The Negligence of Elderly in the Nursing Home System

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In Winn v. Pioneer Medical Group, Inc. involves a neglect case brought forth by the plaintiff concerning her mother’s treatment. According to medical records, Ms. Cox visited Pioneer Medical Group for ten years. Throughout the visits, Ms. Cox was free to ask for a referral from Pioneer or to select a doctor of her choice. Additionally, the flexibility of her schedule ensured she stayed in whichever form she preferred. Surgery was performed on her as a result of medical practitioners at Pioneer withholding crucial information due to the presence of a blackleg. In particular, emergency vascular surgery was performed on her with little success. The second admission resulted in her leg being amputated below the knee before another readmission led to the amputation occurring above the knee. Ms. Cox was hospitalized seven months later with blood poisoning that led to her death. According to the defendants, Ms. Cox was treated as an outpatient, which does not fall in their domain. In particular, inpatients are the only individuals liable for custodial obligations.


Kathleen A. Winn and Karen Bredahl who are Ms. Cox’s surviving heirs are the plaintiffs. Pioneer Medical Group, Inc. and the staff at Pioneer Medical Group where Ms. Cox received her treatment are the defendants. The facts submitted by the plaintiff are as follows; as early as 2000, Ms. Cox started receiving care from Dr. Csepanyi at the facilities belonging to Pioneer Medical Group, Inc. The treatment also involved Dr. Lowe, in 2004, who treated her for painful onychomycosis. Based on Dr. Lowe’s diagnosis, Ms. Cox suffered from impaired vascular flow. A similar report was sent to Dr. Csepanyi hence both parties knew that Ms. Cox was in urgent need for medication. From February 2007 to March 2009, the two doctors were aware of the condition yet they did not do anything neither did they give useful information to alert Ms. Cox about her state (Stanford Law School, 2018). The decision to withhold the information was thus conscious and intentional.

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Ms. Cox was deprived of the needed information from the doctors, which led to her untimely demise. When she was admitted to the hospital, Ms. Cox was suffering from chronic decubitus ulcer toes, which led to vascular surgery. According to the complaint filed by the plaintiffs, patient neglect by Pioneer as a presented issue led to a demurrer of the amended complaint. The allegation was that despite being aware of the condition, the defendants chose not to share the medical information that would have probably saved Mrs. Cox life, which is also a violation of the Elder Abuse and Dependent Adult Civil Protection Act (Kindley 2018).


As per the Elder Abuse Act, professional negligence is excluded. As provided in section 15657.2, “Notwithstanding this article, a cause of action for injury or damage against a health care provider, based on the health care provider's alleged professional negligence, shall be governed by those laws which specifically apply to those professional negligence causes of action.” (§ 15657.2.). The elder abuse is thus not applicable to gross or straightforward practices of negligence by the health providers (Covenant Care, Inc. v. Superior Court (2004) 32 Cal.4th 771, 785 (Covenant Care). This also explains the defendant’s demure sustenance by the Supreme Court.


The California Supreme Court ruled in favor of Pioneer. According to the analysis by the Supreme Court, the focus was placed on the legislature’s intent during the enaction of the Elder Abuse Act where plaintiffs have to prove physical abuse presented under section 15610.63, neglect submitted under section 156610.57 or severe recklessness as per Welf. & Inst. Code § 15657. The determination by the Supreme Court centered on the fact that Pioneer neglected medical care instead of self-care, and the relationship lacked custodial platforms. Hence, Pioneer could not be held accountable for what happened to Ms. Cox. Indeed, considering that Ms. Cox is portrayed as being independent, self-sustaining, and capable of doing everything on her own, the doctors assumed she would take care of her health.

Personal Opinion

According to the ruling of Winn v. Pioneer Medical Group Inc., neglect is applicable if the defendant is the custodian, a judgment I disagree with. Unfortunately, a door is opened by the Winn v. Pioneer Medical Group, Inc., which offers a ground for other entities to take advantage of regardless of how reckless the negligence may be. As long as custodial care is absent, the defendants could get away with whatever atrocity they perpetuated. Winn v. Pioneer Medical Group, Inc. comes out as a dangerous situation modeled into the law at the expense of the patient. As such, the practice process that cites the Winn v. Pioneer Medical Group, Inc. must be reminded about the narrowness of the case. While the law is supreme, a different understanding has to be put in place to curb the gap left after the Winn ruling.

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