Why is this nursing home being fined $10,000?

Belle Plaine, Iowa - A nursing home in Belle Plaine was fined for an unexplained broken leg of a resident. The resident died four-days later but the cause of the death was not given. The fine was $10,000.00. Is this fine fair?

I'm not conversant in the regulations surrounding how nursing homes are allowed to operate, so legally I can't say what regulation the home may have violated. It could be one of restraining or containing patients prone to falling and injuring themselves and then recording in a timely fashion their condition. Could be, maybe it is and maybe not. But in the practice of civil law for compensation the issues are a bit different.

Ordinarily the patient must explain or at least has the burden of proof to prove how the broken leg was caused. Of course in this instance the resident, the plaintiff, is deceased so how can we prove what happened to her? In this instance the law provides what may be an evidentiary tool useful in this instance. It's called res ipsa loquitur and it places the burden of proof to explain the event onto the party who controls the evidence. In this case the nursing home staff had access to and control over the flow of information, the evidence, to prove or disprove negligent conduct. And because the law of torts seeks to make every man's knowledge and information available to the fact finder, forcing them to talk is a very effective remedy. What the Courts do is instruct the fact finder their failure to disclose information they have can be considered in weighing the evidence and a failure to explain how they were not negligent. It's used most often when surgical patients unconscious from an anesthetic are injured during the surgery. Surgical patients unconscious are not able to say what occurred when they were on the operating table, but the surgical staff certainly is and should disclose how the unconscious patient was injured.

Of course you can't assume the nursing home is automatically at fault for the broken leg. This fine may have nothing to do with how the patient was injured; only about their record keeping. As for who is at fault for the broken leg, that's a whole other case of course; one separate and distinct from the duty to keep charts current and entries timely. As for the broken leg well that could just be a natural occurrence of aging.  Was there trauma to the skin? Was the resident able to walk, prone to falling or even suffering from osteoporosis; a condition in which the bones lose calcium and become brittle?

Perhaps Joe Thornton, the nursing home's attorney needs to produce expert testimony; assuming he hasn't already. Go get em Joe.