This case involves an elderly male patient who was admitted to the nursing home after a hospital stay during which he contracted C-Difficile. Upon admission to the nursing home, the patient suffered from fecal incontinence due to the C-Difficile and was not cleaned appropriately by staff. In particular, the patient suffered extensive sores on his buttocks area. The patient suffered deteriorating health and mental status until for almost 2 months before being removed from the nursing home. Upon removal, he required an additional hospital visit for acute care.
Question(s) For Expert Witness
1. Please explain your background in nursing home administration.
2. What protocols or practices should be in place to prevent oversight in nursing care?
Expert Witness Response E-000382
I work as a supervisor in the nursing home setting. I have also worked as a staff development and infection control nurse in the skilled nursing home setting. Due to the potential risk of mortality that coincides with someone having a C-Difficile infection as well as the risk of C-Difficile being transmitted to other patients, there have to be policies and procedures in place for caring for patients with C-Difficile. This would include nursing care protocols. Evidence of training of all nursing home staff (especially nursing staff) regarding how to care for someone with C-Difficile is required. C-Difficile patients must reside in a private room and strict isolation precautions are put in place. Mask, a gown, gloves, and shoe covers must be worn by all staff caring for the patient. Due to the frequency of bowel movements and the potential for skin breakdown, frequent and complete incontinence care must be carried out with barrier creams used to protect the skin from breakdown. These are just a few of the practices that should be in place.
About the author
Wendy Ketner, M.D.
Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.
Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.
Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.
