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Norman v. Life Care Centers of America3/26/2003
NOT TO BE PUBLISHED IN OFFICIAL REPORTS
California Rules of Court, rule 977(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 977(b). This opinion has not been certified for publication or ordered published for purposes of rule 977.
Plaintiff Nancy Norman, individually and as successor-in-interest of decedent Dorothy Quartermaine, appeals a judgment following a jury verdict in favor of defendants Life Care Centers of America, Inc., Life Care Center of Vista, and Vista Medical Investors (collectively LifeCare) in her elder abuse and wrongful death action against LifeCare. Norman contends the trial court prejudicially erred by: (1) refusing to instruct on negligence per se (BAJI No. 3.45); (2) excluding evidence of records of the California Department of Health Services (DHS) regarding LifeCare's violations of regulations in caring for other patients; and (3) excluding part of DHS's records regarding LifeCare's violation of regulations in caring for Quartermaine. We reverse the judgment and remand for further proceedings.
FACTUAL AND PROCEDURAL BACKGROUND
LifeCare operates a licensed skilled nursing facility that provides skilled nursing care for long-term residents and is subject to state and federal regulations. On January 16, 1999, Quartermaine, Norman's 87-year-old mother, was admitted as a resident of LifeCare's nursing facility. LifeCare noted Quartermaine suffered from dementia, myasthenia gravis (a progressive muscle weakening condition), diverticulosis, angina, and chronic back pain. On January 18 LifeCare conducted a fall risk assessment for Quartermaine and assigned her a score of 11, which reflected a moderate risk for falls. Although LifeCare's assessment noted Quartermaine had "episodes of sudden weakness, dizziness, unsteadiness with position change," it did not state that Quartermaine had fallen within the past six months. Based on its assessment, LifeCare's initial care plan for Quartermaine provided for a call bell within her reach and a low bed position. Her physician also ordered that her bed's side rails be kept in the "up" position.
At 4:00 p.m. on January 19, because of Quartermaine's attempts to climb out of her bed, LifeCare updated her care plan to provide her with a personal alarm that was clipped to her clothing and would alert the staff if she left her bed. At 10:15 p.m. that day, LifeCare noted episodes of Quartermaine removing her personal alarm and attempting to climb out of bed.
On January 24 LifeCare noted Quartermaine suffered confusion from visual hallucinations and had poor safety awareness. At 11:45 p.m. that day, she apparently fell and was found sitting on the floor next to her bed with its side rail down. Her physician was notified of this incident.
On January 25 a LifeCare interdisciplinary team discussed Quartermaine's circumstances and updated her care plan to provide her with a sensor pad alarm and to encourage her to ask for assistance in lying down. Another fall risk assessment was conducted and LifeCare assigned her a score of 16, which reflected a high risk for falls. However, it did not mention that Quartermaine had fallen within the past six months. At 12:00 p.m. that day, Quartermaine was found kneeling next to her wheelchair, stating, "I want to down." LifeCare called Quartermaine's physician and daughter to inform them of her fall. On January 26 LifeCare noted Quartermaine suffered confusion from hallucinations.
At 8:00 a.m. on January 28, Quartermaine was found lying on the floor near her bed, apparently because of a fall. Her bed alarm had not sounded. A
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