Plaintiff was an 89-yearold male who came to the hospital on April 30, 2017, after a stroke alert and was transferred to a skilled nursing home. He had moderate dementia and no skin breakdown. As of June 16, 2017, plaintiff had a small, unstageable pressure sore on his left buttock.

As of July 18, 2017, he had two Stage 2 pressure sores on his upper left thigh. For the next six months there were no skin assessments. Tylenol was ordered for use “for pain or fever” greater than 100.5 degrees. There were 167 occurrences of medicine administration by the nursing staff with no charted differentiation between indications on administration between pain or fever.

There were 110 occurrences of care, medication administration, daily activities, meals, therapies and wound treatments documented as “patient refused.” The chart indicated that no pain medication was given for a period of nine months.

On 2018, a surgeon did a debridement of the sacral wound. He was transferred to the hospital emergency department with an admission differential diagnosis of ulceration, soft tissue infection and osteomyelitis.

Plaintiff died on April 22, 2018, with the immediate cause of death as sepsis, dementia and sacral decubitus ulcer. Liability, causation and damages were strongly contested. [020-T-059]