Necrotizing Fasciitis

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CASE: necrotizing fasciitis

FACTS: The plaintiff was a 25-year-old female being held as a pre-trial detainee at a county jail with a history of IV drug use. Upon arrival at the jail, she underwent a medical screening by a corrections officer, who noted that she had “obvious pain or injury” and “obvious signs of fever or infection.” The officer specified that she had an abscess on her left forearm. Several hours later, she underwent a more thorough medical intake screening by one of the defendants, a nurse (RN). The RN documented the presence of a suspected abscess, but stated in her notes that she was waiting to see whether the plaintiff would be released on bail before calling the on-call physician.

On the morning of the arraignment, one of the defendants - another nurse (LPN), spoke with plaintiff in her cell after reviewing the RN’s notes. The plaintiff told the LPN that she was feeling anxious and having tremors, but the LPN did not contact the on-call physician and chose not to initiate withdrawal protocol.

After the arraignment hearing, plaintiff returned to the jail. She immediately asked to see the nursing staff about her arm. An hour later, she saw the LPN at the afternoon sick call, who documented a left arm abscess, swelling, and a possible MRSA infection. Because the LPN’s shift was ending, she instructed the RN to contact the on-call physician. Despite this, the RN waited another two hours before contacting the on-call physician for an order of antibiotics and another three hours after that to give them to plaintiff. She did not document any examination or observation of plaintiff’s arm.

 The infection continued to progress overnight and plaintiff’s condition deteriorated. Her arm began to lose feeling, started turning dark purple/black, and became excruciatingly painful. She begged for help from the defendant corrections officer, who briefly passed by her cell nine times. When the CO was not around, she yelled and banged on the walls of her cell to try and get help. A fellow detainee even joined in yelling and banging on his own cell to try and help her. At one point, the CO told the other detainee that it was plaintiff’s own fault for using needles.

Early the next morning, another corrections officer saw plaintiff in her cell and immediately knew she needed care. The CO summoned the LPN, who documented that the plaintiff needed to go the ER. Instead of requesting an ambulance, the LPN instructed the supervising sergeant to call the nearby sheriff’s department for transport. In the 90 minutes that the plaintiff waited for transport, the LPN provided her neither care nor comfort.

DEFENSE: As a government entity, the jail & its employees claimed immunity, along with general denial of the events. The medical defendants argued that plaintiff would have lost her arm regardless of whether they followed the standard of care.

INJURIES: The infection was Group A strep infection that progressed to necrotizing fasciitis with compartment syndrome. Emergency surgery proved unsuccessful and the plaintiff’s left arm was amputated above the elbow.

SPECIAL DAMAGES: Medical bills: $364,290.82

SETTLEMENT: The parties agreed to settle for a confidential amount.

PLAINTIFF’S COUNSEL: Randolph J. Reis, Esq. & Kimberly Kirkland, Esq.

NAMES/COUNTY: Anonymous v. Anonymous