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Expert Testimony Required In Lawsuit Against Nursing Home

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Fred O. Thompson lived in the Embassy Rehabilitation and Care Center in Iowa. While there, he developed serious bedsores, ultimately requiring surgery to repair the damage. After his recovery, he brought suit against the nursing home, alleging negligent care. His complaint was dismissed by the Iowa courts.

Mr. Thompson was in his early 40s when he suffered a series of strokes between 1985 and 1987. As a result of those strokes, he was unable to speak or move any of his limbs. He moved into a nursing home in 1988.

Six years later, Mr. Thompson was found to be suffering from osteoporosis when he was admitted to a local hospital for treatment of a leg fracture. After a brief hospital stay, he returned to the nursing home.

Once he was back at the nursing home, staff noticed that he had developed ulcerated bedsores on his left buttock. After consultation with his attending physician, they began treatment with a special ointment, and provided an air flotation cushion. An enterostomal therapy nurse (one who specializes in dealing with pressure sores, ostomies and similar problems) was assigned to follow Mr. Thompson.

Through all of this effort, it became clear that one important component of Mr. Thompson’s treatment needed to be relief of the pressure on the affected area. His attending physician and the enterostomal therapy nurse both agreed that he needed to be moved into a new position every two hours, and that his weight should be kept off the worsening ulcers.

Unfortunately, Mr. Thompson himself refused to allow the staff to reposition him; he had a single position he preferred, and he insisted on being left in that position nearly full time. That position (head and feet both up, lying on his back) put most of his weight squarely on the affected area.

Finally, after his condition worsened to a “stage 4” coccyx ulcer, Mr. Thompson’s physician decided surgery was necessary. Surgical trimming and a skin graft were completed about four months after the bedsore was first noticed, and Mr. Thompson recovered quickly. Then he brought suit against the nursing home for failure to effectively treat his condition. He alleged both that surgery should have been undertaken earlier, and that the staff should have repositioned him despite his objections.

The trial court dismissed his complaint on the basis of pretrial motions, and the Iowa Supreme Court agreed. Mr. Thompson had apparently been unable to secure an expert witness who would testify that the nursing home’s care was substandard, and the court ruled that such testimony would be required to allow Mr. Thompson to even pursue his claim. Thompson v. Embassy Rehabilitation and Care Center, January 20, 2000.

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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.