Those in nursing home facilities and long-term care centers are at heightened risk of burn injuries for a number of reasons. The majority of those living in nursing homes have health and mobility issues, which means any attempted evacuation for a fire or other issue is fraught with going to be extremely problematic.
The U.S. Accountability Office estimates there were 2,300 nursing home fires between 1993 and 1999. That breaks down to nearly 400 fires annually. Most are minor, but sometimes, they do result in injury or death.
Common causes of nursing home fires and burns include:
- Flammable medical hazards (pressurized oxygen, electrical equipment, etc.)
- Candles, used unsupervised
- Smoking accidents
- Cooking equipment fires
- Heating element accidents
- Scalding hot water/liquids (in baths, drinks or foods)
These incidents are largely preventable, and when they occur, victims may be entitled to compensation for damages, pain and suffering.
The recent case of Strayton v. Delaware Health Corporation, et al., arose from a burn injury sustained in a nursing home. Litigation focused on whether victim was entitled to medical expenses in excess of the amount written off by Medicare.
According to court records, plaintiff was a 76-year-old resident of a nursing home who needed to use a wheelchair and who was paralyzed in one arm and one of her legs. She had also recently suffered a stroke.
One afternoon, while unsupervised, plaintiff tried to light a cigarette. Instead, she ended up catching her clothes on fire.
She suffered burns on 23 percent of her body and required treatment by more than 30 doctors over the course of a six-month hospital stay at a local burn center.
Plaintiff sued defendants, including the nursing home, for medical negligence resulting in her nursing home injuries. Hospital and other health care providers billed a total of $3.7 million, which is what she would have been on the hook for if she didn’t have medicare coverage.
However, Medicare paid a total of $263,000 for her outstanding bills, which all health care providers considered satisfactory.
Medicare, a taxpayer-funded program, on average pays less than one-third of patient’s medical expenses, to the satisfaction of the healthcare providers, who are required to write off the rest. A Medicare Trust Fund can put a lien on any tort recovery by the patient for whatever is recovered through litigation.
Defendants sought to limit plaintiff’s medical expense damages to the amount Medicare actually paid, versus what she originally was billed for.
Plaintiff argued she was entitled to collect the full reasonable cost of medical services from the party that wronged her, and that the wrongdoer couldn’t benefit from payments victim received from third parties, per the collateral source rule.
However, the superior court and the Delaware Supreme court found the collateral source rule doesn’t apply to amounts that are written off by Medicare. In other words, the expenses recoverable for medical damages are whatever amount Medicare paid.
That does not mean, though, plaintiff can’t collect anything more. She may be entitled to other losses, such as damages for pain and suffering and loss of life enjoyment. It’s just that she won’t be able to collect anything additional for medical bills beyond what Medicaid paid.
Freeman Injury Law — 1-800-561-7777 for a free appointment to discuss your rights.
Additional Resources:
Strayton v. Delaware Health Corporation, et al. , June 12, 2015, Delaware Supreme Court
More Blog Entries:
Lawsuit: Nursing Home Tried to Conceal Medication Error, June 30, 2015, Fort Lauderdale Nursing Home Abuse Lawyer Blog