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$1.3 Million Award Upheld Against Nursing Home Doctor

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After Paul Carter died at the Imperial of Hazel Crest Nursing Home in Illinois, his widow sued both the facility and the doctor in charge of his care. She claimed that after her husband was discharged from a hospital stay back to the nursing home, his physician failed to prescribe the insulin that Mr. Carter, a diabetic, needed to survive. She settled her lawsuit against the nursing home for $125,000; a jury awarded her $1.3 million against the attending physician.

In a sad irony, Mr. Carter was first admitted to Imperial precisely because his wife believed that it provided better care to bedridden patients than the nursing home and hospital where he had been treated. On his first admission his care was taken over by Dr. Abdol Azaran, the medical director at Imperial.

Mr. Carter had been a diabetic for over forty years, requiring daily injections of insulin. Dr. Azaran entered an order to continue daily insulin; because of Mr. Carter’s dementia, he was unable to participate in that or other treatment decisions.

A few days after his initial admission to Imperial, Mr. Carter was hospitalized for a urinary tract infection. During that stay Dr. Azaran ordered that his daily insulin shots be supplemented with periodic blood glucose checks and, when necessary, injections of a faster-acting insulin.

By the time Mr. Carter was returned to Imperial his daily insulin shots had been abandoned in favor of the regular glucose monitoring. In the course of the readmission, however, Dr. Azaran’s order for fast-acting insulin also got cancelled, so that Mr. Carter received no insulin whatsoever. He also had decubitis ulcers on his tailbone and heel, and he refused to (or could not) eat. Mrs. Carter discovered that the insulin had been stopped when she inquired about his condition.

Dr. Azaran did not return at least three attempts to page him for instructions on Mr. Carter’s care, and he was finally re-hospitalized at the direction of Imperial’s Nursing Director. Doctors at the hospital found that he had suffered a mild heart attack, and treated him for decubitis ulcers, dehydration, pneumonia and infection of both his bladder and his decubitis ulcers. Mr. Carter was discharged back to Imperial a month later, and lived another three months at the facility.

The jury awarded $55,000 for actual medical expenses, $385,000 for aggravation of existing medical conditions and $1,060,000 for pain and suffering against Dr. Azaran, and he appealed. The Illinois Court of Appeals upheld the judgment; the evidence supported the jury’s award and it did not “exceed the limits of fair and reasonable compensation.” Dr. Azaran’s novel argument that Mr. Carter “would have paid for a bed to sleep in at the nursing home” did not mean his estate could not recover all the costs of medical care. Carter v. Azaran, July 22, 2002.

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Robert B. Fleming


Robert Fleming is a Fellow of both the American College of Trust and Estate Counsel and the National Academy of Elder Law Attorneys. He has been certified as a Specialist in Estate and Trust Law by the State Bar of Arizona‘s Board of Legal Specialization, and he is also a Certified Elder Law Attorney by the National Elder Law Foundation. Robert has a long history of involvement in local, state and national organizations. He is most proud of his instrumental involvement in the Special Needs Alliance, the premier national organization for lawyers dealing with special needs trusts and planning.

Robert has two adult children, two young grandchildren and a wife of over fifty years. He is devoted to all of them. He is also very fond of Rosalind Franklin (his office companion corgi), and his homebound cat Muninn. He just likes people, their pets and their stories.

Elizabeth N.R. Friman


Elizabeth Noble Rollings Friman is a principal and licensed fiduciary at Fleming & Curti, PLC. Elizabeth enjoys estate planning and helping families navigate trust and probate administrations. She is passionate about the fiduciary work that she performs as a trustee, personal representative, guardian, and conservator. Elizabeth works with CPAs, financial professionals, case managers, and medical providers to tailor solutions to complex family challenges. Elizabeth is often called upon to serve as a neutral party so that families can avoid protracted legal conflict. Elizabeth relies on the expertise of her team at Fleming & Curti, and as the Firm approaches its third decade, she is proud of the culture of care and consideration that the Firm embodies. Finding workable solutions to sensitive and complex family challenges is something that Elizabeth and the Fleming & Curti team do well.

Amy F. Matheson


Amy Farrell Matheson has worked as an attorney at Fleming & Curti since 2006. A member of the Southern Arizona Estate Planning Council, she is primarily responsible for estate planning and probate matters.

Amy graduated from Wellesley College with a double major in political science and English. She is an honors graduate of Suffolk University Law School and has been admitted to practice in Arizona, Massachusetts, New York, and the District of Columbia.

Prior to joining Fleming & Curti, Amy worked for American Public Television in Boston, and with the international trade group at White & Case, LLP, in Washington, D.C.

Amy’s husband, Tom, is an astronomer at NOIRLab and the Head of Time Domain Services, whose main project is ANTARES. Sadly, this does not involve actual time travel. Amy’s twin daughters are high school students; Finn, her Irish Red and White Setter, remains a puppy at heart.

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Matthew M. Mansour


Matthew is a law clerk who recently earned his law degree from the University of Arizona James E. Rogers College of Law. His undergraduate degree is in psychology from the University of California, Santa Barbara. Matthew has had a passion for advocacy in the Tucson community since his time as a law student representative in the Workers’ Rights Clinic. He also has worked in both the Pima County Attorney’s Office and the Pima County Public Defender’s Office. He enjoys playing basketball, caring for his cat, and listening to audiobooks narrated by the authors.