Hospital Liability for a Fatal Pressure Ulcer in Arizona

Attorney Answer

A hospital can be held liable in Arizona for a pressure ulcer caused by failing to turn and clean a patient — but the case will turn on whether you can produce an expert who matches the defendants' exact specialty, and that requirement has defeated cases with facts almost identical to yours.

The obstacle is statutory. Under A.R.S. § 12-2604(A), where the defendant health-care provider is a specialist, a standard-of-care expert must specialise in the same specialty — and be board certified in it if the defendant is — and must have devoted a majority of professional time during the year immediately preceding the occurrence to active clinical practice in that same specialty, or to teaching it in an accredited programme. If the defendant is a general practitioner, the expert need only make the same majority-of-time showing in general practice.

Arizona's appellate courts have applied that to this exact fact pattern, and the result went against the family. In Rasor v. Nw. Hosp., LLC, 243 Ariz. 160, 403 P.3d 572 (Ariz. 2017), the claim was that ICU nursing staff caused a stage IV pressure ulcer by failing to reposition and off-load the patient. The plaintiffs' expert was a board-certified wound-care nurse — plainly knowledgeable about wounds — and she was held not to qualify under A.R.S. § 12-2604 to give standard-of-care testimony, because she had not devoted a majority of her professional time in the preceding year to the defendants' specialty, critical care. That is a real threshold barrier and you should go in knowing it. The courts did soften the consequence in two ways: outright summary judgment was held too harsh, so the plaintiffs were entitled to additional time to find a qualified standard-of-care expert, and on remand the same nurse was held competent to testify about causation even though she could not testify to the standard of care.

There is also no way around the requirement by relabelling the claim. In Cornerstone Hospital of Southeast Arizona v. Blackburn, 231 Ariz. 67, 290 P.3d 460 (App. 2012), the court held that A.R.S. § 12-2604 governs the admissibility of medical standard-of-care evidence in a case brought under Arizona's Adult Protective Services Act just as it does in a medical malpractice action, reasoning that the interest in ensuring the witness has sufficient expertise is no less compelling where a vulnerable adult is involved. Recharacterising a medical-negligence theory as elder neglect does not escape the expert-qualification rule.

On your other two questions. Many Arizona malpractice firms do free initial consultations by phone or video, so an online consult is straightforward to arrange. As for holding the hospital accountable so it does not happen again — a lawsuit produces money damages, not operational change. The routes that actually reach a hospital's practices are regulatory: a complaint to the Arizona Department of Health Services, which licenses and surveys hospitals; a complaint to the Arizona State Board of Nursing about individual nurses; and, if the hospital participates in Medicare, a complaint through the federal survey process. Those cost nothing, do not require a lawyer, and can be filed now, entirely separately from any claim.

What is recoverable, and by whom, depends on whether the claim is brought as a wrongful-death action by the statutory survivors or on behalf of the estate for what your mother endured before she died. Those are different claims with different recoverable damages, and sorting out which applies is one of the first things a lawyer will do.

What you can do

1. Request the complete chart in writing: nursing flow sheets, turning and repositioning logs, Braden or other skin-risk assessments, wound care notes, wound photographs, and the treatment records for the ulcer. 2. Ask specifically for the unit staffing records and assignment sheets for the relevant dates. Under-staffing is often what the turning logs actually show. 3. Preserve any photographs you or other family members took of the wound, with dates. 4. Write down which unit she was on and what kind of clinicians cared for her — ICU, medical-surgical, long-term acute care. Because A.R.S. § 12-2604(A) keys the expert requirement to the defendants' specialty, this determines who your expert has to be. 5. File complaints now with the Arizona Department of Health Services and, if applicable, the Arizona State Board of Nursing. Those are the accountability routes; do not wait on the lawsuit. 6. When you consult a lawyer, ask directly: which specialty were the defendant clinicians, and who is the A.R.S. § 12-2604 expert going to be? A firm that has not thought about that has not evaluated your case. 7. Confirm who is legally entitled to bring the claim before paperwork is filed.

⏱ Time limits apply. A.R.S. § 12-542 sets a two-year period for personal injury and wrongful death claims. Finding a qualified expert under A.R.S. § 12-2604(A) takes time and does not pause that period. When your period started depends on your specific facts.