Former director of nursing at nursing home testifies at malpractice trial

An attorney for a woman suing medical care facilities for failing to properly diagnose and treat her now-deceased father’s pressure ulcers, questioned a former director of nursing for one of the defendants during the third day of the malpractice trial.

Zenobia Teel, who was the director of nursing at the Philadelphia nursing home Willow Terrace, took the stand July 22, facing a long line of questioning from Ruben J. Krisztal, who, along with attorney Bennie Lazzara, represents Camay E. Williams in her suit against Willow Terrace, Albert Einstein Medical Center, Thomas Jefferson University Hospitals and Mercy Health System.

Krisztal sought to show that the defendants were negligent in their treatment, or lack thereof, of Marcel Mackey, Sr., who died in early May 2008.

Mackey, who had originally been taken to the hospital after suffering a stroke, developed pressure ulcers due to lack of appropriate care and attention, the plaintiff’s contend.

On Friday, Krisztal attempted to gauge whether staffing levels at Willow Terrace were appropriate during Mackey’s stay at the nursing home. He asked Teel, who was employed by Willow Terrace for two-and-a-half years during a period from 2006 to 2008, if the facility followed the proper procedures and guidelines to ensure that patients like Mackey would be cared for appropriately.

“The policy was to turn and reposition and mobilize the residents,” Teel testified. “They should be turned every two hours to decrease the pressure in any one area.”

At one point, Krisztal showed photos of Mackey’s wounds, asking the witness if the sores were indicative of a lack of care. Teel said she didn’t want to speculate, since she never personally saw the wounds on Mackey.

Krisztal, however, sought to enforce that Teel, in her position as director of nursing, would have been responsible for ensuring Mackey’s overall well being by overseeing those who would have been entrusted to his care.

Teel, though, painted the picture of a bureaucracy with top-down management style, whereby things could get lost in the shuffle.

Willow Terrace, which Teel said is a part of Albert Einstein Health Network, had in its employ various nurses, certified nursing assistants, floor managers, unit managers and others who would be in charge of caring for patients, Teel said.

At one point in her testimony, Teel did admit that some employees would, at one point or another, express frustrations with their workloads.

“Did you pass that information up the chain of command,” Krisztal asked.

Teel said she would tell her superiors of the staff complaints, “to make them knowledgeable of what was being said.”

Krisztal then asked Teel if she was aware that Mackey might not have experienced the proper turning and repositioning that would have been part of his individualized care plan.

“Was it brought to your attention that Mr. Mackey experienced pain,” the plaintiff’s lawyer asked.

Teel said she couldn’t recall, since the alleged neglect took place four years ago.

Krisztal asked Teel if she ever personally notified Mackey’s family members that his wounds were changing, getting worse. Teel said it would have been someone else’s job to do so.

He then asked Teel if she ever personally witnessed Mackey’s wounds growing in size and developing a foul odor.

While she said she had, on occasion, taken some nursing home residents to the bathroom, a scenario where she would have noticed such sores, she didn’t recall doing so for Mackey, meaning she most likely wouldn’t have noticed the wound changes.

At one point, Krisztal produced nursing home charts showing Mackey’s care plan. The attorney asked the witness how many times Mackey received so-called “range of motion” treatment in the months leading up to his death.

Teel said the chart didn’t say, since it was missing some documentation.

“I knew there were some problems,” Teel said of Mackey’s situation, before adding she couldn’t recall telling hospital administrators the particulars with regard to said problems.

The Philadelphia Common Pleas Court trial is being presided over by Judge Ricardo Jackson.