Plaintiff: pressure ulcer led to leg amputation — $1 million settlement

Type of action: Negligence and tort

Injuries alleged: Unstageable pressure ulcer of the left heel necessitating a below-the-knee amputation

Date resolved: March 25, 2025

Special damages: $190,146.77 in past medical bills

Attorneys for plaintiff: Ellen C. Bognar, Charlottesville and Randall Lee Appleton, Richmond, Allen Allen Allen & Allen

Description of case: This nursing home negligence case involves the defendant facility’s failure to properly offload pressure, leading to multiple pressure injuries and necessitating a below-the-knee amputation.

When the plaintiff was first admitted to the defendant facility in March 2021, she had no skin breakdown and did not require physical assistance with any activities of daily living.
She received antipsychotics for schizophrenia, and by December, her function and appetite began to decline, she was lethargic, and she became dependent for assistance for activities of daily living. The plaintiff also began experiencing bladder and bowel incontinence, but the facility made no changes to her care plan.

In February 2022, a podiatrist noted black eschar on her left heel and wrote an order to offload heels, feet, and ankles from the mattress “for pain relief and ulcer healing assistance.” The plaintiff alleges the nursing home failed to carry out this instruction.

A nurse practitioner ordered a wound care consultation, but the facility did not ensure the plaintiff was seen by the wound care consultant for four weeks, by which time the wound had grown to over 5 cm, with 100% slough/eschar and malodorous drainage. Pressure injuries had also developed on her right heel and bilateral buttocks.

In March, plaintiff became febrile and “catatonic like.” At her family’s request, she was sent to the emergency room, where the orthopedic surgeon determined that the left heel wound was infected, tracked to the bone, and was unlikely to heal, requiring a below-the-knee amputation. The amputation was successful, the plaintiff recovered from the infection, and the other pressure injuries healed.

The defendant facility claimed that it had turned and repositioned the plaintiff, offloaded pressure from her heels, and provided timely incontinence care. The defendant also claimed that the left heel wound had developed in less than two hours of pressure and that its deterioration was inevitable given the plaintiff’s preexisting diagnosis of peripheral vascular disease, which they claimed was the cause of the amputation, not any negligence on the part of the facility.

The case resolved the week before trial following mediation.

Randall Lee Appleton, counsel for the plaintiff, provided case information.

[025-T-118]