Glossary of Legal Terms

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Acute care – A high level of care provided to a patient for a medical condition or illness that a patient is likely to recover from. Once a patient recovers from the illness or injury, they will not need assistance of an acute care facility. In cases of people 65 and older, acute care is considered a Medicare benefit.

Administrative agencies – Agencies created by the legislative branch of government to administer laws pertaining to specific areas such as taxes, transportation, and labor.

Admissible evidence – Evidence that can be legally and properly introduced in a civil or criminal trial.

Adult day care – Similar to day care facilities for children, ‘adult day care’ facilities provide assistance for cognitively or physically challenged adults who may may not be able to care for themselves during the day. Adult day care is a broad term that may apply to private-home-based care or community centers that are staffed by trained care providers to meet the needs of the older adults- meals, therapeutic, health, social and even specialized programs for people with Alzheimer’s or dementia. Usually adult day care facilities are open during normal business hours and most seniors have another type of caregiver when not in the program.

Advance directive for health care – A written document that describes how and what type of medical decisions you would like to be made for you if you lose the ability to make decisions for yourself. In some circumstances a health care surrogate can be appointed to make decisions should an incapacity arise. Examples of an advance directive for health care includes: Health Care Power of Attorney, Living Will or Durable Power of Attorney.

Advanced bedsore – Stage 4 Bedsore or unstageable bedsore: Full thickness skin loss with extensive destruction, tissue death, and/or damage to muscle, bone, or supporting structures (tendon, joint, capsule). They will look like a large, deep, open wound revealing bone and connective tissue. (Warning, a stage four bedsore is extremely disturbing to see)

Adverse drug side effects – A harmful and undesired effect resulting from a medication or other intervention such as surgery. It is secondary to a main or therapeutic effect, and may result from an unsuitable or incorrect dosage or procedure, which could be due to medical error. These effects are generated by a physician/treatment. Some adverse effects only occur when starting, increasing or discontinuing a treatment. Adverse effects may cause medical complications of a disease or procedure and negatively affect its prognosis.

Affirmative defense – A defense raised in a responsive pleading (answer) relating a new matter as a defense to the complaint; affirmative defenses might include contributory negligence or estopped in civil actions; in criminal cases insanity, duress, or self-defense might be used.

Agranulocytosis – Failure of the bone marrow to make enough white blood cells. Bone marrow is the soft tissue inside bones that helps form blood cells.

Air embolism – (Gas embolism) is a pathological condition caused by gas bubbles in a vascular system. Most common is in the human body where gas bubbles are in the bloodstream.

Albumin – Refers generally to any protein with water solubility, which is moderately soluble in concentrated salt solutions, and experiences heat coagulation (protein denaturation); egg whites contain albumin.

Alzheimer’s disease – A degenerative disease that results in cognitive impairment and brain functioning. Alzheimer’s patients may originally demonstrate problems with short-term memory. Over time, more noted problems with language skills, reasoning and overall cognitive ability may develop. Currently, there is no cure for Alzheimer’s.

Amputation – The removal of a body extremity by trauma or surgery.

Amyloidosis – A disease that occurs when substances called amyloid proteins build up in organs. Amyloid is an abnormal protein usually produced by cells in bone marrow that can be deposited in any tissue or organ.

Anemia – A medical condition in which the red blood cell count (hemoglobin) is less than normal.

Appellate court – A court having jurisdiction to hear appeals and review a trial court’s procedure.

Appendicitis – An inflammation of the appendix (a small pouch attached to the beginning of the large intestine).

Arbitration – The hearing of a dispute by an impartial third person or persons (chosen by the parties), whose award the parties agree to accept.

Arbitration Agreements – Predominately in cases involving nursing home negligence, arbitration agreements stipulate that cause of action against a nursing home for personal injuries or wrongful death is to be resolved via private arbitration as opposed to a jury trial. Some state courts have recently held such agreements unconstitutional.

Asphyxiation – The condition of being deprived of oxygen (breathing stopped); suffocation.

Aspiration – The taking of foreign matter into the lungs with the respiratory current.

Aspiration pneumonia – An inflammation of the lungs and airways to the lungs (bronchial tubes) from breathing foreign material. Symptoms include bluish discoloration of the skin (from lack of oxygen), chest pain, cough with foul-smelling phlegm, phlegm with pus or blood, greenish sputum, fatigue, fever, shortness of breath, wheezing, breath odor, excessive sweating, swallowing difficulty.

Assisted Living Facility – A living arrangement that provides assistance with meals, housekeeping, transportation and personal care for people who may no longer be able to tend to their daily living needs. Assisted living facilities (ALF) vary greatly in terms of the services they provide and the level of assistance offered to residents. Unlike nursing homes, assisted living facilities do not provided skilled nursing care. Rather, when a person required skilled medical care, they should be transferred to a nursing home, hospital or more appropriate care facility.

Autonomic dysreflexia – Also known as “AD” or “autonomic hyperreflexia” is a condition characterized by a massive sympathetic discharge that can occur in association with spinal cord injury or disease (e.g. multiple sclerosis). AD is considered a medical emergency.

Autolytic debridement – For bed sore patients, autolysis uses the body’s own enzymes and moisture to re-hydrate, soften and finally liquefy hard eschar and slough; this is a selective process – only necrotic tissue is liquefied and is virtually painless to the patient. This can be achieved with the use of occlusive or semi-occlusive dressings which maintain wound fluid in contact with the necrotic tissue.

Autonomic nervous system – Part of the peripheral nervous system that acts as a control system functioning largely below the level of consciousness, and controls visceral functions (heart rate, salivation, perspiration, diameter of the pupils, micturition – urination, and sexual arousal.

Autopsy – An examination of a body after death to determine the cause of death or the character and extent of changes produced by disease.

Battery – A beating, or wrongful physical violence. The actual threat to use force is an “assault;” the use of it is a battery, which usually includes an assault.

Bed alarm – A notification system that alerts others when a person gets out of bed.

Bed sore – (Bedsore) Wounds on the body primarily caused by: unrelieved pressure; friction; shearing forces; age; continence and body mass. Although bed sores may develop in any part of the body, bony areas of the body such as: sacrum, elbows, knees, ankles and buttocks are particularly susceptible. Most experts widely agree that the best method of bed sore prevention is regularly alleviate the pressure on the prominences by turning patients every two hours. Untreated bed sores may quickly advance resulting in an open would susceptible to infection and other medical complications such as gangrene, osteomyelitis and sepsis. In some circumstances, bed sores may be fatal. Bed sores are similarly referred to as: pressure sores, pressure ulcers or decubitus ulcers.

Bedsore lawsuit – A lawsuit brought on behalf of an individual or an estate against a facility (nursing home/hospital/assisted living facility) where a bedsore may have originated.

Bed rail entrapment – When a resident/patient is caught, trapped, or entangled in the space in or about the bedrail, mattress or hospital frame. This can result in serious injury or death.

Beneficiary – A person who is entitled to receive the benefits or proceeds from a will, trust, insurance policy, annuity, retirement plan or contract. Individuals who receive benefits from Medicaid and Medicare are also referred to as beneficiaries.

Bench trial – (Also known as court trial.) Trial without a jury in which a judge decides the facts.

Blood transfusions – The process of transferring blood or blood-based products from one person into the circulatory system of another.

Board and care home – A group residence that provides residents with meals and assistance with daily care needs. Most board and care facilities are small and house just a handful of people. Board and care facilities do not provide skilled nursing care.

Braden scale – The measurement system used to measure a bed sore stage.

Broken bone – A broken bone may occur when more pressure is put on a bone than it can stand and the bone literally splits or breaks. A break of any size is called a fracture. If the broken bone punctures the skin, it is called an open fracture (compound fracture). A stress fracture is a hairline crack in the bone that develops because of repeated or prolonged forces against the bone.

Bruise – A bruise is an area of skin discoloration resulting when small blood vessels break and leak their contents into the soft tissue beneath the skin.

Burden of proof – In the law of evidence, the necessity or duty of affirmatively proving a fact or facts in dispute on an issue raised between the parties in a lawsuit. The responsibility of proving a point (the burden of proof). It deals with which side must establish a point or points.

Burns – Burns can be caused by dry heat (like fire), wet heat (such as steam or hot liquids), radiation, friction, heated objects, the sun, electricity, or chemicals. Thermal burns are the most common type. Thermal burns occur when hot metals, scalding liquids, steam, or flames come in contact with your skin. Burns amongst the elderly, have the highest rates of complication. Common causes of burns in the nursing home setting include: smoking, fires, over-heated food or improper water temperature.

C difficile – Clostridium Difficile is a bacteria in intestines found in healthy and ill people that causes diarrhea and other intestinal disease when competing bacteria are wiped out by antibiotics.

Call lights – Notification system used in nursing homes/hospitals which allows a patient to contact a nurse or other help when needed.

Capacity – Having legal authority or mental ability. Being of sound mind.

Caps on damages – Monetary limitation placed on the recovery an injured party or estate of deceased may recover.

Caregiver – Any person who provides assistance to an adult who may be unable to function independently or attend to his or her personal needs and daily living functions.

Care manager – A health care professional who oversees long-term care services for an individual. While many care managers may have specialized training, a care manager need not have the specialized training to tend to a patients ‘care plan’ which is typically developed by physicians and medical professionals.

Care plan – Part of nursing practice that provides a written means of planning patient care and discharge planning based upon nursing diagnosis; the plan functions as a means of communicating patient care needs between members of the nursing team to ensure those needs are met; they serve as a means to document changes in patient’s condition, adjustments or additions to nursing diagnosis, as well as patient responses to nursing or medical treatment; care plans enable nurses to provide a holistic approach to patient needs both while hospitalized and after discharge.

Case law – Law established by previous decisions of State Courts, Appellate Courts, Federal Court or the United States Supreme Court.

Catheter – A medical device typically used for patients suffering from incontinence that is inserted into the body and urine is drained into a receptacle bag.

Cause of action – The fact or facts which give a person a right to relief in court.

Cellulitis – A spreading bacterial infection of the skin and tissues beneath the skin; usually begins as a small area of tenderness, swelling and redness (accompanied by fever, chills, sweats and swollen lymph nodes near the infected skin).

Cerebral Palsy – Group of non-progressive, non-contagious motor conditions that cause physical disability in human development, chiefly in the various areas of body movement; the affected area of the brain is the cerebrum (and most likely connections to the cortex and the cerebellum) and palsy refers to movement disorders; a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to nonprogrsseive disturbances that occurred in the developing fetal or infant brain; usually accompanied by disturbances of sensation, perception, cognition, communication and behavior.

Certified nursing assistant – Trained and certified professionals that help nurses by providing non-essential medical assistance to patients. Examples include: bathing, eating and dressing.

Cervical fracture – “Broken neck”, there are seven cervical vertebrae (neck bones) in the human neck, and the fracture of any can be catastrophic; abnormal movement of bones or pieces of bone can cause spinal cord injury resulting in loss of sensation, paralysis, or death.

Chemical debridement – Uses certain enzymes and other compounds to dissolve necrotic tissue; it is more selective than mechanical debridement. The body makes its own enzyme, collagenase, to break down collagen, one of the major building blocks of the skin.

Choking – Partial or complete obstruction of the airway can be due to a foreign body such as food or liquid.

Cholecystitis – The inflammation of the gall bladder.

Chronic pain – Pain that lasts longer than 3 months; it is different than acute pain that is not easy to find the cause; there can be debilitating pain with no revealing injury at all; can begin from an injury.

Chronically ill patient – As the name indicates, chronic illness indicates a person who has been unable to provide his or her daily living needs without the assistance of another person for at least 90 days in the past one year period.

Civil action – An action brought to enforce or protect private rights.

Civil law – Law based on a series of written codes or laws.

Civil lawsuit – Law that determines private rights and liabilities, as distinguished from criminal law; usually involve private disputes between persons or organizations; lawuite based on non-criminal statutes, suck as disputes involving accidents or contracts; typically seek to recover money damages or allow/disallow certain acts, rather than to imprison or punish a person.

Civil procedure – The rules and process by which a civil case is tried and appealed, including the preparations for trial, the rules of evidence and trial conduct, and the procedure for pursuing appeals.

Claim – A debt owing by a debtor to another person or business. In a personal injury setting, a claim refers to the legal rights of a person who was injured due to the fault of others. In the case of wrongful death, a claim refers to the legal rights of the persons estate who was killed due to the fault of others.

Class action – A lawsuit brought by one or more persons on behalf of a larger group.

Clear and convincing evidence – Standard of proof commonly used in civil lawsuits and in regulatory agency cases. It governs the amount of proof that must be offered in order for the plaintiff to win the case.

Clerk of Court – Administrator or chief clerical officer of the court.

Clinitron bed – Air fluidized bed combines air fluidized therapy and low air loss therapy on an articulating frame providing patients with relief from bed pressure sores; it is one of the best treatments for pressure ulcers and also has the ability to elevate the head.

Clogged breathing tube – An obstruction in the airway that was made for a patient that can, within minutes, lead to serious distress, brain injury, and death.

Clogged feeding tube – A widely accepted preventable condition that commonly results when nursing home staff fail to: clean residue or coagulated protein, inadequate flush of tube after feeding and use improper medications.

Closed head injury – Trauma in which the brain is injured as a result of a blow to the head, or a sudden, violent motion that causes the brain to knock against the skull; nothing actually penetrates the brain. They can be diffuse (they affect cells and tissues throughout the brain) or focal (damage occurs in one area); they can range from mild to severe.

Closing argument – The closing statement, by counsel, to the trier of facts after all parties have concluded their presentation of evidence.

Code of Federal Regulations – An annual publication which contains the cumulative executive agency regulations.

Cognitive impairment – Decline in the ability of an individuals ability to perceive people, places or time that requires the substantial supervision of another person. The underlying reason behind a cognitive impairment may include: Alzheimer’s, dementia, traumatic brain injury or birth injury. Evidence of an individuals cognitive impairment can be substantiated by standardized testing or medical examination.

Colostomy – Reversible surgical procedure in which a stoma is formed by drawing the healthy end of the large intestine or colon through an incision in the anterior abdominal wall and suturing it into place; this opening, in conjunction with the attached stoma appliance, provides an alternative channel for feces to leave the body.

Coma – Profound state of unconsciousness; a person in a coma cannot be awakened, fails to respond normally to pain, light, or sound, does not have sleep-wake cycles, and does not take coluntary actions a person in a state of coma can be described as comatose.

Comatose – A person in a coma state.

Common law – Also case law. Law established by subject matter heard in earlier cases.

Comparative fault – A rule in admiralty law where each vessel involved in a collision is required to pay a share of the total damages in proportion to its percentage of fault.

Comparative negligence – The rule under which negligence is measured by percentage, and damages are diminished in proportion to the amount of negligence attributable to the person seeking recovery. Example: Jury finds a plaintiff’s conduct to be 20% responsible for his or her injury, the total award will be reduced by 20%.

Complaint – 1. The legal document that usually begins a civil lawsuit. It states the facts and identifies the action the court is asked to take. 2. Formal written charge that a person has committed a criminal offense.

Conservatorship – Legal right given to a person to manage the property and financial affairs of a person deemed incapable of doing that for himself or herself. (See also guardianship.)

Contingency fee – Any fee for services provided where the fee is only payable if there is a favourable result; in the law is defined as “a fee charged for a lawyer’s services only if the lawsuit is successful or is favorably settled out of court… contigent fees are usually calculated as a percentage of the client’s net recovery”.

Constitution – The fundamental law of a nation or state which establishes the character and basic principles of the government.

Constitutional law – Law set forth in the Constitution of the United States and the state constitutions.

Contempt of court – Willful disobedience of a judge’s command or of an official court order.

Continence – The ability to maintain control of the bowel and bladder. People who cannot control their bowel or bladder function are generally referred to as incontinent and may require a catheter, colostomy bag or diaper.

Contract – An agreement between two or more persons which creates an obligation to do or not to do a particular thing. A legally enforceable agreement between two or more competent parties made either orally or in writing.

Contributory negligence – The rule of law under which an act or omission of plaintiff is a contributing cause of injury and a bar to recovery.

Corroborating evidence – Supplementary evidence that tends to strengthen or confirm the initial evidence.

Counsel – A legal adviser; a term used to refer to lawyers in a case.

Counterclaim – A claim made by the defendant in a civil lawsuit against the plaintiff. In essence, a counter lawsuit within a lawsuit.

Court – A body in government to which the administration of justice is delegated.

Court costs – The expenses of prosecuting or defending a lawsuit, other than the attorney fees. An amount of money may be awarded to the successful party (and may be recoverable from the losing party) as reimbursement for court costs.

Court rules – Regulations governing practice and procedure in the various courts.

Crainiotomy – A procedure to remove a lesion in in the brain through an opening in the skull (cranium); type of brain surgery performed, most commonly, for a brain tumor removal; may also be done to remove a blood clot (hematoma), control hemorrhage from a weak, leaking blood vessel (cerebral aneurysm, repair arteriovenous malformations (abnormal connections of blood vessels), to drain a brain abscess, relieve pressure inside the skull, perform a biopsy, or to inspect the brain.

Cross-claim – A pleading which asserts a claim arising out of the same subject action as the original complaint against a co-party, i.e., one co-defendant cross claims against another co-defendant for contribution for any damages assessed against him.

Damages – Money awarded by a court to a person injured by the unlawful actor negligence of another person.

Damage Cap – A limit placed on the amount a party can recover in certain causes of action or against particular parties. This may be a fix amount of damages set by the state legislature or may be a formula which incorporates the amount of medical bills.

Debridement – Process of removing non-living tissue from pressure ulcers, burns, and other wounds.

Decision – The opinion of the court in concluding a case at law.

Declaratory judgment – A statutory remedy for judicial determination of a controversy where plaintiff is in doubt about his legal rights.

Decubitus ulcer – A decubitus ulcer is an area of skin that breaks down when you stay in one position for too long without shifting your weight. This often happens if you use a wheelchair or you are bedridden, even for a short period of time (for example, after surgery or an injury). The constant pressure against the skin reduces the blood supply to that area, and the affected tissue dies. A pressure ulcer starts as reddened skin but gets progressively worse, forming a blister, then an open sore, and finally a crater. Decubitus ulcers are ‘staged’ or graded according to their severity: stage 1, stage 2, stage 3, stage 4 or unstageable. See also: bed sore, pressure sore or pressure ulcer.

Deep vein thrombosis – Deep venous thrombosis (DVT) is when a blood clot forms in a vein that is deep inside the body. DVT mainly affects the large veins in the lower leg and thigh. The clot can block blood flow. If the clot breaks off and moves through the bloodstream, it can get stuck in the brain, lungs, heart, or other area, leading to severe damage.

Default – Failure of the defendant to appear and answer the summons and complaint.

Default judgment – A judgment entered against a party who fails to appear in court or respond to the charges.

Defendant – The person defending or denying a suit.

Dehydration – Dehydration means your body does not have as much water and fluids as it should. Dehydration can be caused by losing too much fluid, not drinking enough water or fluids, or both. Vomiting and diarrhea are common causes.

Infants and children are more susceptible to dehydration than adults because of their smaller body weights and higher turnover of water and electrolytes. The elderly and those with illnesses are also at higher risk. When severe, dehydration is a life-threatening emergency.

Demurrer – A pleading filed by the defendant that the complaint as filed is not sufficient to require an answer.

Dementia – A general term used to describe a person with deteriorated intellectual ability including: speech, vocabulary, logical thinking, memory loss and physical coordination. The deterioration frequently interferes with difficulty performing daily activities and may remain without treatment options. The underlying medical conditions for dementia may be a number of diseases (Alzheimer’s, Huntington’s or Parkinson’s) or may be the consequence of problems such as organ failure, drug reactions or psychiatric disorders.

Dependent – One who derives existence and support from another.

Deposition – Testimony of a witness or a party taken under oath outside the courtroom, the transcript of which becomes a part of the court’s file.

Depression – A psychiatric condition that as many as 60% of nursing home patients are believed to suffer from characterized by feelings of sadness and helplessness. Signs of depression include: withdrawal from friends and family, isolation, weight gain / loss or difficulty sleeping. Thankfully, depression can usually be treated with forms of therapy and medication.

Diabetes – Affects the body’s ability to use blood sugar for energy; type 1 diabetes (the body’s own immune system destroys the insulin-producing cells of the pancreas – beta cells), type 2 diabetes (non-insulin dependent diabetes, is the most common, these people produce insulin; however, either their pancreas does not produce enough insulin or the body cannot use the insulin adequately), and gestational diabetes (can occur in pregnancy).

Diabetic Ketoacidosis – Potentially life-threatening complication in patients with diabetes mellitus, predominately in those with type 1 diabetes, but can occur in those with type 2 diabetes. DKA results from an absolute shortage of insulin; in response the body switches to burning fatty acids and producing acidic ketone bodies that cause most of the symptoms and complications.

Dialysis – Dialysis is a method of removing toxic substances (impurities or wastes) from the blood when the kidneys are unable to remove these substances.

Direct evidence – Proof of facts by witnesses who saw acts done or heard words spoken.

Direct examination – The first questioning of witnesses by the party on whose behalf they are called.

Directed verdict – In a case in which the plaintiff has failed to present on the facts of his case proper evidence for jury consideration, the trial judge may order the entry of a verdict without allowing the jury to consider it.

Disability – Refers to the physical or mental condition of the injured party and their ability to tend to their own affairs. In some jurisdictions, a disability may extend the statute of limitations beyond the period when the statute would normally run.

Discharge planner – A health care professional in a nursing home, hospital or assisted living facility to assist in helping patients and families transition from one facility to another or perhaps back into an independent living situation.

Discovery – The name given pretrial devices for obtaining facts and information about the case. Generally discovery entails an exchange of written information or interrogatories and oral discovery via depositions.

Discovery Rule – In situations where a ‘discovery rule’ applies, the statute of limitations may be extended to allow an injured person or their family to file a lawsuit on a date after the original statute of limitations would have expired. The reasoning behind the ‘discovery rule’ is that if a person has no reason to know that he or she has been a victim of malpractice, the applicable statute of limitations does not begin to run until the victim of the malpractice knows or should have known that he or she has been the victim of malpractice. It is important to check the applicable statutes to determine if a discovery rule is applicable.

Disfigurement – The state of having one’s appearance deeply and persistently harmed medically, as from a disease, birth defect, or wound.

Dismissal – The termination of a lawsuit. (See with prejudice and without prejudice.)

Diversity of citizenship – The condition when the party on one side of a lawsuit is a citizen of one state and the other party is a citizen of another state; such cases are under the jurisdiction of federal courts.

DNR – Do not resuscitate.

Docket – An abstract or listing of all pleadings filed in a case; the book containing such entries; trial docket is a list of or calendar of cases to be tried in a certain term.

Domicile – The place where a person has his permanent home to which he intends to return.

Door alarm – Notification system that alerts others when a person gets out of their room or the room in which the door is alarmed.

Downs syndrome – Also called Trisomy 21, is a condition in which extra genetic material causes delays in the way a child develops, both mentally and physically; it affects about 1 in every 800 babies.

Drowning – Death from suffocation (asphyxia) caused by a liquid entering the lungs and preventing the absorption of oxygen leading to cerebral hypoxia and myocardial infarction.

Durable medical equipment – Medical equipment that has an extended usage life. Many times durable medical equipment refers to items such as: hospital beds, wheelchairs or walkers. Most durable medical equipment is prescribed by a physician and is paid for by Medicare.

Dysphagia – Refers to any kind of difficulty in swallowing.

Economic damages – Generally refers to fixed expenses for past or future hospitalizations or medical care.

Elder abuse – Elder abuse is doing something or failing to do something that results in harm to an elderly person or puts a helpless older person at risk of harm. This includes: physical abuse; sexual abuse; emotional abuse; neglecting or deserting an older person you are responsible for or taking or misusing an elderly person’s money or property. Elder abuse may occur in any setting– inside the home or outside the home, such as in a hospital, nursing home, or assisted living facility. All 50 states have laws against elder abuse.

Elder care – Any service provided to elders at home, group-home, assisted living or nursing home to help them achieve the highest feasible level of functioning. Usually elder care refers to care provided over an extended period of time to people who rely on caregivers due to loss of physical or mental ability.

Elopement – When a patient or resident who is cognitively, physically, mentally, emotionally, and/or chemically impaired; wanders away, walks away, runs away, escapes, or otherwise leaves a nursing home, care-giving facility or environment unsupervised, unnoticed, and/or prior to their scheduled discharge. Many instances involving patient elopement result in severe injury or death.

Emotional abuse – Emotional abuse of an elder is commonly defined as a pattern of behavior by caregivers that can seriously interfere with a senior’s cognitive, emotional or psychological safety. Emotional abuse of a senior — also referred to as psychological abuse.

Endotracheal tube – A breathing tube used for a time for breathing allowing the airway to remain open; a curved tube placed through the patient’s nose or mouth in the trachea

Entity – A person or legally recognized organization.

Epilepsy – Epilepsy is a brain disorder involving repeated, spontaneous seizures of any type. Seizures (also referred to as “fits” or “convulsions”) are episodes of disturbed brain function that cause changes in attention or behavior. They are caused by abnormally excited electrical signals in the brain.

Eroding policy – Cost of defense is deducted from the policy limits.

Escrow – Money or a written instrument such as a deed that, by agreement between two parties, is held by a neutral third party (held in escrow) until all conditions of the agreement are met.

Esophageal dysphagia – Comes from part of the body, of the esophagus, lower esophageal sphincter, or cardia of the stomach, usually due to mechanical causes or motility problems.

Estate – A person’s property.

Estoppel – An impediment that prevents a person from asserting or doing something contrary to his own previous assertion or act.

Evidence – Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.

Execute – To complete; to sign; to carry out according to its terms.

Executor – A personal representative, named in a will, who administers an estate.

Exhibit – A document or other item introduced as evidence during a trial or hearing.

Ex parte – On behalf of only one party, without notice to any other party. For example, a request for a search warrant is an ex parte proceeding, since the person subject to the search is not notified of the proceeding and is not present at the hearing.

Ex parte proceeding – Action Circumstances which render a crime less aggravated, heinous, or reprehensible than it would otherwise be.

F tags – Federal licensure tags that apply to nursing home care.

Fall during transfer – A patient falling during the transfer to or from a wheelchair or bed is a common nursing home injury particularly among physically disabled patients. Many episodes involving a fall during a transfer stem from the fact the the staff was failing to assist or supervise the patient.

Fecal impaction – A fecal impaction is a large mass of dry, hard stool that can develop in the rectum due to chronic constipation. This mass may be so hard that it cannot come out of the body. Watery stool from higher in the bowel may move around the mass and leak out, causing soiling or diarrhea. If not diagnosed and treated fecal impaction may result in death.

Federal register – A daily publication which contains federal administrative rules and regulations.

Federal supplement – Books which gives the government certain control and power to regulate discharge of pollutants into the nation’s waters in an effort to achieve clean waters.

Feeding tube – A small, soft, plastic tube placed through the nose (NG) or mouth (OG) into the stomach. These tubes are used to provide feedings and medications into the stomach until (and when) the person can take food by mouth.

Fentanyl overdose – Strong narcotic pain reliever typically used to treat chronic pain or intense cancer pain not treatable with lighter drugs; it is stronger than morphine and is not prescribed for common pain symptoms like headaches or back pain; overdose is very serious and can lead to severe health complications and death, overdoses are most likely at the beginning of treatment , at dosage increases, when combined with other narcotics, or when used illegally; signs of overdose include hyperventilation, cold or clammy skin, low blood pressure, contracted pupils, seizures and slowed heartbeat.

File – To place a paper in the official custody of the clerk of court/court administrator to enter into the files or records of a case.

Filing see – The fee required for filing various documents.

Financial abuse – The illegal or improper use of the a person’s property, finances, and other assets without that person’s informed consent or where consent is obtained by fraud.

Finding – Formal conclusion by a judge or regulatory agency on issues of fact. Also, a conclusion by a jury regarding a fact.

First degree burn – Injury to the tissues of the body; burns are classified according to the amount of tissue they affect and how deep they are; first degree burn is the least serious type because it injures only the top layers of skin (epidermis).

Flap reconstruction – Alternative to skin expansion as a method of breast reconstruction after mastectomy; involves creating a skin flap using tissue from another part of the body, i.e. back or abdomen; flap is attached to the chest to create a pocket for implantation or build a breast mound.

Flesh eating bacteria – Necrotizing fasciitis (NF) is a rare infection of the deeper layers of skin and subcutaneous tissues, easily spreading across the fascial plane within the subcutaneous tissue; type I describes a polymicrobial infection, whereas type II describes a monomicrobial infection; causes include Group A streptococcus, staphylococcus gureus, vibrio yulnificus, clostridium perfringens, bacteroides fragilis; infections such as there are more likely to occur in people with compromised immune systems.

Food and Drug (FDA) – A federal agency which sets safety and quality standards for Administration food, drugs, cosmetics, and household substances.

Food poisoning – Food poisoning occurs when you swallow food or water that contains bacteria, parasites, viruses, or toxins made by these germs. Most cases of food poisoning are from common bacteria such as Staphylococcus or E. coli.

Fracture – A break in bone or cartilage. Although usually the result of trauma, a fracture can be caused by an acquired disease of of the bones.

Fraud – A false representation of a matter of fact which is intended to deceive another.

Frozen joints – Adhesive capsulitis is a painful disorder that results from the chronic inflammation, scarring, thickening and shrinkage or the capsule that surrounds the involved joint, classically occurring in the shoulders or the knees.

G tube – Gastric feeding tube is a tube inserted through a small incision in the abdomen into the stomach and is used for long-term enteral nutrition; for placement, the patient is under sedation and the tube goes through the mouth and esophagus into the stomach; they are good for long term use (6 months with replacement being done through an existing passage without any other procedures); g-tubes help when there is swallowing difficulties secondary to neurological or anatomical disorders.

Gangrene – Death of an area of the body; cut off blood supply as a result of various processes, such as infection, vascular (pertaining to blood vessels) disease, or trauma; dry gangrene is a result of a reduction of blood flow through the arteries which appears slowly; wet gangrene is because of an untreated infected wound.

Gastroenteritis – Gastroenteritis is an inflammation of the lining of the intestines caused by a virus, bacteria or parasites. Viral gastroenteritis is the second most common illness in the U.S. It spreads through contaminated food or water, and contact with an infected person.

General jurisdiction – Refers to courts that have no limit on the types of criminal and civil cases they may hear.

Glucose –Simple sugar that serves as the main source of energy for the body.

Grand Jury – A jury of inquiry whose duty it is to receive complaints and accusations in criminal matters and if appropriate issue a formal indictment.

Grantor – The person who sets up a trust. Also referred to as “settlor.”

Guardian – A person appointed by will or by law to assume responsibility for incompetent adults or minor children. If a parent dies, this will usually be the other parent. If both die, it probably will be a close relative.

Guardianship – Legal right given to a person to be responsible for the food, housing, health care, and other necessities of a person deemed incapable of providing these necessities for himself or herself.

Hearing – A formal proceeding (generally less formal than a trial) with definite issues of law or of fact to be heard. Hearings are used extensively by legislative and administrative agencies.

Hearsay – Statements by a witness who did not see or hear the incident in question but heard about it from someone else. Hearsay is usually not admissible as evidence in court.

Hemodialysis – This treatment is usually done in a dialysis facility but can be done at home with the proper training and supplies. HD uses a special filter (called a dialyzer or artifical kidney) to clean your blood. The filter connects to a machine. During treatment, your blood flows through tubes into the filter to clean out wastes and extra fluids. Then the newly cleaned blood flows through another set of tubes and back into your body.

Hemorrhage – Bleeding or the abnormal flow of blood.

Hepatitis – Liver inflammation.

Hip fracture – Break in the bones of the hip.

Home health care – Limited part-time or intermittent skilled nursing care and home health aide services, physical therapy, occupational therapy, speech-language pathology services, medical social services, durable medical equipment (such as wheelchairs, hospital beds, oxygen, and walkers), medical supplies, and other services.

Homemaker services – Common household chores performed by a hired employee or by a volunteer because you may be unable to perform the task yourself. Common examples of homemaker services include: shopping, laundry, cleaning, cooking and transportation.

Hospice care – Hospice care involves a team-oriented approach that addresses the medical, physical, social, emotional and spiritual needs of the terminally-ill patient. Hospice also provides support to the patient’s family or caregiver as well. Hospice care is covered under Medicare Part A (Hospital Insurance).

Hospital – An institution that provides medical, surgical, or psychiatric care and treatment for the sick or the injured.

Hospital error – Any error occurring during an admission to a hospital including errors made by physicians, nurses, and other hospital staff.

Hoyer lift – Name brand for a patient transfer system which allows patients in hospital, nursing homes, residential facilities and people who receive home health care to transfer from bed to chair or another place when their mobility is limited or the patient is too heavy for a standard lift; the lift uses hydraulic power.

Hung jury – A jury whose members cannot agree upon a verdict.

Hyperglycemia – High blood sugar.

Hyperreflexia – Overactive responses at reflex sites.

Hypertension – High blood pressure.

Hypoglycemia – Low blood sugar.

Hyponatremia – Low sodium level in the blood.

Hypotension – Low blood pressure.

Hypothermia – Low body temperature.

Immunity – Refers to the inability to pursue a cause of action against certain entities. In most circumstances, immunity applies to government agencies or municipalities. Depending on the jurisdiction, their may be ‘limited immunity’, where there are limits on the amount an injured party may recover.

Impeachment – A criminal proceeding against a public official.

Impeachment of a witness – An attack on the credibility (believability) of a witness, through evidence introduced for that purpose.

Implied contract – A contract not created or evidenced by the explicit agreement of the parties but one inferred by law; as the use of electric power in your home implies a contract with the light company.

Inadmissible – That which, under the rules of evidence, cannot be admitted or received as evidence.

Incapacity – Lack of legal ability to act; disability, incompetence; lack of adequate power.

Incompetent – One who lacks ability, legal qualification, or fitness to manage his own affairs.

Incontinence – The inability to control bowel or bladder function– bowel incontinence or bladder incontinence.

Indigent – Needy or impoverished. A defendant who can demonstrate his or her indigence to the court may be assigned a court-appointed attorney at public expense.

Infection – The fact or state of being infected, esp. by the presence in the body of bacteria, protozoans, viruses, or other parasites.

Injunction – A prohibitive order or remedy issued by the court at the suit of the complaining party, which forbids the defendant to do some act which he is threatening or attempting to do. Conversely, it may require him to perform an act which he is obligated to perform but refuses to do.

Insolvent – When the total debt of an entity is greater than all of its property.

Insulin – Hormone secreted by the islets of Langerhans and helps with the regulation of the metabolism of carbohydrates and fats, which converts glucose to glycogen, helping to lower the blood glucose levels.

Intentional tort – Wrong perpetrated by one who intends to break the law. Example: battery assault

Interlocutory – Temporary; provisional; interim; not final.

Interrogatories – A set or series of written questions propounded to a party, witness, or other person having information or interest in a case; a discovery device.

Intervention – An action by which a third person who may be affected by a lawsuit is permitted to become a party to the suit.

Involuntary seclusion – Removal of a nursing home patient from the general population or from his or her room against their will or against the wishes of the nursing home patient’s legal representative. Although temporary seclusion may be necessary in cases where a patient poses a risk of harming other patient or himself, most cases of involuntary seclusion are extremely detrimental to the patients physical and psychological well-being.

Joint and several liability – A legal doctrine that makes each of the parties who are responsible for an injury, liable for all the damages awarded in a lawsuit if the other parties responsible cannot pay.

Judge – A presiding officer of the court.

Judgment – The official and authentic decision of a court of justice upon the rights and claims of parties to an action or suit submitted to the court for determination. (See also summary judgment.)

Jurisdiction – The power or authority of a court to hear and try a case; the geographic area in which a court has power or the types of cases it has power to hear.

Jury – A certain number of men and women selected according to law and sworn to try a question of fact or indict a person for public offense.

Kennedy terminal ulcer – Specific type of bedsore (also referred to as a pressure sore, pressure ulcer or decubitus ulcer) that is characterized by rapid onset and rapid tissue breakdown; it was named after Karen Lou Kennedy-Evans (who discovered the medical condition); these develop from poor blood circulation because of unrelieved pressure. These are different from other bedsores because – rapid onset (wounds progress within hours); grows downward instead of horizontally; mostly found on the sacrum; occur almost always in elderly; bedsores are usually irregularly shaped (pear-like); death occurs quickly (24-48 hours of onset).

Ketoacidosis – The body does not use sugar as an energy source because of no or not enough insulin instead fat is used.

Kidney failure – When the kidneys no longer clean the bodies blood by removing excess fluid, minerals, and waste; wastes that are harmful can build up in the body and the body can retain excess fluid.

Lawsuit – An action or proceeding in a civil court; term used for a suit or action between two private parties in a court of law.

Legal process – A formal paper that is legally valid; something issuing from the court, usually a command such as a writ or mandate.

Legionnaires’ disease – Legionnaires’ disease is a type of pneumonia caused by bacteria. It is usually contracted by breathing in mist from water that contains the bacteria. The mist may come from hot tubs, showers or air-conditioning units for large buildings. The bacteria don’t spread from person to person.

Legislation – The act of giving or enacting laws; the power to make laws via legislation in contrast to court-made laws.

Letters of Administration – Legal document issued by a court that shows an administrator’s legal right to take control of assets in the deceased person’s name.

Letters Testamentary – Legal document issued by a court that shows an executor’s legal right to take control of assets in the deceased person’s name.

Liable – Legally responsible.

Liability insurance – Insurance policy to cover an act of negligence by a professional.

Lien – An encumbrance or legal burden upon property.

Litigant – A party to a lawsuit.

Litigation – A lawsuit; a legal action, including all proceedings therein.

Living trust – A trust set up and in effect during the lifetime of the grantor. (Also called inter vivos trust.)

Long term care – A variety of services that help people with health or personal needs and activities of daily living over a period of time. Long-term care can be provided at home, in the community, or in various types of facilities, including nursing homes and assisted living facilities. Most long-term care is custodial care.

Long term care hospital – Long term care hospitals provide treatment for patients who stay, on average, more than 25 days. Most patients are transferred from an intensive or critical care unit. Services provided include comprehensive rehabilitation, respiratory therapy, head trauma treatment, and pain management.

Long term care insurance – An insurance policy to pay (partially or completely) for long-term care. Many long-term care insurance policies cover both medical and non-medical expenses.

Long term care ombudsman programs – Federally funded agencies that provide assistance to nursing home patients when there is a dispute between the patient and the nursing home.

Loss of consortium – A claim for damages based on the recovery of the loss of services a spouse provided.

Malnutrition – Malnutrition is the condition that occurs when your body does not get enough nutrients. There are a number of causes of malnutrition. It may result from: inadequate or unbalanced diet, problems with digestion or absorption, certain medical conditions. Malnutrition can occur if you do not eat enough food and can be fatal in extreme circumstances.

Malpractice – Any professional misconduct.

Mediation – A form of alternative dispute resolution in which the parties bring their dispute to a neutral third party, who helps them agree on a settlement.

Medicaid – A joint Federal and State program that helps with medical costs for some people with low incomes and limited resources. Medicaid programs vary from state to state, but most health care costs are covered if you qualify for both Medicare and Medicaid.

Medication Aides – Has the training to work under the supervision of a licensed health care professional. They are able to give out medications in nursing homes and assisted living facilities.

Medicare – Health insurance coverage to people who are aged 65 and over, or who meet other special criteria administered by the federal government.

Medication error – An incorrect or wrongful administration of a medication, such as a mistake in dosage or route of administration, failure to prescribe or administer the correct drug or formulation for a particular disease or condition, use of outdated drugs, failure to observe the correct time for administration of the drug, or lack of awareness of adverse effects of certain drug combinations. Causes of medication error may include difficulty in reading handwritten orders, confusion about different drugs with similar names, and lack of information about a patient’s drug allergies or sensitivities.

Medication overdose – drug overdose is the accidental or intentional use of a drug or medicine in an amount that is higher than is normally used.

Medical Malpractice – A cause of action against a physician or hospital. Unlike general negligence actions, many medical malpractice cases require certain procedures to be followed prior to filing a lawsuit.

Medi-car – Non-medical transportation typically provided by a private company to those who are unable to drive themselves.

Medivan – Non medical transportation for seniors. Predominately used for transportation to and from appointments, shopping, and hospital visits.

Memorandum – An informal note or instrument embodying something the parties desire to have in written evidence.

Memorialized – In writing.

Mental institution – An inpatient treatment facility for individuals exhibiting severe mental/emotional disorders.

Mesothelioma – Mesothelioma is cancer of that tissue that lines the lungs– mesothelium. It is a rare but serious type of cancer. It usually starts in the lungs, but can also start in the abdomen or other organs. Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles. It can take a long time – 30 to 50 years – between being around asbestos and getting the disease. Treatment includes surgery, radiation, chemotherapy or all three.

Minimum data set – Governmental requirements for assessing individuals to determine level of care during nursing home admission.

Minimum staffing – The minimum number of employees that need to be working at a hospital/nursing home to have a safe ratio with the number of patients/residents.

Minor – A person under the age of legal competence.

Miranda warning – Requirement that police tell a suspect in their custody of his or her constitutional rights before they question him or her. So named as a result of the Miranda v. Arizona ruling by the United States Supreme Court.

Mistrial – An invalid trial, caused by fundamental error. When a mistrial is declared, the trial must start again from the selection of the jury.

Mobility aids – Mobility aids help you walk or move from place to place if you are disabled or have an injury. They include crutches, canes, walkers, wheelchairs and motorized scooters. You may need a walker or cane if you are at risk of falling. If you need to keep your body weight off your foot, ankle or knee, you may need crutches. You may need a wheelchair or a scooter if an injury or disease has left you unable to walk.

Motion – An application made to a court or judge which requests a ruling or order in favor of the applicant.

Motion in Limine – A motion made by counsel requesting that information which might be prejudicial not be allowed to be heard in a case.

MRSA – MRSA stands for methicillin-resistant staphylococcus aureus. It causes a staph infection (pronounced “staff infection”) that is resistant to several common antibiotics. There are two types of infection. Hospital-associated MRSA happens to people in healthcare settings. Community-associated MRSA happens to people who have close skin-to-skin contact with others, such as patients in a nursing home or assisted living setting who share close quarters.

Multiple sclerosis – Multiple sclerosis (MS) is a nervous system disease that affects your brain and spinal cord. It damages the myelin sheath, the material that surrounds and protects your nerve cells. This damage slows down or blocks messages between your brain and your body, leading to the symptoms of MS.

Muscle contracture – a shortening (usually non-reversal) of the muscles that results in a distorting or deformed part of the body (usually a joint).

Myocardosis – heart muscle inflammation.

Necrotic Tissue – When one or multiple cells in the body die, usually in one area, caused by a disruption of blood supply to a part of the body.

Negative pressure wound therapy – (Topical negative pressure, sub-atmospheric pressure dressings, vacuum sealing technique) – A way to promote healing in chronic wounds, fight infection and enhance healing in body tissue. Usually a vacuum helps create pressure in the wounds environment.

Negligence – Failure to use care which a reasonable and prudent person would use under similar circumstances.

Negotiation – The process of submission and consideration of offers until an acceptable offer is made and accepted.

Neuropathy – A disruption in the nervous system secondary to disease or an abnormality.

Never event – A series of 28 inexcusable outcomes in a health are setting. The 28 items were taken by the National Quality Forum. These are defined as “adverse events that are serious, largely preventable, and of concern to both the public and health care providers for the purpose of public accountability.

No-fault Proceedings – A civil case in which parties may resolve their dispute without a formal finding of error or fault.

Non-economic damages – damages that are frequently intangible in nature. Examples: pain and suffering, disability, disfigurement, loss of normal life

Non-jury trial – Trial before the court but without a jury.

Non profit nursing home – Nursing home that does not turn a profit.

Notary Public – A public officer whose function it is to administer oaths, to attest and certify documents, and to take acknowledgments.

Notice – Formal notification to the party that has been sued in a civil case of the fact that the lawsuit has been filed. Also, any form of notification of a legal proceeding.

Nurse turnover – The process of hiring, keeping, and losing nurses as an employee in the health care field.

Nurses aide – aAn employee who is hired to care for patients whose responsibilities are less specialized than a nurses; the aide assists in bathing, feeding, bed making, transporting; they are under the direction of the registered nurse.

Nursing Home Abuse – Nursing home abuse can be defined as any act, failure to act, or incitement to act done willfully, knowingly, or recklessly through words or physical action which causes or could cause mental or physical injury or death to a nursing home resident. This includes verbal, sexual, mental/psychological, or physical elder abuse, including corporal punishment, involuntary seclusion, or any other actions within this definition. Many cases of nursing home abuse allow the injured person or their estate to bring a claim or lawsuit against the offending facility.

Nursing home administrator – The person in charge of all operations and employees at the nursing home. Each state has their own licensing requirements.

Nursing home arbitration – An agreement usually signed in the admission process whereby any injury or dispute between the patient and the nursing home would be resolved before a single person or multiperson panel, taking away the right to jury trial.

Nursing home compare – To assess information from more than one nursing home, while in the process of choosing one, and weigh the pros and cons.

Nursing Home Injury – A general term used to describe any injury occurring to a resident during their admission to a nursing home. A nursing home injury may occur due to an intentional or negligent act of a nursing home employee, agent or patient. Depending on the circumstances, a nursing home injury may give way to a legal cause of action against the responsible party.

Nursing Home Lawsuit – A lawsuit brought on behalf of an injury party or their estate for personal injury or wrongful death against a nursing home.

Nursing Home Neglect – The failure of a nursing home to meet the needs of a dependent patient,which may be intentional- – such as withholding of food, medications, failure to clean or bathe, or unintentional, resulting from genuine ignorance of–or physical inability to address–a particular care need. Many instances of nursing home neglect result in serious injury or death of a patient and give way to a lawsuit against the facility.

Nursing Home Negligence – The failure of a facility or its agents to follow the standard of care in the community. In certain states, specific laws have been implemented by the state legislatures which set forth the standard of care for nursing homes.

 

 

 

 

Objection – The process by which one party takes exception to some statement or procedure. An objection is either sustained (allowed) or overruled by the judge.

Opinion – A judge’s written explanation of a decision of the court or of a majority of judges. A dissenting opinion disagrees with the majority opinion because of the reasoning and/or the principles of law on which the decision is based. A concurring opinion agrees with the decision of the court but offers further comment. (A per curiam opinion is an unsigned opinion “of the court.”)

Oral argument – Presentation of a case before a court by spoken argument; usually with respect to a presentation of a case to an appellate court where a time limit might be set for oral argument.

Order – A mandate, command, or direction authoritatively given. Direction of a court or judge made in writing.

Ordinance – A rule established by authority; may be a municipal statute of a city council, regulating such matters as zoning, building, safety, matters of municipality, etc.

Osteomyelitis – Bone infection can be caused by bacteria or fungi. Osteomyelitis may spread to a bone from infected skin, muscles, or tendons next to the bone, as in osteomyelitis that occurs under a chronic skin ulcer (sore).

Ostomy – Ostomy is a surgical procedure that creates an opening on the abdominal wall for waste products to move out of the body. It is performed when a medical condition such as a pressure sore is so severe that an ostomy offers a better alternative and reduces infection rates.

Overrule – A judge’s decision not to allow an objection. Also, a decision by a higher court finding that a lower court decision was in error.

Pain and suffering – An element of damages recoverable for a personal injury case related to the pain experienced subsequent to an injury and/or related medical treatment.

Paralysis – Inability to move a body part, usually caused by damage to the nerve supply.

Paraplegic – A person with the inability to have use of the lower extremities function secondary to an impairment in motor and/or sensory function; Paraplegia is the result of a spinal cord injury or a congenital condition. This term refers to both legs being effected.

Parkinsons – A movement disorder that includes tremors, rigid muscle tone, slow walking and other movements and an unstable posture; It is caused by a disruption in connections in the central nervous system that effects the persons’ motor skills, speech and other functions.

Party – A person, business, or government agency actively involved in the prosecution of defense of a legal proceeding.

Peg tube – Percutaneous Endoscopic Gastrostomy tube or a feeding tube has one end in the stomach which malleable and held in place with a balloon tip, the other end is outside of the body on the skin with an adhesive. The tube is used for feeding, medication, and/or hydrating and is sometimes semi-permanent.

Peripheral neuropathy – disruption in the communication between the nerves and the spinal cord; the results of this can be numbness, pain, decrease in sensation and no control of muscles.

Permanent injunction – A court order requiring that some action be taken, or that some party refrain from taking action. It differs from forms of temporary relief, such as a temporary restraining order or preliminary injunction.

Personal representative – The person who administers an estate. If named in a will, that person’s title is an executor. If there is no valid will, that person’s title is an administrator.

Person in need of supervision – Juvenile found to have committed a “status offense” rather than a crime that would provide a basis for a finding of delinquency. (See status offense.)

Petitioner – The person filing an action in a court of original jurisdiction. Also, the person who appeals the judgment of a lower court. (See respondent.)

Pharmaceutical errors – Can occur from prescribing the incorrect medication or dosage to the pharmacist filling the incorrect medication or dosage or labeling incorrectly. The medications can react to other medications that are also prescribed adversely causing a toxicity to the patient.

Physical abuse – any type of physical harm caused by one to another involving purposeful contact.

Physical elder abuse – any type of physical abuse against the elderly.

Physical therapy – Rehabilitative specific exercises and equipment that aide patients to regian and enhance their physical abilities.

Picc line – (Peripherally inserted central catheter) is used over a long period of time that goes from outside the body to inside and delivers medications to the patients, it is an inserted IV.

Plaintiff – A person who brings an action; the party who complains or sues in a civil action. (See complainant.)

Pleadings – The written statements of fact and law filed by the parties to a lawsuit.

Pneumonia – An illness that occurs in one or both lungs that derives from bacteria, a virus(es), or fungus.

Power of attorney – An formal instrument authorizing another to act as one’s agent or attorney.

Precedent – Laws established by previous cases which must be followed in cases involving identical circumstances.

Premises liability – Fault imposed on a land owner for an injury sustained due to improperly maintained property.

Presentment – Declaration or document issued by a grand jury that either makes a neutral report or notes misdeeds by officials charged with specified public duties. It ordinarily does not include a formal charge of crime. A presentment differs from an indictment.

Pressure sore – Pressure sore, like the name implies, is a sore or wound that develops due to unrelieved pressure on the body. Over time, the pressure restricts the blood flow to skin, tissue and muscle that results in the death of the material. Over time, the wound may open exposing the underlying layers of muscle and bone. See also: bed sore, decubitus ulcer and pressure ulcer.

Pressure ulcer – Similar to other terms: bed sore, pressure sore or decubitus ulcer, pressure ulcers are commonly found in patients confined to a wheelchair or bed, when unrelieved pressure builds on bony prominences of the body. Common areas for pressure ulcers include: buttock, back, heels, sacrum, and head.

Pretermitted child – A child born after a will is executed, who is not provided for by the will. Most states have laws that provide for a share of estate property to go to such children.

Pretrial conference – Conference among the opposing attorneys and the judge called at the discretion of the court to narrow the issues to be tried and to make a final effort to settle the case without a trial.

Prima facie case – A case that is sufficient and has the minimum amount of evidence necessary to allow it to continue in the judicial process. (See prima facie in the Foreign Words Glossary.)

Primary authority – Constitutions, codes, statutes, ordinances, and case law sources.

Probate – Court proceeding by which a will is proved valid or invalid. Term used to mean all proceedings pertaining to the administration of estates such as the process by which assets are gathered; applied to pay debts, taxes, and expenses of administration; and distributed to those designated as beneficiaries in the will. Conducted in states courts.

Probate court – The court with authority to supervise estate administration.

Probate estate – Estate property that may be disposed of by a will. (See estate.)

Product liability – Legal responsibility of manufacturers and sellers to buyers, users, and bystanders for damages or injuries suffered because of defects in goods.

Prosecutor – A trial lawyer representing the government in a criminal case and the interests of the state in civil matters. In criminal cases, the prosecutor has the responsibility of deciding who and when to prosecute.

Proximate cause – The last negligent act which contributes to an injury. A person generally is liable only if an injury was proximately caused by his or her action or by his or her failure to act when he or she had a duty to act.

Psychological elder abuse – Similarly referred to as ‘mental elder abuse’ or ‘emotional elder abuse’, occurs when nursing home patients are subjected to mistreatment that is psychologically harmful. Though psychological elder abuse may be perpetrated in a variety of ways, it generally occurs when caregivers use their position of authority to humiliate, harass, threaten or intimidate nursing home patients.

Psychotropic drugs – A medication that affects the mind, emotions and behavior in a person.

Public law – That law such as traffic ordinances or zoning ordinances which applies to the public.

Pulmonary embolism – A disruption in a blood vessel in the lungs which stops the circulation in a coronary artery.

Punctured lung – When air or gas accumulated in the pleural area or chest which results in part or all of a lung to collapse (pnuemothorax).

Punitive damages – A type of monetary recovery for an injured person with the intent of punished the wrong doing company or facility.

Pyelonephritis – Bacterial urinary tract infection of the kidney that can be acute or chronic.

Qui tam – A provision of the Federal Civil False Claims Act that permits a nursing home employee (or any U.S. Citizen) to file a lawsuit on behalf of the U.S. government, to file a lawsuit against a nursing home or corporation that fraudulently uses a government funds. Qui tam lawsuits are sometimes referred to as whistleblower lawsuits and allow the individual share a percentage the recovery from the offending facility. Examples of qui tam lawsuits against a nursing home include charging for services never provided, charging for services for deceased people, inflating time sheets and pharmacy fraud.

Reflex sympathetic dystrophy – (RSD) A neurological condition that interferes with skin, muscles, joints and bone that has high levels of pain and is progressive.

Residential Care Facilities for the Elderly (RCFE’s)- Residential Care Facilities for the Elderly provide assistance for seniors who are no longer capable of living independently. However, unlike nursing homes (skilled nursing facilities), RCFE’s have no medical accreditation and are not permitted to provide medical care. When a patient requires medical attention, the facility must get the patient relocated to a different facility.

Respite care – A relief in caring for a family member who usually needs total care by others or to live in a residential facility outside of the home; this care is short-term.

Restraint – Physically stopping a person from moving; holding the person down, tying them to the bed for safety to themselves.

Rotavirus – An infection in the bowels and causes diarrhea.

Sacral wound – A pressure sore that has developed on the persons sacrum or buttocks area. Pressure sores on the sacrum are one of the most common areas for wounds to develop particularly in bed-bound patients where a large amount of pressure and friction are put on the sacral area.

Sacrum – A bone in the shape of a triangle where the spine and pelvic cavity meet at the back, it is between the two hips.

Salmonella – A bacteria that is one of the most common bacteria in foodborne illneses. It causes intestinal infections.

Scabies – Highly contagious disease of the skin that is caused by tiny mites.

Scald – To burn or injure with hot liquid or steam.

Second degree burn – A burn that results in redness, pain, swelling and blisters. They burn both the outer-layer and under lying layer of skin.

Secondary authority – Legal encyclopedias, treatises, legal texts, law review articles, and citators. Writings which set forth the opinion of the writer as to the law.

Sepsis – Sepsis is a bacterial infection in the bloodstream or body tissues. This is a very broad term covering the presence of many types of microscopic disease-causing organisms. Sepsis can develop in patients with advanced pressure ulcers (also called: bed sores, pressure sores or decubitus ulcers). Approximately 55% of people who develop sepsis die from related complications every year.

Service of process – The delivering of writs, summonses, and subpoenas by delivering them to the party named in the document. Also referred to as “service.”

Settlement – An agreement between the parties disposing of a lawsuit.

Sexual abuse – Sexual abuse is any contact or interaction (physical, visual, verbal or psychological) between a child/adolescent and an adult when the child/adolescent is being used for the sexual stimulation of the perpetrator or any other person.

Sexual assault – Sexual assault can be defined as any unwanted touching of a persons body with the intent to sexually gratify the assailant without consent. Sexual assault many take many forms including attacks such as rape or attempted rape, as well as any unwanted sexual contact or threats. . Some types of sexual acts which fall under the category of sexual assault include forced sexual intercourse (rape), sodomy (oral or anal sexual acts), child molestation, incest, fondling and attempted rape.

Sexual elder abuse – Involuntary touching of the genitals, breasts, anus against or without the persons consent to gratify the desire of the perpetrator. Examples of sexual elder abuse include: rape, sexual assault, sexual harassment or sexual coercion.

Shigella – A foodborne, waterborne or person to person contacted bacteria that causes diarrhea and dysentery to those affected.

Skilled nursing facility – A skilled nursing facility (SNF) is an entity certified by Medicare to provide services to patients a combination of nursing and rehabilitative services. Commonly referred to as nursing homes.

Skin graft – A piece of skin that is surgically moved from one area of the body and attached to another area.

Social Security – A system of federal old-age pensions for employed persons begun in 1935. A portion of the payment is deducted from the employee’s salary and an equal portion is contributed by the employer.

Social Security Administration – The federal agency, which administers the national social security program.

Sovereign Immunity – The doctrine that the government, state or federal, is immune to lawsuit unless it give its consent.

Special focus facility – A government developed program to monitor poorly performing nursing homes that have a pattern of chronic non-compliance with federal law and facilities that potentially post a threat to patient safety.

Spend down – A provision in Medicare and Medicaid programs that an individual use up their personal assets to meet eligibility requirements.

Squamos carcinoma – A cancer of the skin that initially looks like a bump or red and scaly patch of skin. It usually appears on badly sun burned, fair skin and is often found on the rim of the ear, face and lips.

Stage 1 Bedsore – Changes in skin temperature (warmth or coolness), tissue consistency (firm or boggy feel), and/or sensation (pain, itching). The ulcer is a defined area of persistent redness in lightly pigmented skin. In darker skin tones, the ulcer may appear with persistent red, blue, or purple hues. Stage 1 bedsores are a warning to caregivers and/or family members, because bedsores develop quickly and progress rapidly. (Similarly referred to as: stage 1 pressure sore, stage 1 pressure ulcer or stage 1 decubitus ulcer)

Stage 2 Bedsore – Partial thickness skin loss involving epidermis (top layer of skin), dermis, or both. The ulcer is superficial and looks like an abrasion, blister, or shallow crater at this stage. Once a bedsore gets past this stage it becomes much harder to treat. (Similarly referred to as: stage 2 pressure sore, stage 2 pressure ulcer or stage 2 decubitus ulcer)

Stage 3 Bedsore – Full thickness skin loss involving damage to, or death of, the subcutaneous tissue that may extend down to, but not through, underlying connective tissue. The wound will look like a fairly deep crater, black at its edges. Stage 3 bedsores are powerfully sad and visually disgusting. (Similarly referred to as: stage 3 pressure sore, stage 3 pressure ulcer or stage 3 decubitus ulcer)

Stage 4 Bedsore – Full thickness skin loss with extensive destruction, tissue death, and/or damage to muscle, bone, or supporting structures (tendon, joint, capsule). They will look like a large, deep, open wound revealing bone and connective tissue. Warning, a stage four bedsore is extremely disturbing to see. (Similarly referred to as: stage 4 pressure sore, stage 4 pressure ulcer or stage 4 decubitus ulcer)

Standard of proof – Indicates the degree to which the point must be proven. In a civil case, the burden of proof rests with the plaintiff, who must establish his or her case by such standards of proof as a “preponderance of evidence” or “clear and convincing evidence.” (See burden of proof.)

Standing – The legal right to bring a lawsuit. Only a person with something at stake has standing to bring a lawsuit.

Starvation – Starvation is the result of a severe or total lack of nutrients needed for the maintenance of life.

Statute – Legislative enactment; it may be a single act of a legislature or a body of acts which are collected and arranged for a session of a legislature. (See statutory law.)

Statute of limitations – statute of limitations is a law, which places a time limit on pursuing a legal remedy in relation to wrongful, conduct. After the expiration of the statutory period, unless a legal exception applies, the injured person loses the right to file a lawsuit seeking money damages or other relief.

Statutory – Relating to a statute; created or defined by a law.

Stay – A court order halting a judicial proceeding.

Stevens Johnson syndrome – A very severe skin disease that is potentially deadly that is the result of a drug interaction that can cause severe pain.

Stipulation – An agreement between the parties involved in a suit regulating matters incidental to trial.

Strict liability – Concept applied by the courts in product liability cases that when a manufacturer presents his goods for public sale, he is representing that they are suitable for their intended use.

Sub-acute care – Medical care provided to a patient in their home or in a skilled nursing facility after a hospitalization to stabilize their condition. Examples of sub-acute care include: ventilator care or dialysis.

Subdural hematoma – A subdural hematoma is a collection of blood on the surface of the brain. Subdural hematomas are usually the result of a serious head injury. Acute subdural hematomas are among the deadliest of all head injuries. The bleeding fills the brain area very rapidly, compressing brain tissue. This often results in brain injury or death.

Substantive law – The statutory or written law that governs rights and obligations of those who are subject to it.

Suffocation – The deprivation of oxygen.

Summary judgment – A judgment given on the basis of pleadings, affidavits, and exhibits presented for the record without any need for a trial. It is used when there is no dispute as to the facts of the case and one party is entitled to a judgment as a matter of law.

Summons – Instrument used to commence a civil action or special proceeding; the means of acquiring jurisdiction over a party.

Surgical complications – Any outcome that is negative after a surgical procedure that is perceived by the patient or the surgeon.

Surgical debridement – The use of a a surgical tool to cut the dead tissue from a wound to clean it out.

Suspension – A temporary loss of the right to practice law by an attorney. (See disbarment or censure.)

Sustain – A court ruling upholding an objection or a motion.

Tardive dyskinesia – Neurological symptoms caused by long time use of neuroleptic drugs. Some of the symptoms can be movements that are repetitive and involuntary. People may also have uncontrolled movements in the face such as a grimace, tongue protrusion, lip smacking, puckering/pursing of the lips and blinking. They may have fast paced ticks in the arms, legs, trunks, and fingers.

Testamentary capacity – The legal ability to make a will.

Testator – Person who makes a will (Female: testatrix).

Testimony – The evidence given by a witness under oath. It does not include evidence from documents and other physical evidence.

Third degree burn – A full thickness burn which destroys the outer layer of skin and the layer underneath.

Tort – A private or civil wrong or injury for which the court provides a remedy through an action for damages.

Tort reform – Changes that may take place in the civil justice system that would lesson tort litigation/damages. Tort is defined as compensating wrongs and harms done by a party to another person, property or other interests. “Tort reform advocates focus on personal injury in particular.”

Tolling of Statute of Limitations – When it is said that a statute is “tolled”, it means that something has stopped the statute from running for a period of time. Possible reasons when a statute of limitations may be ‘tolled’ are include the fact that the injured party is a minor, disabled or the defendant’s bankruptcy.

Transfer related injury – An injury which occurs when a parient is being moved from one place to another (bed to chair, sit to stand) usually in a residential facility.

Treatise – A formal and systematic book or writing containing a narrative statement on a field of law.

Trial – A judicial examination of issues between parties to an action.

Tuberculosis – A highly contagious infectious disease that is caused by bacteria that affects the lungs but can also interfere with other organs in the body.

Tunneling – A connection of different lengths through a solid body which is enclosed except for the ends for entering and exiting.

Ultra sound assisted wound therapy – Using ultrasound to help debride deep wounds (bedsores) that have infections and impaired circulation.

Uncontrolled pain – Pain that cannot be controlled with drugs.

Unexplained bruises – Bruises that are on the body that the patient does not know or is unwilling to tell where they are from.

United States Attorney – A federal district attorney appointed by the President to prosecute for all offenses committed against the United States; to prosecute or defend for the government all civil actions in which it is concerned and perform all duties of the district to which he/she is assigned.

United States Court of Appeals – Courts which hear appeals from federal district courts, bankruptcy courts, and tax courts.

United States Court of Claims – Court which hears actions against the U.S. Government.

United States Court of Military Appeals – Court which hears appeals from court marshal decisions.

United States District Courts – Courts which try both criminal and civil actions and admiralty cases.

United States Magistrate Judge – Courts given authority by 28 U.S.C. s 636. This court hears all preliminary criminal matters, but does not conduct felony trials, and any pretrial civil matters referred by the district court. If all parties consent, criminal misdemeanor and civil trials can be heard by this court.

United States Reports – Publication of court decisions of the United States Supreme Court.

United States Supreme Court – The highest court in the land, established by U.S. Constitution.

Unstageable – Full thickness loss of tissue where the base of the bedsore is covered by slough and/or eschar in the bed of the wound.

Urinary tract infection – An infection that is in the urinary system that involves the kidneys, ureters, bladder and urethra.

Vacate – To set aside.

Ventilator – Machine that helps circulate air in and out of the body.

Venue – Authority of a court to hear a matter based on geographical location.

Verbal elder abuse – Oral, written or gestured language that disparages a nursing home patient made directly to the person or within hearing distance of the person– regardless of the persons ability to understand or appreciate the words themselves.

Verdict – A conclusion, as to fact or law, that forms the basis for the court’s judgment. (See directed verdict.)

Veterans’ Administration (VA) – The federal agency which administers a system of benefits for veterans and their dependents.

Veterans nursing home – A residential facility where veterans can live for nursing home care.

Violation in nursing home – A citation issued by a federal or state regulatory agency in response to a nursing home’s failure to follow regulation. A nursing home violation may result in a monetary fine or restriction on new patients.

Waiver of immunity – A means authorized by statute by which a witness, before testifying or producing evidence, may relinquish the right to refuse to testify against himself or herself, thereby making it possible for his or her testimony to be used against him or her in future proceedings.

Wandering – Wandering (also referred to elopement) refers to a cognitively impaired person moving about a nursing home or long-term care facility without appreciation for where they are going. In some cases of patients suffering from Alzheimer’s or dementia, they may attempt to leave the facility. A nursing home resident’s propensity to wander / elope should be identified in an initial care plan and preventative measures should be implemented by the facility.

Warfarin – A blood thinning prescription medication.

Wheelchair lift – An assistive device that helps lift wheelchairs in and out of transportation or up and down stairs and in and out of pools.

Whistleblower – A person from within an organization who raises awareness about problems and wrongdoings that are going on in that organization.

Will – A legal declaration that disposes of a person’s property when that person dies.

With prejudice – A declaration which dismisses all rights. A judgment barring the right to bring or maintain an action on the same claim or cause.

Without prejudice – A declaration that no rights or privileges of the party concerned are waived or lost. In a dismissal these words maintain the right to bring a subsequent suit on the same claim.

Witness – One who personally sees or perceives a thing; one who testifies as to what he has seen, heard, or otherwise observed.

Wound care – Assistance in helping a wound heal.

Wound vac – Machine that uses negative pressure to help heal an open wound.

Writ of certiorari – An order issued by the Supreme Court directing the lower court to transmit records for a case for which it will hear on appeal.

Wrongful death – A cause of action the family of a person who was killed due to negligence or improper conduct of another party. A lawsuit for wrongful death may only be brought by the personal representative of the decedent’s estate and any recovery is usually distributed according to a distribution set forth in the decedents will. Every state has a civil “wrongful death statute,” or set of statutes, which establish the procedures for bringing wrongful death actions.

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