A federal appeals court has ruled that the jury in an improper medication suit against a nursing home was given proper instructions by a federal trial court. The decision put more responsibility on the accused facility, which could not supply medication reports from a 2007 incident.

In Freudeman v. Landing of Canton, the U.S. Court of Appeals for the Sixth Circuit approved the use of the res ipsa loquitur theory based on the circumstances and injuries suffered by Dorothy V. Freudeman while a resident of the Landing of Canton in Ohio. In short, the facility was found to be solely responsible for Freudeman’s medication regimen and, therefore, could be reasonably held accountable for any lapses.

“The doctrine motivates the defendant to produce evidence that would deter the jury from inferring negligence. Here, the exact cause of Dorothy’s injury was unascertainable by Freudeman [and] Dorothy sustained her injury while she was within the exclusive care of The Landing,” the court observed.

In allowing punitive damages, the court referred to multiple prior medication errors, the fact that two nurses were responsible for the care of 80 residents and that the facility “regularly engaged in the unsafe practice of pre-pouring residents’ medications … the medication cart was ‘a mess’ most of the time … [and] the wrong pills were found in the medication trays. The nurses would borrow medication from one resident and give it to another [and] at the time of her death, over fifty of Dorothy’s pills were missing.”

Testimony in the case included word of falsified medical records and a supervisor who altered records to cover up a medication error, according to the court.

It sided with the Emeritus-owned provider, however, in determining that $1.25 million in punitive damages should be only $800,000. The case’s full citation is Freudeman v. Landing of Canton, 6th Cir., No. 12-3130.