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Even if county nursing home workers provide poor care, the county is not liable unless the inadequate care results directly from an official policy or custom, a federal judge has ruled.

The case in question involves Neshaminy Manor Inc. and Neshaminy Long Term Care, operated by Bucks County, PA. Lauretta Notwick, the daughter of a Neshaminy resident who died in June 2010, sued the county, trying to hold it accountable for the inadequate care she says her mother received.

Notwick’s mother, Almira Will, was admitted to Neshaminy Manor in August 2008. She required continuous oxygen due to end-stage chronic obstructive pulmonary disease. Notwick alleged that her mother’s oxygen tank was often empty or turned off. She also said her mother repeatedly fell while at Neshaminy due to staff negligence, and this led to a hip fracture in April 2010.

An oxygen policy created by Bucks County led to the inadequate care of her mother, Notwick argued in her suit. She cited policy language that staff “may” replace oxygen cylinders with needles halfway in the red, or refill, zone. Judge Lynne A. Sitarski ruled that nursing staff may have provided poor care by not providing enough continuous oxygen, but the language in the county’s policy was not to blame for this.

Similarly, Notwick provided no evidence that Will’s falls were caused because workers were carrying out a county policy, the judge wrote. The plaintiff also did not provide evidence that other residents were given care that was similar to Will.

Sitarski granted a Motion for Summary Judgment in favor of the county.