LANCASTER – The Hamilton Arms Center skilled nursing facility has brought preliminary objections against both the general allegations and demand for punitive damages made by the daughter of a resident who died there in June of last year.
Kathleen Paxton (as Administratrix of the Estate of Betty Jane Hahn, deceased) of Lancaster first filed suit in the Lancaster County Court of Common Pleas on June 19 versus Hamilton Arms Center Opco, LLC (doing business as “Hamilton Arms Center”) of Lancaster, HACHC, LLC of Wilmington, Del. and Panacea Health Corp., of Harrisburg.
The suit explained that Betty Jane Hahn was a resident of the facility from April 25, 2022 through June 24, 2022 and was incapable of independently providing for all of her daily care and personal needs without reliable assistance.
“Ms. Hahn was admitted to Hamilton Arms Center on April 25, 2022, following a hospital stay where she was diagnosed with Alzheimer’s dementia and paroxysmal atrial fibrillation. An April 25, 2022 Medication Review Report notes that Ms. Hahn had a 0.1 cm x 0.1 cm wound on her sacrum at the time of her admission to the Facility. A Nutrition Evaluation created upon intake described the wound as a Stage II pressure ulcer. A wound evaluation completed on April 28, 2022 describes Ms. Hahn’s sacrum wound as a 0.6 cm x 0.5 cm Stage III pressure ulcer. Noted interventions included a turning and repositioning routine, as well as the encouragement of hydration and mobility,” the suit said.
“An April 29, 2022, nutrition note recommended that Ms. Hahn receive supplemental protein liquid twice daily to support wound healing. The order for supplemental protein was not entered until May 9, 2022. By May 12, 2022, Ms. Hahn’s sacrum wound had worsened and was described as unstageable. That same day, Ms. Hahn’s sacrum wound was measured at 1.5 cm x 1.0 cm with slough tissue and a moderate amount of serous drainage. A May 17, 2022 therapy note indicates that Ms. Hahn was self-limiting her food intake due to a history of esophageal dysphagia, and had poor acceptance of the supplemental liquid protein. A once-daily frozen treat and house nutritional shake were added to Ms. Hahn’s nutritional plan.”
The suit added that “a wound evaluation completed on May 19, 2022 described Ms. Hahn’s sacrum wound as Stage IV with bone exposure. The wound was measured as 3 cm x 3 cm, with an unmeasurable depth and undermining present. Necrotic tissue was removed to establish viable tissue, and the evaluation indicated that the exposed bone had osteomyelitis”, in addition to a May 23, 2022 physician progress note which “indicated that Ms. Hahn’s sacral wound had a foul odor with necrotic tissue and bone exposure. The wound was to be cleaned and packed with dressing daily. A 30- day prescription for doxycycline was ordered.”
“On May 24, 2022, Ms. Hahn was weighed at 108.8 pounds. This was noted as a significant weight loss of 20.2 pounds over 30 days. A nutrition note created that same day indicated that the supplemental liquid protein was discontinued due to poor acceptance. A May 25, 2022 late entry daily skilled note indicated that Ms. Hahn’s sacral wound had a foul odor and green/yellow drainage. The wound edges were red and irritated with undermining present. A May 25, 2022 nursing note indicated that Ms. Hahn was turned and repositioned to her side, but rolled to her back shortly after. No additional intervention is noted. On May 26, 2022, Ms. Hahn was seen for her weekly wound evaluation. During the visit, Ms. Hahn’s daughter requested that Ms. Hahn be transferred to the emergency room for further evaluation and treatment of the sacral wound. Ms. Hahn was transferred to the emergency room that same day,” the suit stated.
“Upon admission to the hospital, Ms. Hahn was diagnosed with sacral osteomyelitis and leukocytosis. Vancomycin and ceftriaxone intravenous antibiotics were prescribed. A May 27, 2022 lab report indicates that a wound culture was positive for proteus mirabilis colonies and enterococcus faecalis colonies. Ms. Hahn was seen by an infectious disease physician on May 31, 2022. The physician noted that Ms. Hahn was not a candidate for debridement and wound closure. Palliative care was recommended. On June 2, 2022, Ms. Hahn was discharged from the hospital. Upon discharge, Ms. Hahn was prescribed a two-week course of oral augmentin. Ms. Hahn returned to the Facility on June 2, 2022.”
After continued deepening of her wound and a brief hospital stay and final return to the facility, Betty Jane Hahn passed away on June 24, 2022.
“The defendants negligently caused severe injury to Betty Jane Hahn when they: mismanaged the facility, under-budgeted the facility, understaffed the facility, failed to train or supervise the facility’s employees, failed to provide adequate and appropriate healthcare as described herein, engaged in incomplete and inconsistent documentation; failed to develop an appropriate care plan, failed to ensure the highest level of physical, mental and psychosocial well-being, failure to supervise, failure to ensure safety, failure to implement adequate safety precautions and failure to provide sufficient food and water, which, together, caused Betty Jane Hahn to suffer a Stage IV sacral pressure ulcer with osteomyelitis, severe pain, and ultimately death,” the suit said.
UPDATE
The defendants filed preliminary objections on Aug. 1, which labeled all of the plaintiff’s claims as “insufficient” in a general sense.
“Plaintiff groups all defendants together throughout the complaint. It is well-established that a complaint must include separate counts against individual defendants. Furthermore, under Rule 1019(a), the complaint must apprise the defendant of an asserted claim and provide a synopsis of the essential facts that support the claim. Review of plaintiff’s complaint leaves moving defendants with less detail regarding the claims than is required. As such, moving defendants cannot adequately defend themselves against this complaint, which does not separately identify their alleged individual negligent or wrongful conduct,” the objections stated.
“The moving defendants, as separate and distinct entities are not capable of jointly responding to the allegations set forth in the complaint. The overly broad, vague, and jointly-stated allegations against the moving defendants in plaintiff’s complaint violate Pennsylvania Rule of Civil Procedure 1019(a) and 1028(a)(2) and (3), and, as such, should be dismissed.”
The objections further argued that the demand for punitive damages was inappropriate and ill-founded.
“All claims for punitive damages in plaintiff’s complaint, as well as any language describing moving defendants conduct as ‘reckless,’ ‘intentional’, ‘reckless indifference’ and/or ‘willful and wanton’ should be stricken for lack of specificity. Pennsylvania Rule of Civil Procedure 1028(a)(2) permits the filing of preliminary objections in the nature of a motion to strike for failing to conform to law or rule of the Court. Pennsylvania is a fact-pleading state. Under the Pennsylvania system of fact pleading, the pleader must define the issues, and every act or performance essential to that end must be set forth in the complaint. Under Pennsylvania law, punitive damages may only be awarded for outrageous conduct that is done with reckless indifference to the rights of others or with an evil motive. The purpose of punitive damages is to penalize the wrongdoer and to deter the wrongdoer and others from engaging in similar conduct in the future. Plaintiff’s complaint fails to set forth specific factual averments to support a claim of ‘reckless’ conduct on the part of moving defendant,” per the objections.
“In order to determine whether or not the moving defendants exhibited ‘reckless’ or ‘willful or wanton conduct’ towards Ms. Hahn, this Honorable Court must analyze whether moving defendants actually knew or had reason to know of facts which created a high risk of physical harm to the specific plaintiff. Pennsylvania does not allow for an award of punitive damages for inadvertence, mistake, errors of judgment and the like, which constitute ordinary or gross negligence. Plaintiff alleges no facts reflecting evil motive, maliciousness, recklessness or any other state of mind, as to the moving defendants that would even arguably permit a demand for punitive damages.”
For counts of negligence, survival and wrongful death, the plaintiff is seeking damages in excess of $50,000, plus costs and any other relief the Court deems appropriate given the circumstances.
The plaintiff is represented by Ryan J. Duty of Senior Justice Law Firm, in Pittsburgh.
The defendants are represented by Lee J. Janiczek and Alexander D. MacMullan of Lewis Brisbois Bisgaard & Smith, in Wayne.
Lancaster County Court of Common Pleas case CI-23-04261
From the Pennsylvania Record: Reach Courts Reporter Nicholas Malfitano at nick.malfitano@therecordinc.com