claims arise in the nursing home setting when healthcare professionals in nursing homes provide medical care for the residents. In these cases, plaintiffs have to make sure to comply with the additional requirements for medical malpractice claims.

In a recent case against a nursing home, a resident’s daughter brought a negligence claim against the nursing home and several nurses after the resident fell and died as a result of her injuries. Shortly after the resident’s death, the daughter’s lawyer mailed the nursing home a letter stating that the nursing home and “its employees” were negligent and that their negligence caused the resident’s death. The plaintiff later filed a lawsuit against the nursing home and against several nurses at the nursing home. The nurses filed a motion to dismiss, arguing that the daughter did not comply with the state’s pre-suit requirements.

The issue before that state’s supreme court was whether the letter sent to the nursing home was sufficient pre-suit notice to the nurses named in the lawsuit. Under that state’s laws, a plaintiff must provide at least sixty days’ notice to the defendant before bringing a claim, notifying the defendant of the legal basis of the claim, the type of damages being sought, and the nature of the injuries suffered.

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Because nursing homes generally offer medical care to residents, Maryland medical malpractice claims may arise in the nursing home setting. In a recent medical malpractice case, a family brought a medical malpractice claim after their elderly mother fell. The eighty-nine-year-old patient fell after she got out of her hospital bed, suffering a serious head injury. She had surgery but never fully recovered from the head injury. After her death a few years later, her daughters filed a medical negligence claim against the hospital. The case went to trial, and the court found in favor of the hospital, but the daughters appealed.

On appeal, the plaintiffs argued that the trial court was wrong in finding that the hospital’s failures to comply with the standard of care did not cause the patient’s injuries. At trial, the plaintiffs’ expert, a doctor at Johns Hopkins Health System, testified that the hospital breached the standard of care concerning fall-risk assessments by failing to use a bed alarm and by failing to make hourly comfort rounds. In contrast, the hospital’s expert testified that the hospital met the standard of care and that such measures would not have prevented the patient’s fall.

The appeals court agreed with the hospital, finding that the plaintiffs failed to prove the element of causation. The court explained that the plaintiffs failed to show that the lack of a bed alarm proximately caused the patient’s fall. The plaintiffs were required to show that there was a causal connection between the patient’s injuries and the hospital’s actions. The two experts presented conflicting testimony regarding the effectiveness of bed alarms, and the court noted that the plaintiffs’ expert testified that she did not know whether a bed alarm would have made any difference in this case. Therefore, the court found that the evidence was “too tenuous” to support a finding that the use of a bed alarm or of increased comfort round would have prevented the fall.

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Proving damages is an essential part of any Maryland nursing home claim. In a recent case before a federal appeals court, the court upheld a punitive damages award of over $4 million in a case where the compensatory damages award totaled just $650,000.

The Facts of the Case

In that case, the plaintiffs brought three wrongful death claims against a nursing home after three residents died at the home. The nursing home had a special “vent unit” for ventilator-dependent patients. The plaintiffs claimed that the three residents, who were ventilator-dependent patients, died because of the nursing home’s inadequate staffing and inadequate supplies.

One resident received an anoxic brain injury during the night and was found with his ventilator and all his alarms turned off. Another patient was found dead with her breathing apparatus pulled from her neck and without an alarm or oxygen monitor. Both deaths were found to be caused by understaffing. The third resident died because staff was not able to replace her tracheostomy tube in a timely manner due to a lack of supplies. The case went to trial and the jury awarded the plaintiffs $650,000 total in compensatory damages, and also awarded each plaintiff $1,523,939.16 in punitive damages.

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These days, nursing homes in Maryland and throughout the country often require nursing home residents to sign arbitration agreements upon admission. In a recent case before a state appellate court, the court allowed a case against a nursing home to proceed after the family disputed the validity of the arbitration agreement.

The Facts

The plaintiff sued a nursing home on behalf of her deceased mother after her mother died at the nursing home. The nursing home filed a motion to compel arbitration based on an arbitration agreement that was allegedly signed by the daughter. However, the daughter argued that she did not knowingly sign a mandatory arbitration form on her mother’s behalf when her mother was admitted to the nursing home in 2003.

The 75-year-old mother was admitted to the nursing home on two occasions earlier that year. The first time, the daughter was asked to sign several documents when her mother was admitted, including an arbitration agreement. The daughter refused to sign the arbitration agreement, but the mother was admitted anyways. In court, the nursing home presented another arbitration agreement dated later that month with the daughter’s signature. The daughter claimed that the signature was not authentic and that even if it was, it was obtained by misrepresentation.

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Recently, a state appellate court issued a written opinion in a personal injury case that illustrates a key issue that arises in many Maryland nursing home negligence cases. The case presented the court with the opportunity to discuss the validity of an arbitration clause contained in the nursing home’s pre-admission paperwork. Ultimately, the court concluded that the clause should be upheld and dismissed the plaintiff’s case, holding that the plaintiff was required to submit the case through arbitration.

The Facts of the Case

The plaintiff arranged for himself to stay at the defendant nursing home. The plaintiff was a resident of Nebraska, and the nursing home was a North Dakota corporation with its principal place of business in South Dakota.

Prior to his admission, the nursing home presented the plaintiff with a pre-admission contract. Contained in the contract was an arbitration clause. The clause contained a check-box next to the statement that the parties agree that “any legal controversy, dispute, disagreement or claim arising between the Parties” would be resolved through arbitration. The plaintiff checked the box marked “yes, I do.”

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