Iowa Jury Awards $900,000 Against Mason City Nursing Home After Resident Dies of Dehydration

Maria O'Brien moved into Good Shepherd Health Center, a skilled-care nursing home in Mason City, Iowa, in September 2012. She had dementia, severe osteoporosis and a history of falls and vertebral compression fractures, and the facility classified her as a high fall risk. She stayed two and a half years. She died on April 1, 2015, at age 84, and her death certificate listed dehydration as the underlying cause.

Her four children sued the home in February 2015. The evidence at trial described a long run of unwitnessed falls from a recliner, a wheelchair and a bed, often with no fall-prevention measures in place. Staff were directed not to leave her alone in her wheelchair, and a notice in her bathroom said the same. On March 12, 2014, she was left alone in the bathroom anyway and fell. After that fall she could no longer walk or feed herself, and she developed repeated pressure ulcers.

The nutrition record was the center of the case. O'Brien weighed 127 pounds when she arrived. Her supplements were skipped on 35 occasions in a single month, and she was not placed on a restorative dining plan until the summer of 2014, even though the home's own expert said its policies called for one much earlier. By March 2015 she weighed 84 pounds, a loss of 43 pounds. Her children testified that they often had to feed and give fluids to their mother and to other residents themselves because there were too few staff at mealtimes. Nobody at the home told the family she was struggling with hydration or nutrition, although the nursing notes showed staff knew. She was sent to the hospital on March 28, 2015, where caregivers could not place an IV because of her condition, and she was moved to hospice the next day.

Ben Long and Pressley Henningsen of RSH Legal tried the case for the family in Cerro Gordo County District Court before Judge Christopher Foy. The trial ran nine days in September 2016. The jury found Good Shepherd negligent and awarded $150,000 in compensatory damages for O'Brien's past physical and mental pain and suffering. It also found the home's conduct willful and wanton and added $750,000 in punitive damages, for $900,000 in all. The judgment went to the four children, Kristine Christensen, Stephanie Prohaski, Anthony Savas and Theodore Savas.

Good Shepherd moved for a new trial, a judgment notwithstanding the verdict or a remittitur, and the district court denied all three. The home appealed, challenging four of the negligence specifications in the jury instructions, testimony about its earlier regulatory citations, the submission of punitive damages to the jury, and the size of the punitive award. The Iowa Court of Appeals affirmed on June 6, 2018, and left the five-to-one ratio between punitive and compensatory damages undisturbed.