Defense in medical malpractice trial questions expert witness

By Jon Campisi | Aug 3, 2011

The defense in a medical malpractice case sought to show Tuesday that a number of factors, including pre-existing conditions, were at least in part to blame for a deceased man’s pressure ulcers.

The case of Williams vs. Willow Terrace et al continued Aug. 2 at Philadelphia Common Pleas court in front of a 12-member jury and Judge Ricardo C. Jackson with the second day of testimony from plaintiff’s witness Suzanne Frederick, who has been practicing nursing for nearly three decades.

“I think he was at high risk from the time he was hospitalized,” Frederick said, referring to Marcel Mackey, Sr., whose adult daughter, Camay Williams, is suing a number of medical care facilities for their alleged role in Mackey’s developing pressure ulcers.

Mackey’s family members contend negligence on the part of the facilities led to the patriarch experiencing much pain and suffering in the months prior to his May 2008 death.

The defendants in the lawsuit are Philadelphia-based nursing home Willow Terrace, Albert Einstein Medical Center and Albert Einstein Healthcare Network, Thomas Jefferson University Hospitals, St. Agnes Continuing Care Center, St. Agnes Long Term Care, LLP, Methodist Hospital, and Mercy Health System.

During cross-examination, (the plaintiff’s attorneys had Frederick on the stand Monday), defense counsel Michael Sabo, who represents Albert Einstein Medical Center, said Mackey’s medical records show that he was at risk of developing pressure ulcers from the time he was initially brought into the hospital after suffering a stroke.

While under doctors’ care, Mackey developed ulcers on his legs, which led to gangrene, and the eventual amputation of both of his legs.

Mackey was also diabetic, and had been for some time prior to this latest round of health problems, Sabo said.

In fact, Sabo rattled off an entire list of pre-existing health ailments that might have led Mackey to be more prone to developing pressure ulcers.

“The fact that he was immobile affects the body’s ability to heal, correct,” Sabo asked Frederick.

“It can, yes,” the witness responded.

By the time Mackey arrived at the Willow Terrace nursing home his pressure ulcers were already at a Stage 3, Sabo said, echoing earlier testimony from Frederick.

Frederick testified that at some point in time during his stay at Willow Terrace, Mackey was placed on a special air mattress. The move was designed to help relieve the pressure the patient was experiencing.

Sabo said it was about two months after Mackey left Einstein, and three months after the patient was discharged from Willow Terrace, that his wounds grew significantly in size.

“It did increase in size somewhat, yes,” Frederick testified. “The measurements stand for themselves.”

Defense attorney Michael Doyle, who represents Methodist Hospital, also questioned Frederick Tuesday.

The lawyer got Frederick to agree that by the time he arrived at Methodist Hospital, Mackey already had a Stage 3 ulcer.

“The patient has slough/necrosis right from the beginning, correct,” Doyle asked.

“Yes, in part of it [the wound],” Frederick responded.

Furthermore, Doyle sought to show that the supposed negligence on the part of hospital staff, at this juncture in his care, did not necessarily suffice as the cause of Mackey’s continued deterioration.

The witness seemed to agree.

“There’s not a chart that says he was left on his back for an extended period of time,” Frederick said. “The turning [of the patient] is much better documented here.”

By the time Mackey had left Methodist, his infection had been addressed, Doyle argued.

There will be a break in the trial Wednesday. The defense is expected to call its own witnesses on Thursday, when the trial resumes.

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