Plaintiff's attorney Jeffrey Antonson and defense attorney Greg Blaies deliver their opening statements. Click here to see video from the trial.
Dallas—Staff at a Texas hospital declined to resuscitate an elderly woman suffering from pneumonia and bedsores despite pleas from her adult children to save her, who claimed that she lacked the mental capacity to sign a do-not-resuscitate order, their attorneys told jurors in a medical malpractice trial currently underway in state court.
Opening statements began December 1st in a case filed by the three children of Diane Rimert, who passed away in 2012 at the age of 67, against Texas Health Harris Methodist Hospital, the nursing home where she resided for years, a nursing home doctor and a physician’s assistant. A parade of attorneys delivered five separate opening statements, as each defendant is individually represented.
The children’s attorney, Jeffrey Antonson, told jurors during his opening statement that Rimert died of pneumonia brought on by the development of bedsores, which he said were caused by the negligence of medical staff at a nursing home operated by Pennsylvania Rehab LP. He also claimed that the nursing home allowed Rimert to sign a DNR order and designate a neighbor as having medical power of attorney despite her showing signs of severe mental illness.
The nursing home maintains Rimert’s bedsores were unavoidable despite her receiving appropriate treatment, and the hospital argues it was legally bound to honor the DNR order even though it was contrary to the wishes of children from whom Rimert was long-estranged.
Antonson did not specify the amount of damages he would ask for, but an attorney for the nursing home told the jury that court filings indicated he would seek up to $10 million.
The full trial is being webcast and recorded gavel-to-gavel by Courtroom View Network.
Antonson said that Rimert had a long history of depression, bipolar disorder and psychosis, and this history was clearly evident in her records when she was transferred to the Pennsylvania Rehab facility from a state mental hospital after having been involuntarily committed.
“It was right there on the admission,” Antonson said. “Everyone knew.”
At the time Rimert made her neighbor, Doris Jannigan, responsible for making decisions if she became incapacitated without informing her children. Antonson claimed she never should have been permitted to sign these documents in her condition.
In 2011 Rimert began to develop bedsores, also known as pressure ulcers, on her heels and buttocks. Antonson told jurors that her records showed no documentation of being placed on a special mattress or having her body regularly rotated to prevent the sores from worsening.
“In the medical world, if they didn’t document it, then it didn’t happen,” Antonson said.
Antonson argued that bedsores took such toll on Rimert’s immune system that she developed pneumonia in 2012 and was transferred to Texas Health Harris Methodist Hospital. Once the hospital staff became aware of the DNR order they refused to place Rimert on a ventilator, and she later died.
Once Rimert’s family raised concerns about the validity of the DNR, Antonson said the hospital shouldn’t have automatically stood by a decision that he said was made by lawyers instead of doctors.
“The standard of care required that they either get everyone to agree, or they let the court fix it,” he said.
The hospital’s attorney Greg Blaies countered that Rimert was completely estranged from her three children and had developed a close relationship with Jannigan through their church. He said Rimert’s DNR and power-of-attorney orders were valid and bore the signatures of two witnesses and a doctor.
“Once those documents come over from the facility the law is clear for us,” Blaies said. “We have to follow the advance directives filled out by the patient.”
Pennsylvania Rehab’s attorney Michael Stewart argued that bedsores can develop in as little as two hours, and that their presence alone doesn’t indicate negligence. He described the process as being similar to infants developing diaper rash.
“It doesn’t mean you’re a negligent parent. This stuff happens,” he said.
He said staff at the nursing home attempted to treat Rimert’s bedsores, but that she refused to cooperate by keeping her feet propped on special pillows or engaging in physical therapy.
“If you don’t have a cooperative patient you can’t stop this,” Stewart said. “Every patient in this country has the right to refuse treatment, mentally ill or not.”
The trial is taking place before Judge Martin Hoffman in Dallas County’s 68th Civil District Court.
The plaintiffs are represented by Darrell Adkerson and Jeffrey Antonson of Adkerson Hauder & Benzey PC.
Texas Health Harris Methodist Hospital is represented by Greg Blaies of Blaies & Hightower LLP.
Pennsylvania Rehab LP is represented by Michael Stewart of Stewart Wiegand & Owens PC.
Nursing home physician Adolphis Lewis is represented by Stephen Johnson of Stephen W. Johnson & Associates, and Josephine Juleau, a physician’s assistant at PA Rehab, is represented by C. Timothy Reynolds of Steed Dunnill Reynolds Bailey Stephenson LLP.
The case is Greg Frausto, et al. v. Pennsylvania Rehab LP, et al., case number DC-12-13131.
Email David Siegel at dsiegel@cvn.com.