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Case Study - Hospital Personal Injury

76 year old man was admitted to a hospital in Central Florida for cardiac complaints. He was admitted and underwent several procedures without complications. On the third day of admission the patient fell in the bathroom resulting in a fractured hip and severely bruised lower back with lacerations of this leg, back and scalp. He required surgical stabilization of the femur and admission to a rehabilitation facility postoperatively.


Normally, a personal injury case such as this would be limited to a max of approximately one million dollars. However, this case was different, and resulted in a settlement of just over 3 million dollars because an evaluation of the medical records revealed falsified charting. Prior to the incident, the patient required maximum assistance with two nurses (staff) to assist with ambulation. The nurse's documentation of the incident stated that a single nurse was able to get the patient off the floor and back to bed with minimal assistance. This was clearly a false record as several notes following the incident indicated that the patient continued to require maximum assistance to move in the bed and was not able to ambulate. Discovery revealed incident reports the hospital did not want to see in front of a jury.


Armed with this information, the plaintiff attorney was able to negotiate a settlement of over 3 times the norm for this type of case. When the subrogation lien was evaluated, the insurance company attempted to recover the entire costs of hospitalization. However, the first 3 days of cardiac testing and treatment was not applicable and discarded. Further negotiation of the subrogation lien resulted in a total reduction of 80% of the total medical costs.


While this is case is atypical, evaluation of the medical records and billing resulted in a large settlement for the patient and high profits for the representing attorney.


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