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Flora Patterson died in June 2000 after going 10 days without food or water — and, according to her son, one of the largest private elder care companies in the United States is to blame for her lingering death. The list of defendants is long in Perry G. Patterson’s wrongful-death case, but it focuses on Life Care Center of Lawrenceville, Ga., where Patterson claims his 71-year-old mother stayed for 10 days before she died at Gwinnett Medical Center in June 2000. LCCL is owned by Life Care Centers of America, a Cleveland, Tenn., company that manages or owns more than 240 elder care facilities in 28 states, employs about 30,000 people and counted $1.46 billion in revenue in 2002. LCCA also owns the Life Care Center of Gwinnett, which is also in Lawrenceville, Ga., and Camellia Gardens of Life Care in Thomasville, Ga. LCCA is a fat target, and Patterson isn’t the only Georgia resident who has brought a wrongful-death claim against it in the past three years. Three recent suits against LCCA — one in DeKalb County State Court, one in Fulton County State Court and one in federal court — accuse the company of shoddy management, understaffing, undersupplying its facilities and failure to deliver the services promised to its elderly, chronically infirm residents. All three suits involve incidents at the Lawrenceville facility. Patterson’s case accuses the elder care provider of ignoring repeated fines and warnings from the Georgia Department of Human Resources in regard to the center’s services. The suit also names LCCA CEO Forrest L. Preston, accusing him of siphoning resources from the company. The suit accuses the Lawrenceville facility’s former manager, Scott Keiser, of maximizing profits at the expense of resident care. And it accuses the center’s chief physician, Dr. Jafar Tabatabai, of overseeing shoddy medical services in Patterson v. Life Care Centers of America. In addition to wrongful death, Patterson accuses the defendants of unfair trade practices toward the elderly, fraud, breach of contract and violating the Georgia Fair Business Practices Act. He is seeking burial costs, punitive damages and compensation for his mother’s pain and suffering. Since Patterson filed suit last year, lawyers for both plaintiff and defense have kept this case well out of public sight. Many of the documents in the court file are sealed, and the lawyers are tight-lipped about the case’s scope and specifics. Patterson’s lawyer, Bondurant, Mixson & Elmore’s John E. Floyd, speaking for himself and co-counsel William Q. Bird, declined to comment on the case. LCCA’s lawyer, Daryll Love of Love Willingham Peters Gilleland Monyak, and CEO Preston’s lawyer, Richard H. Sinkfield of Rogers & Hardin, referred questions about the case to LCCA General Counsel Rick McAfee. He did not return calls seeking comment on the Patterson charges. According to the defense’s answer to Patterson’s complaint, the defendants deny responsibility for Flora Patterson’s death. They claim they adhered at all times to state requirements and standards, and were well within the law in treating Patterson. Her death was not the fault of any of the defendants, they say. Patterson’s case has been mired in discovery for months. Most recently, DeKalb State Court Judge Wayne M. Purdom slapped the defense with a $1,000 fine for filing unjustified motions to protect company officers and documents from discovery. On Nov. 25, Purdom denied LCCA’s request for a protective order about the company’s information technology practices, and its request for an order protecting LCCL’s quality control documents, called “Yellow Sheets” in the pleadings. Purdom ordered LCCA to designate a witness to be deposed on the issue of the Yellow Sheets. Also, Purdom wrote, because the defendants had agreed to admit that Georgia Department of Human Resources Survey Reports about LCCL were accurate, there was no need for a protective order barring the plaintiffs from deposing company officers about those reports. “Defendants’ motions for protective orders were not substantially justified,” Purdom wrote. MULTIPLE SUITS ALLEGE SHODDY CARE This is not the only case in which discovery has been an issue for LCCA. In a similar case in Fulton State Court, Chief Judge Albert L. Thompson blasted LCCA for “willful disobedience, bad faith and a conscious disregard for the Court’s orders” with regard to discovery. In that case, LCCL resident James T. Miles had hypoglycemia that allegedly went untreated during his stay. He lapsed into a coma and died. “LCCA’s misconduct is pervasive and has prevented discovery of the facts, delayed preparation for trial, wasted the Court’s time and resources and unnecessarily increased the cost of litigation for the plaintiff,” Thompson wrote in his May 2002 order. He then struck LCCA’s answer, and the case settled shortly thereafter for an undisclosed amount in Miles v. Life Care Center of America. Another case against LCCA is in federal court in the Northern District of Georgia. In that suit, the plaintiffs accuse LCCL of not giving Edwin B. Hendrix the medication prescribed by his doctor, thus causing his death in Hendrix v. Life Care Centers of America. LCCL, located at 210 Collins Industrial Way in Lawrenceville, has been in operation since November 1998. According to the complaint, starting in 1999, the Georgia DHR did a series of surveys that pointed out severe deficiencies in the center’s operations. The complaint says DHR issued fines against LCCA and its affiliates in Georgia between 1999 and 2001. According to the complaint, an April 6, 2000, report found that LCCL was “not in substantial compliance” with Medicare and Medicaid requirements for treatment of patients on those programs. The DHR report indicated “an immediate jeopardy to resident health and safety.” The DHR defines “immediate jeopardy” as “a situation in which the provider’s noncompliance with one or more requirements … has caused, or is likely to cause, serious injury, harm, impairment or death to a resident.” According to the plaintiffs, the nursing staff at LCCL begged Keiser, the manager at the Lawrenceville facility, for more staff and supplies. However, Keiser refused, telling those who complained, “You don’t understand the budgetary constraints,” the plaintiffs wrote. LCCA and LCCL officers knew about the problems at the Lawrenceville center, the plaintiffs claim. They knew about the inadequate staffing and supplies, the negative DHR reports and fines, and other problems with residents’ health care. “LCCA continued to embrace profit over patient care at LCCL, and the problems persisted,” Floyd wrote. Into this environment came Flora Patterson, who was admitted to long-term care on June 16, 2000. She had suffered a massive stroke and had to receive food, medicine and water through an abdominal “g-tube.” The plaintiff says that although Patterson was mentally alert, she was “totally dependent on others to maintain her well-being. “Although Mrs. Patterson couldn’t physically take care of herself, she understood her situation and surroundings and had cognitive function,” Floyd wrote. Patterson spent 10 days in the subacute care recovery unit but didn’t receive the special treatment she needed to survive. According to the plaintiffs, on several occasions center staff brought her to the dining room and placed food and drink in front of her. However, due to her stroke, Patterson was unable to feed herself or tell anyone that anything was wrong. According to the plaintiffs, Patterson was found unresponsive and transferred to Gwinnett Medical Center “unkempt, severely dehydrated and septic” on June 26. She died June 27 of severe dehydration. “Mrs. Patterson starved to death because the defendants failed to feed her,” Floyd wrote. The plaintiffs also charge that someone had falsified Patterson’s chart to suggest she had received proper care. “If the Pattersons had realized the actual services and level of care at LCCL … the Pattersons would have immediately removed Flora Patterson from the facility,” Floyd wrote. IS CEO TO BLAME? Part of the plaintiff’s strategy, apparently, is to question CEO Preston’s management of the company. The suit details what it says are questionable management practices. “In the final equation, this carefully integrated web of companies generates millions of dollars in income for Preston, which he retains largely tax-free,” Floyd wrote. The suit says Preston’s squeezing of profits contributed to the facility’s alleged inability to provide proper care. Preston is a well-known businessman in his native Cleveland, Tenn. He contributes to Republican causes and comments regularly on Republican candidates in the press. He is a high-profile supporter of the Rev. Franklin Graham’s Operation Christmas Child, which sends gifts to children in impoverished countries at Christmas. LCCA’s Web site proclaims that the company’s work is “rooted in the Judeo-Christian ethic.”

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