by Riley Edenbeck
COLUMBIA — Healthcare companies and a nursing center appealed a court decision requiring them to pay out millions in a wrongful death lawsuit.
Jean Watkins, representing her late mother, Mildred Watkins, filed wrongful death and survival actions against Sterling Healthcare, Countrywood Nursing Center and Guardian Resources following her mother’s death during her stay at Countrywood in Hopkins in 2011.
The circuit court that handed down that initial decision called the case “the most egregious case of elder neglect/abuse” it had ever witnessed. SC appeals court judges John Geathers, Blake Hewitt and Kristi Curtis found that determination “well supported by the record” in their September ruling, but they did poke some holes in that lower court’s judgment, reducing the damages the medical provider must pay from nearly $30 million to nearly $24 million.
Even though that total was reduced, it’s back up into the $30 million range by now — 7.25% percent interest has been accruing on the nearly $24 million since it was decided, Watkins’ legal counsel said.
After the businesses repeatedly failed to comply with discovery requests, the circuit court sided with Watkins. The businesses then appealed the award of punitive damages and an order compelling them to provide financial and insurance-related records. The appeals court found that the lower court erred in setting aside a statutory cap on the damages, thus lowering what the companies must pay.
“We are very happy that the Court of Appeals recognized the severe trauma that Mildred Watkins and her family endured,” attorney Jennifer Purdy said, who has represented the Watkins family for over a decade and secured the initial judgment. “This has been a long road for the Watkins family, and much work lies ahead of us. However, we are committed to continuing this fight until justice is achieved for Mildred Watkins.”
It’s not yet clear whether the businesses will request an additional hearing or a writ to the state Supreme Court, Robert Eaton, the attorney representing Sterling Healthcare and Countrywood Nursing Center, said on Oct. 1.
Watkins’ legal counsel requested a rehearing Oct. 8 to recoup about $5 million of the damages shaved off by the Court of Appeals. If the businesses decide to continue the case, it could be another year or two before those numbers are certain.
Watkins has since filed a companion case in federal court in an attempt to hold the companies’ owners at the time of her mother’s stay accountable for what happened. That case awaits a state Supreme Court decision to move forward.
Mildred Watkins’ stay at Countrywood
Less than nine months into her stay at Countrywood Nursing Center in Hopkins, Mildred Watkins died from urosepsis at 73 years old.
According to the appeal decision, on March 8, 2011, Mildred Watkins was admitted to Countrywood for rehabilitation after falling at her home. Watkins had several pre-existing conditions at the time of her admission, but they were all managed through treatment and medication. She was listed by a Countrywood physician as having high rehabilitative potential, and her family expected her to return home after she regained her strength.
She weighed between 100 and 115 pounds at the time of her admission, which decreased over time to 79 pounds. Watkins was hospitalized eight times while in Countrywood's care. Her first hospitalization occurred within the first 24 hours of admission, though doctors found nothing wrong with her and immediately released her.
On March 15, Jean Watkins visited her mother and found her unresponsive. At Jean’s urging, Mildred was taken to the hospital where she was diagnosed with a urinary tract infection.
On August 22, 2011, Mildred Watkins was transported to her dialysis appointment, where workers “noticed her altered mental state” and took her to the hospital. Doctors diagnosed Watkins with another UTI and admitted her for three days.
On October 8, 2011, Jean Watkins noticed her mother was acting strangely, had a fever, and was complaining about her thumb, which appeared swollen. Jean testified in court that when she asked about the injury, Countrywood staff said that her mother banged her hand on the bedrail. Jean demanded that her mother be taken to the hospital for an X-ray. Doctors diagnosed Watkins with a severely dislocated thumb and another UTI.
Jean testified that an ER doctor raised suspicions about Watkins' thumb injury. She stated that the doctor was doubtful Watkins caused the injury herself and that her thumb had to have been "twisted or turned or pulled back." That detail wasn’t reflected in her mother’s medical records and only appeared in the record through Jean’s testimony. Mildred Watkins was unable to tell her daughter what caused the injury.
Countrywood staff then called Jean Watkins on Nov. 7, 2011 to tell her that her mother cut her leg while getting into bed. When Jean arrived, she discovered her mother bleeding from a large laceration on her leg. A certified nursing assistant informed her that while staff was getting Watkins into bed, Watkins cut her leg on a piece of metal that was protruding from the bed. Jean again demanded that Watkins be taken to the hospital. Mildred’s leg wound was five centimeters long and required ten staples to close.
Jean filed a complaint with the now defunct state Department of Health and Environmental Control regarding the incident. The complaint and Countrywood's response were admitted at the damages hearing, and in the response, Countrywood's nurse manager reported that the staff "found a metal projection on the lower bed frame that could have caused the skin tear."
Staff then performed an audit on all of the beds in the unit and found 15 other beds with the same metal protrusion from the bed frame.
Jean Watkins later testified with photo evidence that Countrywood sawed off Watkins' bedrails and left behind an exposed, jagged piece sticking out from the bottom of the bed. Mildred Watkins returned to the hospital on Nov. 17 for surgery to repair her dislocated thumb.
On Nov. 20, Jean visited her mother again and learned she was not eating, had been vomiting, and had diarrhea. She again insisted her mother be taken to the hospital. Upon admission, Watkins was diagnosed with a severe UTI with possible systemic response syndrome.
Due to a cast on her arm from surgery on her thumb, doctors had to insert a central line in her leg for her IV. Over the 10 days she was in the hospital, nurses and doctors noticed multiple bruises, skin tears, open wounds, abrasions, and decubitus ulcers on her body. These skin conditions were also noted by Countrywood upon her readmission to the facility.
Mildred Watkins' final hospitalization was on Dec. 7, 2011. Jean Watkins visited her mother on that date and found her unresponsive and "slumped over" in her wheelchair, drooling, and wearing a saturated bib. Jean noted that her mother's clothes were filthy. Jean testified that when she asked staff to call an ambulance, one staff member asked her why they should when Watkins "wasn't going to get any better."
Mildred Watkins was eventually transported to the hospital via ambulance and admitted to the medical intensive care unit. She was diagnosed with urosepsis and an advanced bed sore on her lower back. Doctors also noted scratches on areas of her body that she was unable to reach herself, and that she weighed only 79.36 pounds. Watkins died on Dec. 15, 2011, from complications of urosepsis.
During her time at Countrywood, staff performed weekly "skin audits" documenting the condition of Watkins' skin. To accurately perform the audit, staff must not only visually examine the patient's skin but must touch the skin as well. Jean Watkins testified at trial that when she reviewed her mother's medical records, she found several skin audits that reported her mother's skin condition on dates when she could not have been examined by Countrywood staff because she was hospitalized.
History of the case
Jean Watkins filed suit on Aug. 22, 2014, and served the businesses with discovery requests the same day. A month later, the businesses filed answers denying all allegations, but did not provide the necessary information.
After nearly a year of the businesses refusing to share information, Watkins filed a motion to compel in July 2015. The circuit court ordered the businesses to produce the requested information by Dec. 20.
When the businesses failed to comply by the deadline, Watkins sought sanctions, and the court ordered a damages hearing. The businesses appealed the sanctions order, and the Richland County appeals court affirmed it.
The circuit court held a damages hearing in November 2022. Two witnesses testified, including Jean Watkins and her sister Kim Watkins.
The circuit court set aside the noneconomic damages cap that had been set because it found the businesses "repeatedly acted in a grossly negligent, reckless, willful, wanton, and reckless manner" which resulted in Watkins' injuries and her untimely death.
Further, the court pointed to the skin check audits as proof that the businesses "knowingly and willfully falsified medical records, pretending to provide treatment and services that they could not have provided, because [Watkins] was hospitalized at the time the alleged examinations were performed."
The court set aside the cap on punitive damages, with Judge Frank Addy finding:
“[T]his is the most egregious case of elder neglect/abuse I have ever witnessed — and most of the similar cases I have seen involve the criminal side of my jurisdiction. … If any of the three corporations were a person, they would be jailed for the rest of their lives.”
Damages reduced
The original damages awarded by the circuit court, just short of $30 million, were arrived at in part by setting aside the statutory cap on punitive damages for the survival action brought by Jean Watkins, due to the judge’s determination that there was “intent to harm” on the part of the healthcare companies.
That led to the circuit court ordering payment of nearly $17 million in punitive damages for that action, and nearly $20 million in total. The court ruled that the companies owed $10 million for damages in Watkins’ wrongful death action.
The appeals court determined that the circuit court was wrong in assigning “intent to harm” to the companies, thus limiting the punitive damages to four times the compensatory damages awarded in the case, which landed just shy of $2.8 million. Thus, the appeals court reduced the punitive damages owed in the survival action to just over $11 million, settling on a total of nearly $14 million in damages for that action.
Raising the issue to federal court
It’s not required for nursing homes to have liability insurance, according to federal law.
In this case, all three of the business entities were owned and operated without that insurance. Countrywood Nursing Center, while still a company on paper, divested itself of all its assets, attorney Graham Newman said, who also represents Watkins.
That essentially makes it impossible to collect on the judgment issued by the appeals court, requiring Watkins to file a companion case in federal court seeking to “pierce the corporate veil” of the businesses’ entities, Watkins’ legal counsel said.
“A $23 million judgment now is obviously still a big deal,” Eaton said, “but the other case has a bit more of an impact on how much money is going to be recovered by [Watkins].”
Such a case essentially allows Watkins to pursue legal action against individual investors, owners and other stakeholders in the businesses in an attempt to prove their fraudulent behavior, remove their liability protections and recoup money against their personal assets.
“The judgment on paper is not a judgment in reality,” Newman said. “We think it is fundamentally unfair to Mildred and her family that this company chose to exist without liability insurance in an industry in which potential damages include misery and death, and did include both of those things in this case.
“While there is no liability insurance available to us from the corporations,” Newman added, “we do believe that there are monetary assets available from those that own the corporation and made the decision to run the corporation without the necessary insurance.”
That case has been on hold since February, awaiting a decision from the S.C. Supreme Court on some questions about state law. Watkins’ legal counsel didn’t have an estimate of when a decision might be reached.
Full Article & Source:
‘Egregious case’ of elder abuse: Companies ordered to pay $30M after SC woman’s 2011 death
